How Occupational Therapists Practice Psychotherapy!
Updated: Feb 22, 2022
February is Psychology month, which is a time to celebrate how continued advances in the science of psychology contribute to individuals leading happy and healthy lives. Psychology is a science that focuses on better understanding the thoughts, feelings, and emotions of an individual. When you hear about psychological treatment, your immediate thoughts likely go to practitioners such as psychologists and psychiatrists. Certainly, these colleagues are the important foundation on which psychological treatment grows, but as a holistic profession that focuses on the complete person, Occupational Therapists frequently provide treatment to improve psycho-emotional well-being, referred to as counselling, and psychotherapy.
There are a few differentiators between counseling and psychotherapy, the most notable being the severity of the client’s illness and resulting functional impairment. Counselling occurs when an Occupational Therapist (OT) provides education, guidance, encouragement, or supportive problem-solving to a client with mild or moderate illness and functional impairment. When these strategies are used in conjunction with a therapeutic relationship, to an individual with severe illness and functional impairment, it is considered psychotherapy (Standards for Psychotherapy, 2018).
Due to the severity of the client’s condition, providing psychotherapy is considered a controlled act. A controlled act is defined as a procedure or activity which may pose a risk to the public if not performed by a qualified practitioner (Standards for Psychotherapy, 2018). OTs have been granted the authority to provide psychotherapy services, as a qualified practitioner, due to their training in disorders of thought, cognition, mood, emotional regulation, perception, or memory and relevant treatment approaches.
At NCCO, we regularly work with individuals who are experiencing challenges with their psycho-emotional functioning. After a traumatic event, such as a motor vehicle collision, and the resulting impact on their function, our clients often experience impairments such as depression, anxiety, specific phobias, and post-traumatic stress disorders, as diagnosed by their treating psychologist or psychiatrist. The OTs on our team are trained in a variety of treatment modalities to enable these clients in reaching their functioning goals, by providing counseling and/or psychotherapy.
One treatment modality often used by OTs includes motivational interviewing (MI). MI is a client-centered approach that helps clients explore their ambivalence to ultimately lead to behaviour change. For example, when a client is experiencing depression and wants to participate in more cooking tasks, but feels they are unable to do so, our OTs work with the client on exploring their desires and motivations around changing this behavior. The goal is that the client comes to believe, through their own thoughts, that this is a behaviour they are capable of and begin to engage in working towards this goal.
A recent study by Hsieh et al., examined the use of MI in 27 individuals who had sustained a traumatic brain injury and as a result were experiencing challenges with their psycho-emotional functioning. Participants who received MI showed a greater engagement in their therapy program and as a result showed a reduction of anxiety, stress, and non-productive coping. Evidence like this demonstrates the value MI can hold in increasing client participation in therapy, despite psycho-emotional challenges they may be experiencing.
Another approach our OTs use in both counseling and psychotherapy is Solution-Focused Therapy (SFT). This is an evidence-based approach which focuses on the specific language used by the OT, to have the client develop their best hopes and a solution to achieve this hope. By centering on hope, the focus of treatment shifts away from the “problem” and begins to facilitate change.
In a 2016 study by Sari & Gunaydin, the effectiveness of SFT with individuals experiencing depressive symptoms was examined. 48 individuals with depressive symptoms participated, with some participants receiving SFT and others receiving irrelevant training, such as lessons in communication skills. Findings demonstrated that those who received SFT experienced a reduced frequency and intensity of depressive symptoms. This research illustrates how empowering clients through the use of SFT can have them lead the way to reaching their goals regarding their psycho-emotional functioning.
When applying counselling and psychotherapy interventions, OTs at NCCO ensure that they remain competent in these areas of practice. This may come through completing intervention-specific workshops, completion of specific course work, professional development opportunities, and lunch-and-learns with experts in the field. The OTs at NCCO always ensure we are ready to provide the care our clients need. If you would like to work with one of our OTs, you can submit a referral here.
Standards for Psychotherapy. College of Occupational Therapists of Ontario. Revised August 2018. URL: https://www.coto.org/docs/default-source/default-document-library/standards-for-psychotherapy-2018.pdf?sfvrsn=f713ae81_2
Hsieh, M., Ponsford, J., Wong, D., Schonberger, M., Taffe, J., & McKay, A. (2012). Motivational Interviewing and cognitive behaviour therapy for anxiety following traumatic brain injury: A pilot randomized controlled trial. Neuropsychological Rehabilitation, 22(4), 585-608. doi: 10.1080/09602011/2012.678860
Sari, E., & Gunaydin, N. (2016). Effectiveness of Solution-Focused coping with Depression Training on Depression Symptoms. Alpha Psychiatry, 17(5), 369-375. doi: 10.5455/apd.208951.