Four Emerging Practice Areas in Occupational Therapy to Know

There are many new and interesting emerging practice areas in occupational therapy that help to meet the constantly evolving needs of society. Our field is always evolving in order to stay relevant in the modern world and to provide services appropriate to our current world challenges.

This article will explore the following four emerging practice areas in OT: virtual reality, telehealth, OT for refugees and asylum seekers, and sleep management. 

Four New Emerging Practice Areas in Occupational Therapy 

1. Virtual Reality 

What is it?

Virtual reality (VR) is defined as an immersive and interactive technology, whereby the user is fully immersed in a 3D environment with a 360-degree view of their virtual surroundings. OTs have begun to use VR by integrating it into their OT sessions, as well as recommending it is used at home as part of a home exercise program. 

What is the benefit of using virtual reality and why is it an emerging practice area in OT?

1. Virtual reality in rehabilitation is task-orientated and provides high numbers of repetitions in a fun and interesting manner in order to target neuromotor changes. It has been shown that VR elicits higher doses of repetition in comparison to traditional therapy (1).
2. OTs can provide patients with the opportunity to engage in a specific situation, such as driving or confronting a phobia, without experiencing the risks or errors that may occur in real life situations. 

How do OTs use VR?

A common way in which occupational therapists use virtual reality is by targeting upper limb rehabilitation in the stroke population. The patient moves their arm while trying to control a virtual object, such as holding an apple. This allows the patient to get in many repetitions of arm movements while trying to incorporate the movement into a virtual functional task. 

Occupational therapists have even been using virtual reality to aid in home modifications as well as increasing awareness of what can increase the risk of falling in the home environment. This is done by providing patients with a simulated home with barriers in order to educate and increase their awareness of environmental barriers that exist in homes and trying out possible solutions to them in the VR (2). Furthermore, VR is being used to measure people’s homes to see if assistive devices will be appropriate in the home space, before they are purchased (2).

Virtual reality is also commonly used in pediatric rehabilitation, as it allows children with physical or neurological conditions to engage in games that are usually inaccessible for them. The use of VR in pediatrics provides the opportunity to target motor control and motor learning, as well as targeting cognitive and communication skills, while engaging in a game (1).

2. Telehealth

What is it?

Telehealth, also known as teletherapy, is the provision of healthcare and therapy services remotely with the use of internet access on a phone, tablet, or computer. Telehealth has existed for many years, but the pandemic was a key driver in accelerating the use of telehealth in occupational therapy. 

Why is it an emerging practice area in occupational therapy?

1. It lowers costs for our patients
2.  It makes medical care more accessible to all
3. It’s convenient for both the OT and the patient
4. Many OTs are looking for remote jobs, and this is one way to achieve this goal

I believe that telehealth has become an emerging practice area for occupational therapists because it allows us to work from home, which is so rare in our profession. There are job positions for OTs that involve telehealth sessions only, and this appeals to many OTs who want to cut down on their driving time or want more flexibility in their schedule. 

My experience with telehealth OT:

I’ll admit that I was quite nervous for my first telehealth session. As OTs, we are so used to being hands-on and physically guiding and correcting movement. I find that telehealth does require a bit of planning in advance in the way of emailing patients resources prior to the session, such as a cognitive resource or a home exercise program.

While I do believe that seeing a person in real life facilitates a better connection, I love that I can offer OT intervention to individuals who live in remote or rural areas and would not have otherwise have access to telehealth as well as the convenience that it affords my patients. 

3. Occupational Therapy for Refugees and Asylum Seekers

As a result of forced displacement, there are significantly higher numbers of refugees and asylum seekers throughout the world. Occupational therapists are the experts in occupational deprivation, and therefore OTs working with refugees has become its own emerging practice area. There is a big demand for our skillset to assist this vulnerable group in society to help integrate into their new environment.

Refugees and asylum seekers experience many psychosocial difficulties when resettling, and many of them have been exposed to repeated trauma and instability (3).

Our OT skillset lends well to this practice area, as we have considerable knowledge on how to improve health and well-being through engagement in meaningful occupation as well as our knowledge of mental health, occupational justice and our holistic perspective (4).

What are OTs doing with refugees and asylum seekers?

• Facilitating engagement in meaningful activities to aid in processing their trauma and to develop skills needed to adapt to the host community
• Facilitate integration into the local society through the development of the following skills: vocation, psychosocial, and coping mechanisms
• Offer counseling and education
• Running support groups

4. Sleep Management

Sleep is classified as one of our occupations that supports active engagement in our other life occupations. There is significant research proving that getting adequate sleep is linked with mental and physical health, and insufficient sleep can lead to decreased occupational performance (5).

Sleep is a topic that I address almost daily with my patients in a variety of conditions: stroke, traumatic brain injury, chronic pain, and mental health difficulties. AOTA has emphasized the important role that OTs play in sleep, however, despite this, there are very few OTs working in sleep clinics. It is, however, becoming more common for OTs to address sleep in their sessions regardless of the setting.  

I remember learning about the importance of rest and sleep in university, but I do not recall learning how to treat it. If you would like to learn more, be sure to check out our article about OT’s role in sleep: Don’t Sleep on Occupational Therapy’s Role in Sleep. We hope to empower more OTs to feel more confident in treating sleep difficulties.

What do OTs address in sleep management?

• Education
• Promoting environments conducive to sleep
• Targeting daytime activity to promote occupational balance, and reducing daytime sleep through this
• Sensory based interventions
• Targeting sleep hygiene
• Cognitive behavioral therapy (CBT)

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These emerging practice areas are just a few of the new areas that OTs are starting to specialize in. Other areas that OTs are beginning to get more involved in include (but are not limited to) working with older adults and  driving, chronic disease management, preventative and holistic care, and palliative care.

There is a great need for OTs to conduct more research on our role in these emerging practice areas in order to prove the value of our profession in these areas.

We would love to hear if you are involved in working in or researching any of these emerging practice areas in occupational therapy, or if you have identified any new areas that OTs are becoming involved in. Let us know your thoughts and experiences in the comments below. We will be adding to this article over time as more new and exciting practice areas evolve.

 

References:

1. Aran, O.T. et al. (2017) ‘Virtual Reality and Occupational Therapy’, Occupational Therapy – Occupation Focused Holistic Practice in Rehabilitation [Preprint]. Available at: https://doi.org/10.5772/intechopen.68799.
2. Hwang, N.-K. and Shim, S.-H. (2021) ‘Use of Virtual Reality Technology to Support the Home Modification Process: A Scoping Review’, International Journal of Environmental Research and Public Health, 18(21), p. 11096. Available at: https://doi.org/10.3390/ijerph182111096.
3. Psychouli, P., Louta, I. and Christodoulou, C. (2023) ‘Development of the Refugees and Asylum Seekers Occupational Satisfaction (RASOS) Assessment Tool’, International Journal of Environmental Research and Public Health, 20(19), p. 6826. Available at: https://doi.org/10.3390/ijerph20196826.
4. Trimboli, C. and Halliwell, V. (2018) ‘A survey to explore the interventions used by occupational therapists and occupational therapy students with refugees and asylum seekers’, World Federation of Occupational Therapists Bulletin, 74(2), pp. 106–113. Available at: https://doi.org/10.1080/14473828.2018.1535562.
5. Yoo, I, (2023). ‘A scoping review of sleep management as an occupational therapy intervention: expanding a niche area of practice in mental health’, Irish Journal of Occupational Therapy, 51(2). Available at: https://www.emerald.com/insight/content/doi/10.1108/IJOT-01-2023-0001/full/html.