The Occupational therapy Is a type of treatment in which ordinary activities are planned that people perform in their daily lives 2 . It can be put into practice in children, adolescents, adults and the elderly. The Occupations encompass both mental abilities and actions that have a purpose and meaning for the patient.
Thus, when designing an occupational therapy program, it is done in an individualized way, setting as objectives the activities that are Important for the particular patient.
The life of Andrés, a 22-year-old college student, took an unexpected turn while having dinner with his friends:
" We were just having dinner when suddenly my left side fell asleep and then I fainted"(...)"Therapists do their best for patients," Says Andrés. "They helped me practice everyday activities, like getting in and out of a car and doing the shopping. They wanted me to regain my self-sufficiency As much as I ".
Since the Occupational therapy Is a profession that has undergone many changes since its inception, it is difficult to define it simply.
In 1996, the American Occupational Therapy Association Conducted a survey of the US general population to find out how discipline. Of the people who had heard of it, 87%, only 15% were able to define it satisfactorily 1 .
Characteristics of Occupational Therapy
The activities to be trained in occupational therapy are selected in each case based on their therapeutic value in the recovery of a normal and satisfactory life For the patient in question. They are skills that the patient is no longer able to perform as a result of their physical or psychological alterations.
The methods used by these therapists can be very varied: art, music, dance, crafts, etc. They are only tools, the only important thing is Goal: to recover important skills for the patient.
According to American Occupational Therapy Association , This entails the use of activities with clear objectives or interventions designed to Achieve functional goals that promote health, prevent damage or disability, disease, cognitive impairments as well as develop, Improve, maintain or re-establish the highest possible degree of independence of individuals.
Occupational therapy focuses on three types of activities:
- Work : These are activities and productive tasks, regardless of whether an economic compensation is received for the realization of the Themselves. The activities or occupations of work could, in this way include, be a parent, student, volunteer, etc.
- Leisure : Leisure activities include all those hobbies that we choose to do freely and that give us pleasure. They can be fun, Creative, exciting, relaxing or stimulating. Leisure includes play, imagination, self-exploration or the establishment of relationships social.
- Personal care : Activities of this type include the basic tasks necessary for personal maintenance (grooming, clothing, etc.) and Domestic activities of daily life (cooking, cleaning, etc.).
Occupational Therapy also includes a case-by-case assessment to determine which skills are most relevant to each patient.
Simply put, Occupational Therapy teaches people how to help themselves.
What services are included in an occupational therapy program?
- Counseling and providing treatment in accordance with the demands of the patient, family and other people in the environment.
- Interventions aimed at developing, improving, maintaining or re-establishing everyday life skills, including care activities Personal, social relationship with the environment, work, play and leisure and educational,
- Development, improvement, maintenance or restoration of sensory, motor, perceptive, neuromuscular, emotional, motivational, Cognitive, psychosocial,
- Education of the patient, his / her family and other people in the environment regarding interventions that can be performed beyond the Clinical environment.
Activity as a therapeutic tool
Activity is a fundamental dimension of human existence. We all have an innate and spontaneous tendency to be active and explore the world. The Activities, both in terms of process and outcome, are of high value at different levels. It is this concept of activity that defends itself In Occupational Therapy:
- We use activity as a learning tool to develop skills and help patients explore themselves, others And its environment.
- Engaging in activities offers the opportunity to gain awareness of our competence, control and mastery skills. This is derived in a Improvement of self-esteem Y Self-efficacy .
- Activity stimulates our senses and activates us. It motivates and gives energy both physically and mentally.
- Participating in activities also has a social value, combining fun and pleasure. It offers the opportunity to interact and connect with Providing a sense of belonging to a community.
- Activity can be a vehicle for expressing and exploring feelings.
- The activity is productive. Both the process and the outcome can be highly rewarding.
Who is Occupational Therapy for?
Being encompassed within an interdisciplinary treatment and monitoring framework, Occupational Therapy is used in a great diversity of conditions Clinics
- Processes with acquired brain damage:
- Stroke .
- Cranioencephalic injury .
- Degenerative diseases.
- Different spinal cord injuries (traumatic, congenital, tumoral, etc.).
- Functional and neurological swallowing disorders.
- Communication disorders of functional and neurological origin.
- Physical and intellectual disability.
- Cognitive and sensory impairments.
- Palliative care.
- Mental health.
With focus on practice, what does an occupational therapist do?
There are a multitude of goal-oriented activities that could be used by occupational therapists. This is one of the characteristics of the Discipline that make it highly motivating for the therapist: therapeutic design allows the creative development of the professional.
However, the choice and creation of activities is often limited by the preferences of the patient and his family, their culture, In addition to the therapeutic resources available.
There are certain activities that have more fame and acceptance within the programs of Occupational Therapy 3
The spectrum of social activities used in occupational therapy are intended to promote interaction and idleness as well as to develop New interests and hobbies.
- Handicrafts : In many units of day is common to see group activities of craftsmanship. The most successful craft sessions are those in which the objectives are clearly defined and in which the products designed are intended for sale.
In 1998 scientist McDermott demonstrated that group craft activities were translated into high-powered communication exchanges Socio-emotional compared to other types of group activities 4 .
- Sports and Games : Whether competitive or not, sports and games offer fun, challenging opportunities, group interactions And optimal leisure possibilities.
Examples of this type of activities are swimming, gym, badminton, table tennis, bingo, trivial, etc.
Many scientific research has demonstrated the relationship between physical exercise and mental health 5 .
- Communication and exchange activities : These characteristics could be incorporated into almost all activities. In this way, the Members of a group to share their experiences and provide support and motivation to others.
- Groups of discussion : Groups are formed in which all the participants have something in common about which to speak. Share experiences Similar and coping strategies is the idea behind discussion groups. In these groups you can simply debate but Can add activities such as role-play, modeling, or feedback.
- Anxiety Relaxation and Management Courses : These are based on the principles of Cognitive-behavioral therapy , Combining education with Group relaxation activities.
- Psychotherapeutic activities
This type of highly specialized activities come from the psychodynamic school and are oriented to facilitate the expression and exploration of feelings.
There are two fundamental orientations: the analytic (centered on the symbolic potential of activities) and the humanist (oriented towards personal development).
Some of the techniques used are: education, Cognitive restructuring , Systematic desensitization, role play and relaxation .
- Creative writing The main objective is the expression of feelings, emotions and internal conflicts. " Words provide an opportunity for liberation from the imagination 6 ".
- Projective activities Art, theater, or music are examples of creative activities that help patients gain a better understanding of their conflicts Internal and exploration of their emotions.
The key element of this type of activity is the projection or externalization of the feelings enclosed in a creative object. This type of Therapies have been clinically described already by Sigmund Freud , Who called them sublimation activities.
Occupational Therapy and Perceived Control
All people who have mental illness or brain damage have one thing in common: the feeling of loss of control of their lifetime.
It is not only a matter of knowing that they are now patient, it is about facing a cascade of unexpected vital changes: professional losses, losses Social, environmental degradation, etc. This causes fear and insecurity about the future.
Occupational therapy tries to deal with fears and feelings of uncontrol, tries to give meaning to existence, is to return to Achieve a functional life at all levels.
Therapists Rebeiro and Cook explored in 1999 the use of occupational therapy to give meaning and control to life. The study demonstrated three Benefits of therapy that go beyond functional recovery:
- Patients said they felt important and worthy.
- Therapeutic activities conveyed to patients a sense of personal competence.
- Participants developed positive self-definitions.
Activity and personal meaning
It is necessary to understand the activities in the context of the personal meaning attributed by each person. Thus, different people understand and They interpret their occupations in different ways.
Each one of us chooses to carry out activities that have an idiosyncratic meaning both symbolic and practical. As Professor Crabtree postulated "Human nature is to extract meaning from their occupations."
Let us think, for example, in photography. The activity is the same but for each person it means something different. While some will enjoy taking Photographs in their travels or special occasions and share them with their social environment, others take their camera with them to immortalize scenes Of artistic, expressive or emotional importance.
Activity as an Identity Building Tool
Ribeiro and Allen explored in 1998 the case of a patient schizophrenia Which considered volunteering a fundamental part of his life.
Before starting his volunteer activity, he said, his life was characterized by the social stigma of his pathology and his identity both Social and personal was organized around this stigma.
He perceived his volunteer work as an occupation of great social value that enabled him to contribute to society and to be a part and active member of she. His work helped him build an acceptable social identity as a competent individual.
Occupations and culture
Occupational therapists should be very careful when choosing and evaluating the activities that will be included in the treatment program of a Particular person or group. This is so because the occupations have different meanings or are performed differently depending on the Culture of the person.
A very illustrative example of this is gathered in the book" The practice of Psychosocial Occupational Therapy ": An occupational therapist was about to Evaluate the functionality of an individual when performing their activities of daily living.
The man was about to make a cup of tea. The therapist considered that his functional abilities were highly depleted when he observed that he placed Directly the tea leaves inside the kettle.
However, it did not take into account that the individual in question came from an African people in which tea is customary to elaborate in that way.
And how have you benefited from occupational therapy?
- Whiting, F. & Steib, P. (1998). Skills for the job of living-more than just a slogan. OT Week, 12 (4); 16-18.
- Punwar, A.J. & Peloquin, S.M. (2000). Occupational Therapy: Principles and Practice. Lippincott Williams & Wilkins.
- Finlay, L. (2004). The Practice of Psychosocial Occupational Therapy. Nelson Thornes Ltd.
- McDermott, R. 1998, 'Learning Across Teams: The Role of Communities of Practice', Knowledge Management Review, May / June.
- Everett, T, Donaghy, M, Feaver, S. (2003). Interventions for mental health: An evidence-based approach for physiotherapists and occupational
Therapists. Butterworth Heinemann: Edinburgh
- Atkinson, K. & Wells, C. (2000). Creative therapies: A psychodynamic approach within occupational therapy. Cheltenham, UK: Stanley Thornes
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