Occupational Therapy?? What's that?

 

After I got into college and while I was in the hostel , I had family members and neighbors asking my mother about what I was studying for. I don't know what she told them, but I know for a fact that they didn't ask her more; instead they waited for me to get back. Every holiday when I was home from college, this question used to come back to me. No matter what explanation I gave, people didn't seem to get an idea of what exactly Occupational therapy was. 

"So you treat all conditions and all age groups?"😐

"Is your job like that of a teacher's?"😕

"It must be difficult teaching children with low intelligence, right?"😒

"When you say 'rehabilitation', what exactly do you mean? Do you provide artificial limbs?"😣

"is this a branch of nursing?" (😏Duh!!)

"What do you mean when you say you treat people with fractures? So are you a Bone Specialist's assistant?"😩

"is it something like career counselling? Do you provide jobs for people?"😱

......the list is endless. I end up escaping from the scene completely exhausted. "Occupational Therapy? What is that?", was the question I hated the most!!

On the bright side, every Occupational Therapist is blessed with that one extremely rare encounter with that magical person who actually knows what and who you are. It looks something like the meme below.

So what exactly is Occupational Therapy? There are so many definitions you can find on the internet, but let's look at it from a common man's point of view.

In very simple terms, anything and everything you engage in, on a typical day, is considered your occupation. This can be anything ranging from sitting up in bed after you wake up, brushing your teeth and taking a shower, to working in your office, making a meal, playing an instrument or driving your car, and many more.

Anything that prevents you from independently and effectively engaging in your occupation, like an illness or injury, which may be congenital or acquired, that may leave a temporary or (God forbid) a permanent state of dysfunction, needs intervention. 

This intervention aims at helping you get back to doing the things you always did prior to whatever just hindered you. Based on how affected you are by the illness or injury, you will be assisted and trained to get back to your typical lifestyle either independently or with assistive aids to promote independent function.

Oh, and did I forget to mention it? This intervention is called Occupational Therapy or OT in short.

The scope of OT is so extensive that it caters to all age groups and almost all conditions. With key roles in Pediatrics, Orthopedics and Neurology, Mental health, Cardio-pulmonary rehabilitation, and many more, you would typically find OTs in schools, therapy centres for children with special needs, hospitals, palliative care homes, mental health facilities, geriatric centres and physical rehabilitation centres. You may also find OTs in medical equipment companies, designing ergonomic furniture and mobility devices.

I don't want to open a Pandora's Box right here, but just to give you a brief outline, I'll go a bit into each stream an OT caters to.

Orthopedics:

OT's role in orthopedics is a wide area of practice. It ranges from upper extremity (UE) conditions such as fractures, lacerations, amputations, burns,  surgical repairs of tendons, nerves, acquired conditions such as tendonitis, carpal tunnel syndrome, trigger finger, adhesive capsulitis are just a few to be named. All the UE conditions fall in a specialized area of  OT practice called as hand therapy. 

Lower extremity conditions such as hip, knee fractures, replacements and Back conditions such as fusions, repairs and fractures which are treated in inpatient settings with the goal of facilitating independence in everyday tasks.

Rheumatology:

OT is all about independence and what better than your hands to make you independent. Imagine that you are unable to use your hands and fingers. I mean, can you even imagine a good one hour without being able to use your hands? With inflammation, pain, stiffness in the joints, fatigue and emotional distress to top it all, Arthritis can be quite crippling. Not just Rheumatoid arthritis, but conditions like osteoarthritis, juvenile arthritis, psoriatic arthritis, ankylosing spondylitis and scleroderma are dealt with in OT. The therapist helps with joint protection techniques, advice on how to prevent further damage, suggesting adaptive aids to maximize function and independence.

Neurology: 

Neurology is another important field of OT. Occupational therapists hold a pivotal role in the proper evaluation and treatment of an individual who has sustained a brain injury, spinal cord injury or been through a prolonged neurological illness, as patients suffering from neurological conditions are often limited in their ability to perform activities of daily living. The OT attempts to diminish or compensate for cognitive, perceptual or motor deficiencies so that the individual may reach the highest possible level of independent function. 

Cardiology:

Occupational Therapy in cardiac rehabilitation is aimed at decreasing the physiologic and psychologic patient overwork, allowing them to return successfully to their home and work environments. OT helps teach the clients a more ergonomic and stress-free way to do regular daily tasks with more energy conservation and without risk. If there are physical restrictions following a severe heart attack or a cardiac condition, an OTs role would be to advise on what can done to maximize independence at home, through home adaptations or assistive equipment.

Mental Health:

OTs specializing in mental health use a range of psychological and occupational therapy based strategies to help people understand and cope with their daily function which may be affected due to various psychological and psychiatric factors. Mental health OTs assist people who are struggling with adverse life circumstances, such as grief and adjustment, emotions, stress and parenting, and can help people with severe and complex mental health conditions, from anxiety to depression.

Pediatrics:

This may be the most 'heard about' field of Occupational Therapy, I suppose. Pediatric OTs work with children who have physical, neurological or developmental conditions that interfere with their growth, development and function. Autism Spectrum Disorders (ASD), Sensory Processing Dysfunction (SPD), developmental delays, congenital disorders, chromosomal abnormalities and many more conditions are dealt with by an OT. Play therapy, Sensory Integration and Activity based Intervention are some of the modalities you would find an OT using while interacting with the pediatric population.

Geriatrics:

OTs work with elderly patients and teach them exercise and rehabilitation techniques that make completing daily tasks, such as dressing, eating, and bathing, much easier. Again, joint protection and energy conservation techniques are taught and of course, home and environment modifications suggested. The geriatric client population is also trained to use assistive devices like built-up spoons, long handled reachers, adaptive clothing, etc. to enhance independence.

Oncology:

According to the American Occupational Therapy Association, the role of Occupational therapy in Oncology  is "to facilitate and enable an individual patient to achieve maximum functional performance, both physically and psychologically, in everyday living skills regardless of his or her life expectancy". 

Cancer and its treatment can cause interruptions in daily routines affecting how individuals perform their self-care, work, leisure and socializing. Individuals with cancer may experience these difficulties as a result of the disease or from the effects of its treatment. Occupational therapy intervention in Oncology may include management of activities of daily living (ADLs) such as bathing and dressing through adaptations to the activity and environment, lifestyle changes such as preventative health, improved fitness, etc. Therapy may also include energy conservation and relaxation management techniques to support health and the ability to participate in meaningful activities, and  cognitive strategies to address memory, organizational executive function deficits, and low-energy tasks that focus on restoring engagement in daily occupations such as sitting in the park, reading a newspaper, or conversing with a friend. Therapeutic exercise and positioning to maintain function, mobility, and strength and Lymphedema management to reduce limb swelling, which can limit range of motion and the ability to move and complete ADLs, are also other areas of intervention.

Work Placement and Work Rehabilitation:

OTs do work placement evaluations for young adults with physical, sensory and intellectual challenges (moving out of their schools/ training centres), thus helping them be to productive and self reliant in adulthood. OTs also promote success in the workplace by improving the fit between the person, the job tasks, and the environment. Occupational therapists also provide services related to ergonomics, accessibility, the aging workforce, and workplace health and wellness issues. Anyone who is having difficulty fulfilling the worker role due to an illness or injury, and who desires to return to work or enhance work performance, can benefit from work rehabilitation (which I'd rather refrain from going into, only because there is so much to say about it). 

I know I have dug deeper than I intended to, but there is still lot's more an OT can do. 

I doubt if you would come across another profession so versatile and rewarding.

So, I guess you know by now what to say when you hear somebody go, "Occupational Therapy?? What's that?"