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Occupational Therapy

What is Occupational Therapy?

Occupational Therapy (OT) is an allied health care profession that intervenes with individuals of all ages who have or are at risk of developing an illness, injury, impairment or condition, including mental health difficulties. Occupational therapy aims at assisting individuals achieve their maximum level of function and independence within the home, school, work and social environments through the therapeutic use of everyday life activities. Occupational therapists intervene wit people and communities to enhance their ability to engage in the occupations they want to, need to, or are expected to do.
The Occupational Therapy (OT) Process 
The process is based on the holistic and client-centered approach  
The following are the steps that OT practitioners follow in order to provide their therapeutic services:
1.  Referral: This is the process by which the consultant psychiatrist or medical doctor working in the mental health field in liaison with the individual request OT services. Through the use of the individual's personal data, diagnosis and reason for referral, the occupational therapist determines whether the individual can benefit from OT intervention.

2.  Assessment/Evaluation: Information about the individual is gathered through the use of interviews, gaining feedback from relatives/carers, and observations made while the individual is carrying out different activities. This helps identify one's abilities and difficulties in areas of self-care, paid or unpaid work and leisure interests.

3.  Goal Setting: Through the gathered information, a treatment plan, which specifically addresses the individual's particular needs, is formulated, and clear treatment goals are set. This is done in collaboration with the individual, family members and the other health care professionals.  

4.  Intervention: This includes applying the treatment plan into action through the use of activities which are meaningful to the individual (e.g. cooking, painting, and typing). Activities used support the individual's interests, needs, health, and participation in daily life. Intervention can be carried out either individually or within a group. At times, intervention involves the modification of the occupation or the environment to better support their engagement in occupations. Thus, the occupational therapist carries out home, school or work visits. This is done to assess and suggest adaptations in the individual's environment so that it will further facilitate participation in daily activities. 

5.  Review Stage: Following a number of sessions a re-assessment is carried out to establish whether the goals were achieved or need to be changed. This determines whether the individual can be discharged or requires further intervention. 

6.  Discharge: When the individual achieves the set goals, no further intervention is required and is therefore discharged from OT services.
Occupational Therapy Areas of Concern
Occupational Therapy assists the individual to gain the maximum possible level of function and independence in the following daily activities and areas of daily life.
Activities of Daily Living: OT assists the individual to acquire the necessary skills to become independent in performing activities related to one''s personal care. These include activities such as:
•     Personal hygiene (e.g. bathing, shaving)
•     Dressing (e.g. selecting appropriate clothing for a specific time of the day)
•     Functional mobility (e.g. moving from one place to another safely)
•     Personal device care (e.g. care of dentures and glasses)
•     Sexual education (e.g. education about sexual expression and associated benefits and risks)
•     Toilet hygiene (e.g. dressing and undressing, cleaning oneself) 

Instrumental Activities of Daily Living: OT helps the individual to achieve the maximum possible level of function in performing activities which are necessary to support daily life within the home and the community. These include:
•     Care of others (e.g. care of children, pets)
•     Communication management (e.g. verbal and non-verbal skills, using a telephone, writing and reading letters and emails)
•     Community mobility (e.g. use of public transport and road safety)
•     Money handling and budgeting (e.g. increasing awareness about value of money)
•     Shopping (e.g. preparing a shopping list)
•     Home hygiene and maintenance (e.g. dusting, washing the floor, doing laundry)
•     Safety within the home and community (e.g. outlining hazards in one''s home)
•     Meal preparation and clean up (e.g. preparing, serving meals and cleaning up)
•     Personal health management and maintenance (e.g. healthy eating, medication routine, and participation in physical exercise) 

Rest and Sleep: OT encourages the individual to have adequate rest and sleep which enable a balanced healthy lifestyle. This area also includes the process of sleep preparation that involves preparing self and the room for a comfortable rest (e.g. changing clothes, making the bed).
Education: OT encourages the individual to participate in activities that support learning and increase individual''s involvement in the environment. This area includes both formal (e.g. academic and non-academic activities), and informal education participation (e.g. literacy skills programmes, cookery classes).
Work: OT encourages involvement in activities that help the individual engage in the process of employment or voluntary work. This includes:
•     Employment seeking and acquisition (e.g. selecting appropriate employment according to the individual''s abilities, potential and health-related needs, as well as preparing for job interviews)
•     Job performance (e.g. assessing and monitoring the individual''s skills or patterns whilst at work)
•     Retirement preparation and adjustment (e.g. development of a new daily routine)
•     Exploration and participation in voluntary work (e.g. assisting individual to choose the proper opportunities to be involved in unpaid work according to one''s abilities) 

Play: OT encourages the involvement of children in age-appropriate play activities that support learning and entertainment. The process involves play exploration where the appropriate activities are identified, and play participation where participation in safe play is promoted.
Leisure: OT assists the individual to gain the skills necessary to participate in non-obligatory activities during the time which is not committed to work, self-care and sleep. This involves helping the individual in exploring leisure pursuits and encouraging participation in leisure.
Social Participation: Occupational therapists retrain individuals in achieving skills required to interact with others, such as skills used to relate with family members, friends, and service-providers (e.g. keeping boundaries, use of appropriate verbal and non-verbal communication). These skills are then generalized in society by enabling interaction as well as involvement in community activities, groups or organizations.
Contact Details
Occupational Therapy services in mental health care are offered at Mount Carmel Hospital, Child and Adolescent Mental Health Services, Mater Dei Hospital Short Stay Psychiatric Unit, and community services in various localities in Malta. For further information contact:
Occupational Therapy Department
Mount Carmel Hospital
Notabile Road,
Tel: 2330 4070 / 2330 4509