10 Reasons Why OTs Should Be Using Occupation-Based Interventions
Occupation-based interventions: It may seem like common sense to use these as occupational therapists. After all, our title has the word “occupation” in it, for goodness sake!
Unfortunately, assembly-line therapy has reduced the use of occupation-based treatments in favor of exercises that make point of service and high productivity the main objective versus providing quality, occupation-based interventions that are true to our roots.
We may not notice this right away as new grads. When we’re first exiting the academic world to greet the paying one, we are eager and excited to see what our future careers hold for us. Aside from being treated as colleagues and coworkers rather than students, we have the opportunity to finally put what we learned into action with our patients.
Fast forward a few years.
The never-changing caseload starts to wear on us. Primary payers shrink our individual treatment time with each patient to save a few dollars. We’ve gotten one too many refusals to come to therapy. Our company won’t update our therapy equipment or budget money for OT-related supplies but are all ears for maintaining exercise equipment.
Eventually, we stop asking questions that truly matter during initial evaluations. We forget to put our patients first in the plan-of-care. And we start to feel more like a personal trainer rather than a therapist.
Although therapeutic exercise has its place in the OT process, there comes a point where we have to step back and assess what we are providing for our patient: A work-out, or true occupational therapy?
10 Reasons Why OTs Should Use Occupation-Based Treatments
1. Occupation is what we are about.
As occupational therapists, we have a chance to shine and to offer what no other healthcare profession can: the use of occupation-based activities to heal and to restore people. With our clinical eyes and unique skill-set, we can turn daily activities into meaningful therapy interventions.
2. It provides us a holistic approach.
The use of occupation means that we’ve had to go to initial efforts to learn specific information about our patients: interests, hobbies, priorities, time usage at home, medical history and so on.
The more we present opportunities for our patients to complete meaningful tasks, the more we learn about them from a personal and medical standpoint. In the end, we truly do what’s best for our patients when we view them holistically.
3. Discharge results are actually satisfying.
As part of plan-of-care requirements for most OT practices, we are obligated to include goals that are functional in nature. Instead of typing up, “Pt to participate in 20 minute-duration of upper body therapeutic exercise at 5 lbs per UE”, we type up more practical goals like “Pt to increase upper body strength to (insert score) in order to facilitate Independence in functional mobility and toileting task completion.”
When we sit our patients down for an upper body exercise regimen (and only that regimen) every day and discharge them home, we are left wondering if they will independently complete their own toileting.
Encouraging active participation in occupation reassures both the patient and the therapist about what performance at home will look like.
4. Re-admission numbers go down.
In 2016, an independent study by Rogers, Bai, Lavin, and Anderson was published in Medical Care Research and Review. The authors found that occupational therapy is “the only spending category where additional spending has a statistically significant association with lower readmission rates”.
Three primary diagnoses that were assessed included myocardial infarction, heart failure, and pneumonia. They further add that because of occupational therapy’s focus, we catch things that often go ignored in a medical setting.
5. You create better rapport with your patient/client.
Developing a therapeutic connection with a new patient can already be awkward enough until you learn more about the individual. There’s also nothing like prolonging the awkwardness by sticking your patient on an arm bike every day and sitting on the other side of the gym waiting until they’re done.
When you incorporate occupation-based tasks into the intervention, it tells the patient that you were listening at initial evaluation. It reassures them that you have a vested interest in them and their success.
6. Refusals go down.
With the exception of fitness center fanatics, most patients aren’t keen on the idea of exercising every time they go to therapy. Riding a stationary bike or plugging away on the upper body ergometer for the treatment session literally and metaphorically gets the patient nowhere.
Besides, other healthcare professionals are capable of providing exercise regimens too. Some patients might be more willing to complete their therapy if they are offered the chance to participate in tasks that matter to them and are in line with their goals.
7. Occupation-based interventions provide healthy challenges for you and your patient.
According to an article published by Forbes in 2017, “boredom” is one of the beginning signs that an employee is approaching burnout. Running a patient through the same exercises and modalities every day (especially if it’s a means for killing time rather than functionally improving the patient) creates a dull experience.
Providing occupation-based interventions spices up therapy sessions, which gives you AND the patient challenges to look forward to.
8. Payers need to see occupation-based treatments.
Medicare, Medicaid, and private insurance companies need to know on an annual basis that their funds are going to good use. As OTs, we are constantly subjected to justifying our practice in order to ensure coverage.
By doing so, we need to be using interventions that are specific to our skill-set, interventions that no one else can provide. The best way to reflect and represent our practice is to use occupation-based treatments.
Now more than ever with the changing healthcare system, we truly need to show our distinct value as occupational therapists.
9. Research shows occupation is better.
For years since the creation of occupational therapy as a profession, evidence-based research has been pouring out regarding the use of occupation-based treatments and effective intervention with patients. Refer to the American Journal of Occupational Therapy or any other international OT journal for resources on this.
10. It’s more fun!
Using occupation-based interventions may shake things up for every session, but additionally such tasks allow us therapists to get to know our patients on a whole new level. We can joke, laugh, and cry together as we guide them through the therapy process. We walk away entertained and knowing that we just might have made a difference in their lives.
I hope this list helps encourage all OTs and COTAs to incorporate more occupation-based treatments in their everyday practice. Would you add anything to this list?
*If you’re looking for more on this topic, also be sure to check out this podcast from Seniors Flourish where Mandy Chamberlain, OTR/L and I talk about how occupational therapists can add more occupation based treatment ideas and documentation into our daily practice.