What is Occupational Therapy, anyway?

Updated: May 3, 2020

Do you remember the episode of FRIENDS where Rachel and Monica lost their apartment because they didn’t know what Chandler did for a living? I would love to be up for bid on an apartment where my competitor had to describe what I do.

Occupational therapy….what a peculiar profession. So peculiar, in fact, that one of my assignments in graduate school was to write an “elevator speech.” This speech could be given in the time spent on an elevator, and described exactly what an occupational therapist does, and how we impact our clients. I use a version of this elevator speech with every single one of my clients.

“As your occupational therapist, I am concerned with what we call, ‘occupations,’ which is anything that you do or want to be able to do. My goal is to help you to participate in these things…from the very basics of getting dressed, brushing your teeth, and combing your hair, to whatever else you do during the day: work or housework, taking care of family or pets, and leisure. If it’s important to you, it’s important to me too.”

To that which many of my older-adult clients reply, “Well, I don’t have teeth anymore so we don’t have to worry about that one.” 😐 😂

Occupational therapists work to improve your independence and/or participation in ‘occupations,’ which we define as anything you spend your time doing. Yes. The profession is really that broad.

Are OTs concerned with and trained to improve the biomechanical implications of an orthopedic injury? Yep.

In these scenarios (such as rotator cuff injury or repair, joint replacement, or a traumatic injury to the hand) many occupations are affected from the basics of self care to putting away dishes in a cabinet to working on the farm. We care about every single one of those occupations and will work to restore appropriate biomechanical control, manage pain, and make adaptations to tasks when necessary.

Are OTs concerned with and trained to address the physical, cognitive, and psychosocial implications of a neurological insult (such as stroke or traumatic brain injury)? Yep.

Neurological diagnoses are so complex. In many, many cases the physical body and the cognitive thought processes of the brain are affected. Occupational therapists play a unique role in addressing all of the above. We work to improve the musculoskeletal function, the cognitive function, and address how our clients can overcome and/or adapt any residual symptoms so that they can continue to participate in their specific,meaningful occupations.

Are OTs concerned with and trained to work with children? Yep.

Children have occupations too. Think: activities of daily living (ie dressing, bathing, grooming/hygiene); play; sleep; being a student; etc. OTs work to maximize independence and participation in any and all of the occupations in which a child may be involved.

Are OTs concerned with and trained to work in mental health? Yep.

This setting is where OT began. Difficulties in mental health and well-being can be a big limitations to full participation and/or independence in meaningful occupations. I would say that these professional roots shine through occupational therapy in every setting. When our clients’ occupational participation is out of order, their mental health is affected. Occupational therapists are holistic thinkers, and mental health and well-being should be addressed with every client in every setting.

Are OTs concerned with and trained to treat the “lower half of the body?” Actually, yes.

“OTs treat the arms and PTs work with the legs…right?” This is a common misconception and one that I could write an entire blog post about, but I will keep it short today. OTs cannot adequately address participation in occupations with only one half of the body. The idea the OTs are only trained and concerned with the upper half of the body is comical. If my client doesn’t have the leg strength to stand up from the toilet, I address the issue by prescribing leg-strengthening exercises. If my client doesn’t have the flexibility to put their leg in hole of their pants, I address the issue by prescribing lower extremity stretching. If my client doesn’t have the balance to reach into an upper-cabinet, I address the issue by developing standing balance activities.

This is not to say that we do not need the collaboration with our colleagues in the physical therapy field. We do. Physical therapists have specific expertise in the function of the lower extremities, and we need their expertise. But, case-in-point: occupational therapists are holistic thinkers, and this should include addressing the entire body.

I have only scratched the surface of what a person working in the occupational therapy field may address. Our field is broad because ‘occupation' is broad. I suppose an occupational therapist could make the case that everyone needs occupational therapy. This may be true…every person, at any given time, is participating in “occupation.” An occupational therapist is just standing by, waiting to help you make that occupation better: more efficient, safer, and more fulfilling.

Your OT,