You are here

Home

About Occupational Therapy in Mental Health

There are two unique aspects to Occupational Wellbeing that form the primary domains ofOccupational Therapy:

  1. the impact of ‘occupation’ or ‘activity’ on a person’s health and well-being; and,
  2. the impact of illness, disability, and life changes on a person's capacity to function in their occupations/activities.
 
The centre of our focus is on Occupational Roles. An ‘Occupational Role’ is any activity that occupies our use of time. Our profession has several different methods for classifying Occupational Roles, but at Enable OT we use the following five categories:
·     Vocational or work roles
·     Leisure roles
·     Self-care roles (a.k.a. “Activities of Daily Living” or “ADL”)
·     Daily living roles (a.k.a. “Instrumental Activities of Daily Living” or “Living Skills”)
·     Relationship roles (eg. parent, daughter, friend, employer)
 
Every life task falls under one of these categories – from getting enough sleep through to getting a job; from reading a book to reading correctly your partner’s facial expression when they are telling you something.
 
How an individual’s Occupational Roles are mixed and structured has a huge impact on a person’s health and well-being – especially so in the area of mental health. Much of the research across a variety of specialties (epidemiology, occupational medicine, occupational science, sociology, psychology, vocational rehabilitation, occupational therapy, general medicine, recovery, psychiatry etc) validates this.
 
Health flows from a life that characterised by occupational wellbeing principles. A life where the occupational roles are sufficient, sustainable, congruent, meaningful, and adaptable.
  •  Sufficient: the person has enough occupational roles to govern their use of time, but not so many occupational roles that they cannot function successfully in those roles. 
  • Sustainable: there is an overall balance between the physical, social, cognitive, emotional and spiritual effort of a person’s life, when compared to physical, social, cognitive, emotional and spiritual replenishment they receive. If in one or more areas the person is giving more than they are replenishing, then they will become exhausted/depleted and will get sick. (eg. Emotional exhaustion leads to Depression.). If in one or more areas the person is replenishing more than they are giving, then they feel underutilised and worthless.
  • Congruent: there is a good match between the person (values, expectations, standards, hopes for the future), their roles, their environment (physical, social, and economic environments), and their temporal context. Occupational dysfunction occurs if a significant and unresolved clash exists between anyone of these facets of a person’s life – for which the negative social impacts can be enormous. For example, a young woman who’s three primary occupational roles as ‘mother of young children’, ‘full-time employee’, and ‘household manager’ fails to find a way to resolve the obvious clashes except by yelling at the kids to get things done. The kids grow up surrounded by stress and conflict. Her partner leaves. Relationship disintegration occurs as she does the basics just to survive. Such social isolation is a key factor in mental and physical illness.
  • Meaning: the person has a key role(s) that brings them great fulfilment. This role something they thoroughly enjoy. It matches their unique abilities and interests, absorbs them (they don’t notice the passing of time). It allows them to make a valued contribution to their community through doing something they love to do. People without such a role experience purposelessness and lack direction. A person with has such a role, but who is ‘driven’ in their performance of it, is destructive to themselves and others.
  • Adaptability: the person has the necessary skills/abilities (physical, social, cognitive, emotional and spiritual) to be able to function as successfully as possible in their occupational roles. They also have a routine that creates a framework for accomplishment while allowing sufficient flexibility for the unexpected. A person lacking in a particular ability (egs. Assertive communication, anger management, or generating alternatives to problems) is going to experience difficulties across all their occupational roles. A person who has no routine structure to their day, flounders. A person who is rigidly structured is completely thrown by the unexpected.
 

 
In short, without the jargon, OT's focus building ‘lives worth living’ – lives that are uniquely right for each person. The person:
  • has just the right amount to do (not too little or too much)
  • has a balance in work, rest and play.
  • has a life that uniquely matches who they are
  • has at least one thing they do that they find exciting, absorbing and fulfilling
  • and has the skills/abilities and organisation to manage their responsibilities and activities in such a way as to make the most out of their potential.
 
How we do this is simple.
 
We use occupation as therapy.
 
In other words, we prescribe, restructure and rehabilitate life's activities (ie.Occupations) in accordance with the principles of Occupational Well-Being to restore overall mental and physical health. We:
1.       Stimulate development (or rehabilitate) where skills are lacking or abilities are impaired
2.       Restructure occupational roles where there is insufficiency, unsustainability, incongruence, meaninglessness, or maladaption.
3.       Modify environments and contexts where they inhibit function and well-being.
 
We do this through the legitimate tools of Occupational Therapy:
·     Therapeutic activity
·     Education and training
·     Specific rehabilitation techniques
·     Therapeutic relationship
·     Environmental modification (typically social and economic environments than physical ones in the mental health field)
·     Prescription of aids and equipment (very rarely used in mental health)
 

Click here for some examples relevant to mental health....

©2009 Enable Occupational Therapy in Mental Health Pty Ltd