What is Holistic Occupational Therapy?

We’re so excited to feature holistic occupational therapist Linda Schiano Moriello, OTR/L, for this great article all about holistic occupational therapy. We love that research-backed holistic practices are becoming more mainstream and accepted in OT and look forward to sharing how you can incorporate holistic OT approaches in your day to day practice.

Occupational therapists are skilled at taking a holistic approach in order to help a person achieve success in meaningful occupations. Because of our unique whole-person approach to treatment, “holistic occupational therapy” is highly relevant to our practice.

Holistic occupational therapy is officially known as Complementary Health Approaches and Integrative Health (CHAIH). The American Occupational Therapy Association (AOTA) has even issued a statement supporting the use of CHAIH as component of occupational therapy practice.

If you’re interested in how you can incorporate this into your practice, or you just want to know more about holistic OT, this article will help explain what these practices are and how they relate to OT.

What is Complementary and Integrative Health?

“Complementary” refers to a non-mainstream practice that is used in conjunction with conventional medicine, like using natural products or engaging in mind and body practices. For example, yoga is one of the most widely used complementary practices.

“Integrative” refers to a holistic approach to the person’s health, such as considering pain management for military veterans. When used together, CHAIH can contribute to improved occupational performance of individuals in any context, from pediatric settings to skilled nursing facilities.

What are Complementary Health Approaches and Integrative Health Practices?

There are many different CHAIH that can be incorporated into a holistic occupational therapy practice to promote client factors needed for functional engagement in occupations. While some, like yoga and meditation, may be fairly common, others may be less widely recognized and understood.

The following are just a few of the CHAIH gaining popularity that occupational therapy practitioners can incorporate into their practice.

Aromatherapy

Using essential oils is an easy way to incorporate complementary health approaches into a treatment session. In addition to having a pleasant scent, essential oils can also have beneficial effects on the mind and body.

While there are many different uses for essential oils, perhaps the most beneficial for occupational therapy practice are the calming or energizing effects they can have on the nervous system.

Scents such as lavender, orange, chamomile, ylang ylang, and rose have been known to have a calming effect in order to promote relaxation and/or sleep or even reduce agitation in clients with dementia. Uplifting scents like peppermint, lemon, lime, ginger, and rosemary can help improve attention and alertness.

When choosing an essential oil, look for ones labeled as “therapeutic grade” and make sure the person does not have allergies or take medications that could negatively interact with the oil.

Guided Imagery

Guided imagery is a form of meditation that is led by a practitioner to help the person utilize all of their senses and emotions to visualize an image. The image may represent the pain or problem the person is dealing with or a solution to the problem.

By incorporating aspects of the subconscious mind, the person may be more able to cope with or resolve their problems or reduce their pain. Research has shown that guided imagery has many effects on a person’s health and well-being, including reducing blood pressure, anxiety, and pain.

Reiki

Reiki is a Japanese technique that is used for stress reduction, pain management, relaxation, and healing. The word Reiki translates into “spiritually guided life force energy” and is administered by gently laying one’s hands on certain points on the body in order to work with the body’s energetic field.

Reiki is a non-invasive practice and can help a person achieve a calmer and more relaxed state in just a few minutes. To use Reiki, you must take a class taught by a Reiki master, but you might have an opportunity if you attend AOTA’s conference or other state OT conferences.

Yoga

Yoga involves a series of strengthening and stretching muscles while simultaneously focusing on breath control. The use of yoga has widespread psychological and physical benefits and can be used with everyone from children with autism spectrum disorders to older adults with Parkinson’s Disease.

It has been shown to help improve emotional regulation, strength, balance, and range of motion as well as decrease pain, reduce anxiety, and prevent falls.

Because occupational therapists are skilled at adapting activities, we are able to modify the positions and/or environment to help the individual engage in this practice safely and successfully.

“Can I Bill for This?”

If you’re thinking, “This is great, but can I bill for this in my practice?” The answer is “YES!” AOTA supports the use of CHAIH when used as a preparatory activity, occupation, or activity.

Depending on the activity and purpose, CHAIH can be billed under codes such as neuromuscular re-education or therapeutic activity.

As always, be sure that your documentation includes the purpose and functional outcome of the activity and that the intervention is client-centered and occupation-based.

Things to Consider Before Using CHAIH

While you might see the benefit of using CHAIH with your clients, there are a few things to take into consideration to ensure it is used therapeutically.

First, think about the client factors: Does the person have any cultural or religious beliefs that might interfere with their participation? Do they have any contraindications that would make the intervention unsafe?

For example, a client may be unwilling to participate in a yoga group because they think it involves a religious practice, or they may be taking medications that could make performing an inverted position like “downward dog” potentially dangerous.

Educate yourself and your client and always ask permission before using any CHAIH. After confirming the person is appropriate for the selected approach, you must also make sure that the intervention positively contributes to the person’s health and well-being. Lastly, it should fall within the scope of occupational therapy practice.

Where Should I Start?

One of the best ways to start using CHAIH in your practice is to create a practice for yourself first. Performing a few yoga stretches when you get out of bed, smelling peppermint oil at your desk to help you focus on your paperwork, or downloading a guided meditation to help you relax or fall asleep are just a few ways you can start introducing CHAIH into your daily routines.

There are also many CEU courses offered through or approved by AOTA that can provide more detailed information about some of the topics described. The resources and courses listed below are full of information to help get you started.

Where Can I Learn More?

AOTA Online Course: OT with Complementary Health Approaches and Integrative Health (CHAIH)

Holistic Occupational Therapy Organization

National Center for Complementary and Integrative Health

Reiki and Occupational Therapy (Rebecca Austill Clausen, OTR)

Holistic Healing Certificate – Putting it Into Practice (Emmy Vadnais, OTR/L)

This post was originally published on January 23, 2020 and updated on February 5, 2023.