Who are Occupational Therapy Practitioners (OTP’s)?

• Allied Healthcare Professionals
• A clinical practice considering both physical and mental health components of successful participation in daily occupations.
• OTP’s specializing in mental health use client-centered occupation-based interventions, identify unique strengths and barriers both personal and environmental, offer adaptations as needed and facilitate skill building with the use of a variety of targeted interventions improving quality of life and independence.

(AOTA, 2020)

Hallmark components of OT programs in the mental health setting:

• Cognitive interventions (*components of Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) may be included.
• Sensory integration and interoception awareness, emotional regulation and coping.
• Build self-efficacy through mastering skills for successful participation in various occupations including work, education, volunteering.
• Build healthy routines for self-care
• Social participation skills
• Structured exercise (mindful movement, safe aerobic exercise)
• Facilitate intrinsic motivations through exploration of occupational identity
• Interventions to improve quality of sleep

(AOTA, 2020)

OT service delivery in the mental health setting:

• One-on-one
• Group interventions
• Within the community
• Communication with other members of the healthcare team is important to support patient progress and address barriers.

(AOTA, 2020)

**Interventions are uniquely designed for the specific needs and goals of each individual**

Work/ Education success with OT:

Many individuals living with severe mental illness (SMI) desire to work however, face barriers to participation which may include coping with challenging symptoms, experience a lack of self efficacy, difficulty with emotional regulation, social functioning, and problem solving (Harfush & Abo-Elyzeed, 2019; Torregrossa et al., 2022). The need to build skills to be able to successfully participate in work or education is important for over all success (Harfush & Abo-Elyzeed, 2019; Noyes et al., 2018). A systematic review including MEDLINE, PsycINFO, CINAHL, OTseeker, and the Cochrane Database of Systematic Reviews reveals evidence that occupational therapists play an important role in facilitating the ability of patients living with severe mental illness to successfully participate in employment, educational and social roles contributing to improvements in occupational justice, and self-efficacy through experienced success and improved quality of life (Noyes et al., 2018).

Structured Exercise and Mental health:

Structured exercise programs are shown to be a benefit adjunctive treatment for patients with schizophrenia in improving hippocampal volume, BDNF levels leading to synaptic plasticity and neurogenesis, global mental functioning, reduction of negative symptoms and showing positive outcomes including improvement of physical health (Korman et al., 2023). A systematic review and meta-analysis identified 18 RTC involving 734 participants living with schizophrenia identified good evidence that structured exercise, in particular aerobic exercise positively impacts global functioning in individuals living with schizophrenia. Results reveal also a positive impact on social functioning and functions of daily living, which are both important as individuals with SPMI exhibit deficits in social functioning and consistency with performing self-care tasks (Korman et al., 2023).

Cultivating Motivation for improved Success and Quality of Life: Inclusion of OT in Mental Health:

Identifying motivation leads to establishing meaningful goals which is important to understand and build meaningful goals for measurable success. A mixed-methods study by Yazici et al (2016) utilized qualitative and quantitative data involving interviews and questionnaires, the Clinical Global Impression (CGI) Scale and the Global Assessment of Functioning (GAF) to identify the resulting reduction of caregiver burden with the ability for patients to be able to successfully identify meaningful goals. Occupational therapists are qualified to help facilitate individuals living with SMI to identify meaningful goals fostered by intrinsic motivators to help cultivate progress and experience improved success and quality of life through the ability to work towards meaningful goals (Yazici et al., 2016).

Sensory Interventions and Interoception Awareness in Emotional Regulation. Unique Impact of OT:

Individuals living with SMI experience difficulties with regulating emotions and coping with stress or challenges in various situations. A relationship in abnormal activity of the insula resulting in depersonalization in individuals with schizophrenia and these deficits in interoception awareness can contribute to the lack of ability to regulate emotions when needed in situations (Medford et al., 2024). A systematic review using mixed-methods articles using databases CINAHL, Embase, Pubmed, Web of Science and Cochrane found four sub themes involving positive effects resulting from sensory interventions and sensory rooms for this population. These positive effects included a calming of mood, calming of the patient’s body, improved performance in self-care, and improvements in patient-nurse relationship (Ma et al., 2021). Interoception awareness is paramount for individual living with SMI as deficits in this area have been shown to be a culprit in an increased disability involving depersonalization and increased positive symptoms. Occupational therapy has a unique role in regard to offering interventions involving sensory and interception awareness improving self-awareness and selfagency and positively impacting successful occupational performance (Ma et al,. 2021; Medford et al., 2024).

*Additional research articles included with references below.