Editing Occupational therapist (section)

== Role ==
Occupational therapists are skilled healthcare  professionals who promote participation, health, and well-being through meaningful engagement in everyday activities. One of their main goals is to help their patients function effectively in their roles and routines in everyday life.<ref>{{Citation |title=In brief: What is occupational therapy? |date=2024-07-31 |work=InformedHealth.org [Internet] |url=https://www.ncbi.nlm.nih.gov/books/NBK561515/ |access-date=2025-03-05 |publisher=Institute for Quality and Efficiency in Health Care (IQWiG) |language=en}}</ref>

Occupational therapy practitioners work with clients of all ages in diverse practice areas, some of which include rehabilitation after illness/injury, pediatrics, mental health, geriatrics, assistive technology, health and wellness, pain management, work/industry, and community accessibility.<ref>{{Cite web |title=Occupations and everyday activities |url=https://www.aota.org/practice/domain-and-process/occupations-everyday-activities |access-date=2025-04-01 |website=American Occupational Therapy Association}}</ref><ref>{{Cite web |title=What does an Occupational Therapist (OT) do? Career Overview, Roles, Jobs {{!}} AAMS |url=https://careercenter.aams.org/career/occupational-therapist-ot |access-date=2025-04-01 |website=Association of Air Medical Services |language=en}}</ref>

Occupational therapists may promote client participation and independence in life by strengthening client factors and performance skills such as physical, cognitive, and perceptual abilities. OTs may also help clients achieve their desired outcomes by facilitating their use of adaptive strategies, adaptive equipment, and/or environmental modifications.<ref name="health promotion">{{cite web| url=https://www.aota.org/~/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/HW/Facts/FactSheet_HealthPromotion.pdf |archive-url=https://web.archive.org/web/20190518122625/https://www.aota.org/~/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/HW/Facts/FactSheet_HealthPromotion.pdf |archive-date=2019-05-18 |url-status=live | title=Occupational Therapy's Role With Health Promotion | publisher=American Occupational Therapy Association|year=2014}}</ref>

Occupational therapists focus on providing a client-centered, holistic approach to each patient, using therapeutic interventions geared toward the person, occupation, and environment. Occupational therapists bring attention to a person's unique identity, abilities, strengths, interests, and environment to provide strategies and techniques that will allow clients to live life to the fullest. Occupational therapists foster promotion of self-esteem, self-efficacy, and a sense of achievement through doing, being, and belonging in a client's choice of activities, roles, routines, contexts, and environments. <ref>Bazyk, S. (2011). Mental Health Promotion, prevention, and intervention with children and youth: A guiding framework for occupational therapy. AOTA Press.</ref> Occupational therapists can also provide prevention and education regarding physical, mental, and social-emotional aspects of health and wellness within the realm of prevention, promotion, and intervention.{{cn|date=June 2024}}

Occupational therapists are often involved in multidisciplinary teams that may include health care practitioners such as physicians, nurses, [[Physical therapy|physiotherapists]], [[Speech–language pathology|speech and language therapists]], [[rehabilitation psychology|rehabilitation psychologists]], and social workers. Building effective partnerships with other professionals in the interest of quality service provision to clients are essential to valuable practice. Collaboration with members of the client's team enriches interdisciplinary communication and ensures the best outcomes for clients.<ref>{{cite journal | doi=10.1046/j.1440-1665.2001.00334.x| title=Effective Interdisciplinary Teamwork: An Occupational Therapy Perspective| year=2001| vauthors = Fossey E | journal=Australasian Psychiatry| volume=9| issue=3| pages=232–234| s2cid=71745617}}</ref> The client and their family and caregivers remain the central focus and driving force of the team.{{cn|date=June 2024}}

===Work-related therapy===
Some occupational therapists treat individuals whose ability to function in a work environment has been impaired. These practitioners arrange [[employment]], evaluate the work environment, plan work activities, and assess the client's progress. Therapists also may collaborate with the client and the employer to modify the work environment so that the work can be successfully completed.{{cn|date=June 2024}}

===Pediatric practice===
Pediatric occupational therapists support their communities by providing services to infants, toddlers, children, youth, and their families across a variety of settings that might include schools, clinics, and homes. They do this by implementing intervention that is driven by science and backed by evidence.  A child's life is made up of "occupations".  These "occupations", or daily activities, include play, learning, and socializing. The role of the pediatric occupational therapist is to support the child in any environment in which the child is not able to carry out the desired occupations.  The most common areas of practice for a pediatric occupational therapist include: [[neonatal intensive care unit]]s (NICU), early intervention, schools, and outpatient services. Areas of emerging practice include primary care and community-based.{{cn|date=June 2024}}

==== Neonatal intensive care units (NICU) ====
From the beginning of life, occupational therapists might work with infants who are medically fragile in NICU of medical centers. An occupational therapist might address areas such as feeding/nutrition, positioning, development, sensory processing and integration, and sleep.{{cn|date=June 2024}}

==== Early intervention ====
An occupational therapist may work with children in early intervention, from birth to three years old. The role of the occupational therapist is to support the child's needs by collaborating with the caregivers/parents. The goal of the occupational therapist in early intervention is to support the achievement of developmental milestones. They do this by providing intervention and education in the context of play and daily living. Therapeutic intervention may include feeding/nutrition, physical development, play skill development, social/emotional development. In early intervention, a strong emphasis is placed on parent/caregiver education. The reason Occupational Therapists are vital to the NICU, is due to the vulnerability of premature infants.<ref name=Ross2017>{{cite journal | vauthors = Ross K, Heiny E, Conner S, Spener P, Pineda R | title = Occupational therapy, physical therapy and speech-language pathology in the neonatal intensive care unit: Patterns of therapy usage in a level IV NICU | journal = Research in Developmental Disabilities | volume = 64 | pages = 108–117 | date = May 2017 | pmid = 28384484 | pmc = 5484726 | doi = 10.1016/j.ridd.2017.03.009 }}</ref> NICU-based therapists teach the skills the infant needs to live optimally.<ref name=Ross2017/> However, they do this while simultaneously understanding the medical interventions occurring, and how these medical needs need to be worked around during a therapy session.<ref name=Ross2017/> Infants who received more therapy displayed better neurological behaviors.<ref name=Ross2017/> Occupational Therapists mainly focus on positioning the child, including equipment and how to promote optimal development.<ref name=Ross2017/>

==== Schools ====
Once a child is over the age of three and meets eligibility for special education services, the child may receive occupational therapy services through an [[Individualized Education Program]] (IEP). In the school setting, the goal of occupational therapy is to support the implementation of the IEP. The occupational therapist might do this by providing direct or indirect services.  Direct services might include individual or group services.  Indirect services might include consultation with their school team, creating modifications and/or accommodations for the classroom, and/or providing training to the school team.{{cn|date=June 2024}}

====Outpatient services====
Occupational therapists might also work with children in an outpatient clinic. When serving children in an outpatient clinic, services typically have to meet the criteria for medical necessity. Occupational therapists continue to focus on "occupations"; however, the "occupations" typically are related to medically necessary occupations such as safety and health.{{cn|date=June 2024}}

==== Primary care ====
Primary care for occupational therapists is an emerging area of practice. Traditionally a primary care office included physician, physician assistant, nurse, or nurse practitioner. In this model, the physician is limited to diagnosing and medical management. The field of occupational therapy is advocating for occupational therapists to become a part of primary care teams.  In regard to children, an occupational therapist could contribute by providing early parent training, developmental screenings, tips for wellness and prevention.{{cn|date=June 2024}}

===Community-based===
Another emerging area of practice for occupational therapy is promoting health and wellness through community-based programming. Occupational therapist can do this by coaching and consulting in the community. It is implemented through not just the OTs but through the community stakeholders and those with disabilities themselves.{{cn|date=June 2024}}

OTs work in community-based rehabilitation projects as trainers and educators to help teach community members while facilitating them and developing programs.<ref>{{Cite web|url=https://www.wfot.org/resources/community-based-rehabilitation|title=Community Based Rehabilitation|website=World Federation of Occupational Therapists|date=August 5, 2019|language=en|access-date=August 5, 2019}}</ref>

Some examples include backpack awareness, promoting physical activity in families, creating inclusive community environments such as churches and health facilities, advocacy at government levels, conducting rallies, etc.{{cn|date=June 2024}}

===Human displacement===
This refers to forced movement of communities by environmental or social factors which causes loss of occupational activities. This is caused by a number of factors including [[natural disaster]], [[famine]], [[armed conflict]] or developmental and economic changes. Occupational therapists work with these displaced persons in order to help rebuild roles, routines, [[self-efficacy]], so that occupational imbalance, injustice, or deprivation does not occur.  Occupational therapists work through community-based programs that are client-centered and [[culturally sensitive]].<ref>{{cite web |title=Resource Manual:Occupational Therapy for Displaced Persons|page=9|url=https://www.wfot.org/resources/wfot-resource-manual-occupational-therapy-for-displaced-persons | website=World Federation of Occupational Therapists| date=March 2019| access-date=August 1, 2019}}</ref>

===With older people===
Occupational therapy is very beneficial to the older population. Therapists help older people lead more productive, active, and independent lives through a variety of methods, including the use of adaptive equipment. Occupational therapists work with older people in many varied environments, such as in their homes in the community, in hospital, and in residential care facilities to name a few.  In the home environment, occupational therapists may work with the individuals to assess for hazards and to identify environmental factors that contribute to falls. Occupational therapists are often instrumental in assessing for appropriate wheelchairs for older people who may need them.  In addition, therapists with specialized training in driver rehabilitation assess an individual's ability to drive using both clinical and on-the-road tests. The evaluations allow the therapist to make recommendations for adaptive equipment, training to prolong driving independence, and alternative transport options.{{citation needed|date=September 2020}}

===Mental health===
During World War II, [[occupational therapy]] began to play a far bigger role in the treatment of soldiers in psychiatric hospitals run by or for the British military.<ref>{{cite journal | vauthors = Jones E | title = War and the practice of psychotherapy: the UK experience 1939-1960 | journal = Medical History | volume = 48 | issue = 4 | pages = 493–510 | date = October 2004 | pmid = 15535476 | pmc = 546369 | doi = 10.1017/S0025727300007985 | doi-access = free }}</ref> Therapists found that engagement in occupation (usually crafts such as [[woodwork]], [[signwriter|sign writing]], [[carpentry]], etc.) was an effective intervention for increasing [[Emotional self-regulation|self-regulation]] and mental [[well-being]] in people with physical disabilities such as loss of limb and mental illness. <ref>Kuypers, L., & Winner, M. (2011). Chapter 1 Get Ready...Understanding the curriculum. In The zones of regulation: A curriculum designed to foster self-regulation and emotional control. essay, Think Social Publishing, Inc.</ref> In the decades since, occupational therapy has continued to advance and services in mental health now aim to promote positive [[mental health]], prevent mental health problems, and help manage mental health challenges by providing client-centered care. According to the World Federation of Occupational Therapists (2019, p. 2), occupational therapists recognize that good mental health enables people to realize their potential, cope with life's normal stresses, work productively, and contribute to their communities". Occupational therapists acknowledge the unique identities of each individual and their lived experiences and values choice and autonomy with one's recovery journey to promote participation in meaningful occupations of everyday life.<ref>{{cite journal | vauthors = Swarbrick M, Noyes S | title = Effectiveness of Occupational Therapy Services in Mental Health Practice | journal = The American Journal of Occupational Therapy | volume = 72 | issue = 5 | pages = 7205170010p1–7205170010p4 | year = 2018 | pmid = 30157004 | doi = 10.5014/ajot.2018.725001 | doi-access = free }}</ref> Occupational therapists address the needs of clients in all phases of mental health recovery and in all settings, ranging from acute inpatient mental health settings to community mental health settings.<ref>{{cite journal| vauthors = Champagne T, Gray K |year=2016 | title=Occupational therapy's role in mental health recovery| url= https://www.aota.org/~/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/MH/Facts/Mental%20Health%20Recovery.pdf|website=AOTA}}</ref> Occupational therapists also work with clients on a large continuum of mental health challenges, including clients with substance-use disorders, mental illness, eating disorders, stress-related challenges, trauma, and adverse experiences.<ref>{{cite web | url=https://www.samhsa.gov/trauma-informed-care | title=Interagency Task Force on Trauma-Informed Care | date=April 28, 2020 }}</ref> Skilled interventions with clients may include:
* Self-regulation and coping strategies (e.g. mindfulness, grounding)
* Emotional awareness training and emotional regulation strategies, including advocacy
* Social emotional skills and training
* Social cognitive skills
* Training in executive functioning strategies
* Quality of life measures and awareness
* Implementation of healthy habits and routines
* [[Motivational interviewing]]
* Strategies to reduce stress
* Sensory modulation-related interventions to self-regulate
* Behavioral interventions, such as [[cognitive behavioral therapy]] (CBT) or [[dialectical behavioral therapy]] (DBT)
* Trauma-informed care
* Skills training with accommodations or compensatory strategies
* [[Mental health literacy]]
* Lifestyle redesign, a preventative occupational therapy intervention to promote wellness

===With terminally-ill patients===
Occupational therapy (OT) practitioners help patients with [[terminal illness]]es and conditions by assisting them with their needs related to end-of-life support. All of the areas of a patient's life including work, play and leisure are widely affected. An occupational therapist provides various treatment modalities to help such individuals to restore or maintain their deteriorating performance components by using their remaining capabilities to give them a sense of self-importance and a measure of self-confidence. The World Federation of Occupational Therapy (WFOT) recognizes the important role OT practitioners have in end-of-life care. In working with patients who have severe health conditions, disabilities and terminal illnesses, the OT clinician will help these individuals engage in meaningful, everyday occupations, as well as exercise the right to well-being and the best quality of life despite the unavoidable conclusion to their lifecycle. An OT practitioner understands the transactional relationship that exists between the individual, environment, and occupation; so that life enhancing, ongoing performance in quality of life activities are promoted. The WFOT recognizes an optimistic presence for OT in end-of-life care with an ongoing need for advocacy and support.<ref>{{cite journal|title=Occupational Therapy in End of Life Care|year=2016|url=https://wfot.org/assets/resources/Occupational-Therapy-in-End-of-Life-Care.pdf |archive-url=https://web.archive.org/web/20191227035307/https://wfot.org/assets/resources/Occupational-Therapy-in-End-of-Life-Care.pdf |archive-date=2019-12-27 |url-status=live|website=WFOT}}</ref>

===With people experiencing chronic pain===
Occupational therapists often work within interdisciplinary or multidisciplinary teams (professionals such as physical therapists, nurses and physicians) to help individuals with [[chronic pain]] develop active self-management strategies.  An area of specific concern to occupational therapists is the usage of a patient's time <ref>{{Cite journal |doi = 10.1080/11038120410019081|title = Time use and activity patterns in women with long-term pain|year = 2004| vauthors = Liedberg GM, Hesselstrand ME, Henriksson CM |journal = Scandinavian Journal of Occupational Therapy|volume = 11|pages = 26–35|s2cid = 144732251}}</ref> but it is also common for occupational therapists to help people return to work, and to return to leisure and family activities.<ref>{{cite journal | vauthors = Persson E, Rivano-Fischer M, Eklund M | title = Evaluation of changes in occupational performance among patients in a pain management program | journal = Journal of Rehabilitation Medicine | volume = 36 | issue = 2 | pages = 85–91 | date = March 2004 | pmid = 15180223 | doi = 10.1080/16501970310019142 | doi-access = free }}</ref>  Occupational therapists may use a variety of interventions including [[biofeedback]], relaxation, goal setting, problem solving, planning, and can use those tools within both group and individual settings.<ref>{{cite book| vauthors = Strong J, Unruh AM, van Griensven H |date=November 23, 2013 |title=Pain: a textbook for health professionals|url=https://www.elsevier.com/books/pain/van-griensven/978-0-7020-3478-7 |orig-year=October 8, 2001|publisher=Churchill Livingstone|isbn=978-0-7020-3478-7 }}</ref> Therapists may work within a clinic setting, or in the community including the workplace, school, home and health care centers.  Occupational therapists may assess occupational performance before and after intervention, as a measure of effectiveness and reduction in disability.<ref>{{cite journal | vauthors = Carpenter L, Baker GA, Tyldesley B | title = The use of the Canadian occupational performance measure as an outcome of a pain management program | journal = Canadian Journal of Occupational Therapy | volume = 68 | issue = 1 | pages = 16–22 | date = February 2001 | pmid = 11233684 | doi = 10.1177/000841740106800102 | s2cid = 39840728 }}</ref>

===Models===
Occupational therapists can work from a variety of models, both broad and discrete. Top-down approaches are considered more broad and focus on the occupation itself while taking into consideration the many contextual factors (environmental, social, cultural, etc.), in comparison to bottom-up approaches which are more narrow or discrete. These models include the Person-Environment-Occupation (PEO), Person-Environment-Occupation-Performance (PEOP), Canadian Model of Occupational Performance and Engagement (CMOP-E), Model of Human Occupation (MOHO), and Ecology of Human Performance (EHP).{{cn|date=June 2024}}

===Assessment===
In order for an individual or group to receive occupational therapy services they must first be referred by themselves, another health care provider, or through their support system (family, friends) to receive an occupational therapy evaluation. As part of the service delivery process, the evaluation consists of the initial occupational profile followed by an analysis of occupational performance.<ref name="auto">American Occupational Therapy Association, 2014</ref> Occupational therapy evaluations and occupational therapy assessments are important in determining an individual's skill set or deficiency. Through the occupational profile, which is a structured interview of the client, an occupational therapist can identify the client's self-perceived strengths and limitations in participating in daily occupations and help create an individualized treatment plan that addresses the occupations that are meaningful and necessary to the client. As part of the occupational profile, an occupational therapist also seeks to identify physical and social supports and barriers to participation.<ref name="auto"/> Occupational therapists often gather additional information by communicating with the client's support system, which may include a child's parents/guardians, a student's teacher, an adult's spouse/siblings/friends, or a senior's caretaker. The analysis of occupational performance may be gathered through standardized assessments, clinical observations of the client performing a set of tasks and activities, and analysis of the physical or social environment and context in which the client performs the occupations.  Occupational therapist utilize skilled observation simultaneously with evaluation of motor and process skills and the effect on the ability of an individual to perform complex or instrumental and personal [[activities of daily living]] (ADLs).  Occupational therapists are trained in the administration of standardized assessments across the lifespan from [[infancy]] to old age, although some standardized assessments require an occupational therapist to gain additional certifications to administer.{{cn|date=June 2024}}

Examples of the types of assessments or skill areas occupational therapy practitioners assess include:{{cn|date=June 2024}}
* [[Sensory processing]] skills
* [[Visual perception]] and visual motor skills
* [[Gross motor skills|gross motor]] and [[fine motor skills]]
* [[Handwriting]]
* Upper Limb Hand [[dexterity]]
* [[Cognition]] and [[intelligence]]
* School-based evaluations
* [[Developmental milestone]]s
* Daily living tasks include dressing and eating
* Pain
* [[Executive functioning]]
* Environmental assessments
* Employment-based assessments
* [[Ergonomic]] assessments
Through the initial evaluation process, occupational therapists work with the client to establish an individualized treatment plan. Data is collected and recorded throughout the treatment process to be utilized to assess progress and guide ongoing client-centered intervention. This data is also frequently utilized for reimbursement of services. At the conclusion of therapy services, an occupational therapist will complete an outcome assessment which may include a re-evaluation.<ref name="auto"/>

Assessment may also be more broad such as assessing the accessibility of public spaces for all individuals. Occupational therapists can provide recommendations for building design to allow for access for all. Occupational therapists are also skilled at completing home safety assessments and altering the environment or providing accommodations for ways to complete occupations in the home and for increased safety of clients and caregivers. Occupational therapists can also complete driving assessments to determine the required accommodations in the car or the ability of an individual to safely drive. Furthermore, occupational therapists can work with whole organizations to assess their workspaces to ensure that the work demands and physical set up are conducive to safe working habits to prevent workplace injuries.{{cn|date=June 2024}}