• In its simplest terms, occupational therapists and occupational therapy assistants help people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations). Common occupational therapy interventions include helping children with disabilities to participate fully in school and social situations, helping people recovering from injury to regain skills, and providing supports for older adults experiencing physical and cognitive changes. Occupational therapy services typically include:
• Therapy after rotator cuff and carpal tunnel surgery, for example. They work to rehab the upper extremities from the shoulder down through the fingers.
• an individualized evaluation, during which the client/family and occupational therapist determine the person’s goals,
• customized intervention to improve the person’s ability to perform daily activities and reach the goals, and
• an outcomes evaluation to ensure that the goals are being met and/or make changes to the intervention plan.
Occupational therapy services may include comprehensive evaluations of the client’s home and other environments (e.g., workplace, school), recommendations for adaptive equipment and training in its use, and guidance and education for family members and caregivers. Occupational therapy practitioners have a holistic perspective, in which the focus is on adapting the environment to fit the person, and the person is an integral part of the therapy team.
Occupational therapy is regulated in all 50 states, the District of Columbia, Puerto Rico and Guam. Different states have various types of regulation that range from licensure, the strongest form of regulation, to title protection or trademark law, the weakest from of regulation. The major purpose of regulation is to protect consumers in a state or jurisdiction from unqualified or unscrupulous practitioners.
State laws and regulations significantly affect the practice of occupational therapy. Laws or statutes are enacted by legislators, who are elected public officials. Regulations specifically describe how the intent of the laws will be carried out. These regulations are developed by regulators, who are appointed public officials of various departments in state government. Both kinds of officials make decisions that directly and indirectly affect occupational therapy practitioners.
AOTA continuously monitors and analyzes state legislation and regulations affecting occupational therapy.
Occupational therapy practitioners treat people of all ages and abilities. In this section we have invited a client to share their own experience to show what makes occupational therapy interventions unique and valuable. I have been treated by an occupational therapist for “frozen shoulder” (pain and stiffness from inflammation) for 4 months.
I was previously misdiagnosed, but when I finally made the right decision to seek medical intervention by an orthopedic surgeon, I was diagnosed properly and referred to Michael (owner of Helping Hands Therapy Center). When I met him, I had excruciating pain in my right humerus and had very limited range of motion. I couldn’t sleep due to the pain. Injections and painkillers did not help. After the evaluation, I knew that I would be in “good hands” with Michael. He was totally transparent with the course of therapy and the prognosis. He told me that with aggressive treatments and diligence on my part with off-site exercises, I would get back a good arm and shoulder. I go swimming a couple of times a week, and do fitness activities which Michael definitely endorses. He said that his therapy would not be fun, but that I would see positive results and be able to resume my swimming and other activities. When I went back to the orthopedic surgeon for a follow up after only three sessions with Michael, I had made more improvement than the doctor expected.
Before starting occupational therapy, I could not engage in some daily tasks, such as putting on a shirt, sweater, and jacket. I also had trouble applying underarm deodorant on my left armpit (with my right hand due to my shoulder condition) and washing in that area. Placing things on shelves was also a major challenge. On the recreational front, I had trouble playing basketball (which is one of my favorite hobbies). Putting on my car seat belt was also a challenge.
During the course of therapy, Michael accentuates stretching techniques. He also incorporates activities into the therapy sessions. For example, he shows me the best way to put on a shirt, sweater, and jacket to minimize the pain attached to these activities. This also applies to putting on a seatbelt. During the exercise portion of therapy, I place Velcro objects on a board as high as I can reach. Michael also encourages me to place objects on shelves (as high as I can reach) at home as a follow up. Since the shoulder doesn’t get as much exercise as the arm and hand, I am encouraged to keep my upper arm in motion as much as possible. Michael recommended that I wash and vacuum my car instead of taking it into a car wash. Although due to laziness I am tempted to cheat and take the easy way out, I have been cleaning my car myself and saving money, while helping my shoulder by keeping it moving. The drought in Brooklyn, New York, and the buildup of pollen on the car windows allow me to engage in this activity quite often. Regarding basketball, at the therapy center I use a combination exercise ball and rebounder, whereby the ball weight is gradually increased and the rebounder is raised accordingly as my range of motion and strength have increased. The area becomes a makeshift basketball court and has served its purpose well. In addition, I purchased a hoop and basketball for my apartment as a follow up activity. Due to Michael’s approach, I am now able to play on a regular basketball court with almost no limitations.
Michael approaches the treatments with a high degree of professionalism and expects his staff to behave in the same manner. He treats his patients with respect, dignity, and a sense of humor. I have written down all his humorous comments and refer to them when I need an emotional lift. Frankly, I am not Michael’s most cooperative patient. However, he is able to “bring me back in line” with his sense of humor.
At the end of each session, I thank Michael and shake his hand. His reply is, “It is my pleasure to help you.”
I expect to be finished with therapy in the next few weeks, with the results that I was hoping for. I currently have very few limitations, and I now consider my situation a minor nuisance. I owe