Occupational therapy

Occupational therapy aims to promote people's health and wellbeing through everyday activities.

Information written and reviewed by Certified Doctors.

Contents

Introduction

Occupational therapy aims to promote people's health and wellbeing through everyday activities.

An occupational therapist can identify problem areas you may have in everyday life, such as dressing or getting to the shops, and will help you work out practical solutions.

By using different techniques, changing your environment and using new equipment, an occupational therapist can help you regain or improve your independence.

Who can benefit from occupational therapy?

Occupational therapy is used when someone is having difficulty with everyday tasks. This could be because of a:

Occupational therapists work with people of all ages and can look at all aspects of daily life, from the home to the school or workplace.

Read more about when occupational therapy is used.

Occupational therapy techniques

Occupational therapists identify activities which are causing difficulties. They then help by doing one of the following:

  • teaching a different way to complete the activity
  • recommending changes that will make the activity easier
  • providing devices that make activities easier

For example, after a hip replacement someone may find it difficult to get in and out of the bath. Grab rails could be fitted in the bathroom to make this easier.

Someone with rheumatoid arthritis (a condition that causes pain and swelling in the joints) may find it hard to lift small objects. Special equipment, such as a wide-handled vegetable peeler, may be available to make tasks easier.

Read more about occupational therapy techniques and equipment.

The aim of these changes is to allow you to improve your ability to do everyday tasks. This can include both work and leisure activities.

Read more about occupational therapy rehabilitation.

How is it accessed?

The way you access occupational therapy depends on the duration and severity of your condition.

Read more about accessing occupational therapy.

When it is used

Occupational therapy is used to treat a wide range of conditions.

Some of these conditions include those that:

  • are present from birth
  • develop with age
  • are the result of an accident

Occupational therapy is also used as part of a rehabilitation programme (a programme of treatment designed to help someone recover from illness or injury), for example after surgery or to treat depression.

Health conditions

Occupational therapy may be used to treat conditions including:

  • arthritis – a condition that causes pain and inflammation of the joints and bones, which can make handling objects difficult
  • depression – when you have feelings of extreme sadness that can last for a long time and interfere with your daily life
  • multiple sclerosis (MS) – a condition of the central nervous system (the brain and spinal cord) that affects the body's actions, such as movement and balance
  • Parkinson's disease – a condition that affects the way the brain co-ordinates body movements, including walking, talking and writing
  • schizophrenia – a mental health condition that causes psychological symptoms, such as hallucinations (hearing or seeing things that do not exist)
  • dyspraxia (developmental co-ordination disorder) – a condition characterised by difficulty in planning smooth, co-ordinated movements
  • chronic pain – a constant experience of pain that lasts a long time
  • chronic fatigue syndrome – when you have constant exhaustion that doesn't go away after sleep and rest

Conditions in children

Occupational therapists may also work with children with conditions such as:

  • cerebral palsy – a set of neurological conditions (conditions affecting the brain and nervous system) that affect a child's movement and co-ordination
  • Down's syndrome – a genetic condition that affects a baby's normal physical development and causes mild to moderate learning difficulties
  • dyspraxia – a disability that affects movement and co-ordination
  • learning disability – a disability that affects the way someone understands information and communicates
  • spina bifida – a series of birth defects that affect the development of the spine and nervous system

Ageing

Occupational therapy may be used to address problems that develop as a result of getting older. For example, you may find certain movements are not as easy as they used to be, such as getting out of bed in the morning. An occupational therapist can suggest equipment and adaptations to your home or new techniques that may be helpful.

Occupational therapy also includes providing devices and helping devise strategies to aid memory and improve function in people with conditions associated with ageing, such as dementia (an ongoing decline of the brain and its abilities) and Alzheimer's disease (the most common form of dementia).

Rehabilitation and recovery

Occupational therapy can be used after an accident, illness or operation to help you recover and regain as much independence as possible. For example, occupational therapy may be used after:

  • a hip fracture – this usually requires surgery followed by a rehabilitation programme to help you regain full mobility (the ability to move)
  • a severe head injury – after a severe head injury you may find everyday activities at work or home difficult and occupational therapy may help you recover
  • a stroke – you may have some weakness on one side of your body and need to learn new ways of carrying out daily activities
  • an addiction – this can make it hard to stay in work

Techniques and equipment

Many different techniques and equipment can be used as part of occupational therapy, depending on the problems you are having.

Some of these techniques are explained below.

Thinking about activities differently

A key aim of occupational therapy is to help you develop or maintain a satisfying routine of meaningful everyday activities that can give you a sense of direction and purpose.

This can include help with things like community living skills such as budgeting, domestic or personal care routines, leisure activities, and involvement in work or voluntary activities.

An occupational therapist will look at the activity you are finding difficult and see if there is another way it can be completed. For example, if you are finding it difficult to:

  • peel and chop vegetables – perhaps you could buy vegetables that are already prepared
  • walk to your local shop – perhaps there is a bus that runs past your house or you may be able to do your shopping on the internet
  • do the ironing – perhaps you could sit down while you iron

An occupational therapist will also help find new ways to carry out an activity by breaking it down into small individual movements, and will then practise the steps with you.

For example, if you cannot get up out of a chair without assistance, an occupational therapist will go through each stage of the movement with you until you can confidently get up on your own.

For children, an occupational therapist may develop a game or activity that your child can complete daily. This could be aimed at improving your child's:

  • hand strength
  • concentration
  • social skills

Focusing on a small goal, such as improved hand strength, may eventually help with larger problems, such as your child's ability to dress themselves.

Adapting your environment

Part of occupational therapy may involve making an environment suitable for your physical or cognitive needs. This could be your home, workplace or where you are studying, and may involve changes such as:

  • putting in ramps, so an area can be accessed in a wheelchair
  • fitting a stairlift
  • fitting grab rails, for example by the stairs or beside the bed
  • fitting a raised toilet seat, bath lift or shower seat to make the bathroom easier to use
  • clearing up clutter, reorganising cupboards or providing visual cues so you can safely move around and reach what you need

Using special equipment

Occupational therapists can also advise about what special tools or pieces of equipment you may find helpful. For example:

  • a walking stick, walking frame or a wheelchair
  • electric can openers or electric toothbrushes
  • knives with large handles and chunky pens (if you have difficulty holding small objects)
  • a non-slip mat for the bath
  • a special keyboard or mouse to help you use a computer
  • voice-controlled lights or voice-controlled software on a computer

You should mention any difficulties to your occupational therapist, no matter how small they seem, as there may be all kinds of specialised equipment available. For example, you could have a special comb to style your hair more easily, or a device to turn the pages of a book.

Rehabilitation

Rehabilitation aims to improve your ability to carry out the everyday activities that have been affected by illness, injury or surgery.

Occupational therapy attempts to help you get the most out of life. As well as being able to complete everyday activities, there are other areas of your life that should also be included in your rehabilitation programme, in particular:

  • your work life
  • your leisure life

Workplace rehabilitation

Workplace rehabilitation, or vocational rehabilitation, means helping someone with a health condition return to work or start working, or enabling them to carry on working. "Work" does not have to mean a paid role – you could be a full-time parent or a volunteer.

An occupational therapist could help by:

  • advising you about possible careers
  • assessing your workplace
  • assessing your role at work
  • assessing your ability to complete work activities, and finding ways to assist you if necessary
  • finding ways to manage your condition while at work
  • providing additional training
  • helping to find a way to cope with problems like discrimination and prejudice
  • helping your employers manage your return to work and increasing awareness of your condition
  • monitoring your progress

Leisure rehabilitation

Leisure rehabilitation could cover any fun activity, such as taking up a hobby or attending social events.

Taking part in leisure activities can prevent people feeling isolated because of their condition and improve their quality of life. While you need to be able to care for yourself and work, being able to take part in activities simply for pleasure is also important.

An occupational therapist may discuss what goals you would like to achieve, and then break this down into single tasks. For example, if you like going shopping but find it tiring, your occupational therapist may suggest taking regular breaks. If you have a love of gardening but find it difficult to reach the flower beds, your occupational therapist may suggest sitting on a stool rather than trying to bend down.

Activity grading and graded exposure

One way your occupational therapist may encourage you to return to work or resume your hobbies is with activity grading. Activity grading is a way of breaking down an activity you want to complete into stages that become increasingly more difficult.

For example, if your goal is to walk to work but it is too far for you to do at once, this can be broken down. On your first day, you can get the bus most of the way and then walk the last part. Each week, you could get off the bus a stop earlier and increase the distance you walk. The activity becomes increasingly difficult as you gradually reach your goal of walking to work.

As you become more confident with an activity, you can progress to the next stage and eventually reach your goal.

Graded exposure is similar to activity grading, but is more focused on dealing with the emotional and psychological element of rehabilitation. It is used to help gradually build your confidence and establish meaningful routines which you may have otherwise avoided.

Accessing occupational therapy

How you access occupational therapy depends on your particular circumstances.

See the advice below about buying your own equipment if you choose to access occupational therapy privately.

Short-term conditions

If you require occupational therapy because of a short-term condition, Speak to one of the healthcare professionals treating you. They will discuss your needs with you and decide if you would benefit from occupational therapy.

If it is decided you would benefit from occupational therapy, an assessment with an occupational therapist can be arranged. At your assessment, your occupational therapist will decide if you need any equipment or training.

Long-term conditions

If you have a long-term condition affecting your ability to carry out most everyday activities, you may be able to access occupational therapy through your local council.

The criteria may vary between councils, but should include the following points:

  • there is a critical risk to your independence and wellbeing – for example, you are unable to wash, dress or feed yourself
  • there is a substantial risk to your independence and wellbeing – for example, you are unable to carry on with many areas of your employment or education
  • your needs may be due to a physical or learning disability or a mental health condition – however, temporary medical conditions are not usually covered

You can contact the social services department of your local council to arrange an assessment with an occupational therapist, or you can be referred for an assessment by:

  • your doctor or consultant (specialist doctor)
  • a nurse
  • another healthcare professional
  • a social care professional

Assessing your needs

An occupational therapist can carry out a health and social assessment to identify what areas of your everyday life are causing problems. They will discuss your needs with you and explain what help is available. An assessment and any advice or information should be free.

Accessing equipment

An occupational therapist can make decisions about what equipment would be most useful to help you live independently. These decisions are made as part of your health and social care assessment (see above).

Equipment might include items such as:

  • two-handled cups, tap turners and kettle tippers for the kitchen
  • grab rails and raised toilet seats in the bathroom
  • bed raisers and hoists in the bedroom

Read more about occupational therapy techniques and equipment.

Equipment loans

If you need some equipment on a short-term basis, for example because someone with a disability is visiting you, your local Red Cross can often lend you wheelchairs and other equipment for short periods.

Content supplied by NHS Choices