Areas of practice in occupational therapy

The role of occupational therapy allows occupational therapists to work in many different settings, work with many different populations and acquire many different specialties. This broad spectrum of practice lends itself to difficulty categorizing the areas of practice that exist, especially considering the many countries and different health care systems. In this section, the categorization from the American Occupational Therapy Association is used. However, there are other ways to categorize areas of practice in OT, such as physical, mental, and community practice (AOTA, 2009). These divisions occur when the setting is defined by the population it serves. For example, acute physical or mental health settings (e.g.: hospitals), sub-acute settings (e.g.: aged care facilities), outpatient clinics and community settings.

In each area of practice below, an OT can work with different populations, diagnosis, specialities, and in different settings.

 
Occupational therapy during WWI: bedridden wounded are knitting.Children and youth Occupational therapists work with infants, toddlers, children, and youth and their families in a variety of settings including schools, clinics, and homes.[32] Occupational therapists assist children and their caregivers to build skills that enable them to participate in meaningful occupations. Occupational therapists also address the psychosocial needs of children and youth to enable them to participate in meaningful life events. These occupations may include: normal growth and development, feeding, play, social skills, and education.[33]

Occupational therapy with Children and Youth may take a variety of forms:[32][33]

Promoting a wellness program in schools to prevent childhood obesity
Facilitating hand writing development in school-aged children
Promoting functional skills for children with developmental disabilities
Providing individualized treatment for sensory processing difficulties
Addressing psychosocial needs of a child and teaching effective coping strategies
Health and wellness The practice area of Health and Wellness is emerging steadily due to the increasing need for wellness-related services in occupational therapy. A connection between wellness and physical health, as well as mental health, has been found; consequently, helping to improve the physical and mental health of clients can lead to a general increase in wellness.[34]

As a practice area, health and wellness can include a focus on the following:[34][35]

Prevention of disease and injury
Prevention of secondary conditions
Promotion of the well-being of those with chronic illnesses
Reduction of health care disparities
Enhancement of factors that impact quality of life
Promotion of healthy living practices, social participation, and occupational justice
Mental health According to the World Health Organization, mental illness is one of the fastest growing forms of disability.[36] There is a focus on prevention and treatment of mental illness in populations including children, youth, the aging, and those with severe and persistent mental health issues.[37] Occupational therapists provide mental health services in a variety of settings including hospitals, day programs, and long-term-care facilities.[38]

Occupational therapists help individuals with mental illness acquire the skills to care for themselves or others including the following:[39]

schedule maintenance
routine building
coping skills
medication management
employment
education
community access and participation
social skills development
leisure pursuits
money management
childcare
Productive aging Occupational therapists work with older adults to maintain independence, participate in meaningful activities, and live fulfilling lives. Some examples of areas that occupational therapists address with older adults are driving, continuing to live at home, low vision, and dementia or Alzheimer’s Disease (AD).[40] When addressing driving, driver evaluations are administered to determine if drivers are safe behind the wheel. To enable independence of older adults at home, occupational therapists perform fall screens and evaluate older adults functioning in their homes and recommend specific home modifications. When addressing low vision, occupational therapists modify tasks and the environment.[41] While working with individuals with AD, occupational therapists focus on maintaining quality of life, ensure safety, promote independence, and utilize retained abilities.[42]

Rehabilitation Occupational therapists address the needs of rehabilitation, disability, and participation. Occupational therapists provide treatment for adults with disabilities in a variety of settings including hospitals (acute rehabilitation, in-patient rehabilitation, and out-patient rehabilitation), home health, skilled nursing facilities, and day rehabilitation programs. When planning treatment, occupational therapists address the physical, cognitive, psychosocial, and environmental needs involved in adult populations across a variety of settings.

Occupational therapy with adult rehabilitation, disability, and participation may take a variety of forms:

Working with adults with autism at day rehabilitation programs to promote successful relationships and involvement in the community[43]
Increasing the quality of life for a cancer survivor or individual with cancer by engaging them in occupations that are meaningful, providing therapy for lymphedema management, implementing anxiety and stress reduction methods, and fatigue management[44]
Training individuals with hand amputations how to put on and take off a myoelectrically controlled limb as well as training for functional use of the limb[44]
Using and implementing new technology such as speech to text software and Nintendo Wii video games[45]
Communicating via telehealth methods as a service delivery model for clients who live in rural areas[46]
Providing services for those in the armed forces such as cognitive treatment for traumatic brain injury, training and education towards the use of prosthetic devices for amputations, and treatment for psychological distress as a result of post-traumatic stress disorder[47]
Travel occupational therapy Because of the rising need for occupational therapists,[48] many facilities are opting for travel occupational therapists—who are willing to travel, often out of state, to work temporarily in a facility. Assignments may run as short as 8 weeks or as long as 9 months, but typically last 13–26 weeks in length.[49]

Work and industry Occupational therapists may also work with clients who have had an injury and are trying to get back to work. Testing may be completed to simulate work tasks in order to determine best matches for work, accommodations needed at work, or the level of disability. Work conditioning and hardening are approaches used to restore performance skills needed on the job that may have changed due to an illness or injury. Occupational therapists can also prevent work related injuries through ergonomics and on site work evaluations.[50]