Occupational therapy (OT) is a client-centered health profession dedicated to promoting health and well-being through participation in daily life. Therapists work with people across the lifespan to enable them to engage in the activities they want and need to do, which are referred to as “occupations.” When injury, illness, or disability creates a barrier, OT provides a systematic, therapeutic approach to regain or maintain independence in their home, work, and social environments.
Defining Occupational Therapy for Adults
For the adult population, occupational therapy is uniquely defined by its holistic perspective on function. The term “occupation” refers to all the daily tasks that occupy a person’s time and give life meaning, extending far beyond simple employment. OT addresses the physical, psychological, social, and environmental factors that may hinder an adult’s ability to participate in these meaningful activities.
Occupational therapy often gets confused with physical therapy (PT), but their primary aims are distinct. Physical therapy focuses mainly on restoring movement, strength, range of motion, and physical function. Occupational therapy, by contrast, focuses on the patient’s ability to perform specific daily tasks, often involving adaptation, cognitive function, and modifying the surrounding environment.
The approach of an occupational therapist is one of adaptation and mastery of tasks, rather than recovery of impairment. For instance, a physical therapist may work to increase arm strength, while an occupational therapist will focus on using that strength to successfully prepare a meal or perform self-care. Interventions are always relevant to the individual’s life roles and goals.
Core Focus Areas: Restoring Daily Life Activities
The therapeutic focus of adult occupational therapy is structured around two major categories of daily activities. The first category includes Activities of Daily Living (ADLs), which are the fundamental tasks of self-care and personal mobility. These core activities include functional tasks like bathing, dressing, personal hygiene, and the ability to feed oneself.
The second category is Instrumental Activities of Daily Living (IADLs), which encompass the more complex activities required for independent living in the community. IADLs require higher-level cognitive skills and include tasks such as managing personal finances, preparing complex meals, and managing medication schedules. The ability to drive a car or utilize public transportation also falls under the domain of IADLs.
Beyond self-care and household management, occupational therapy addresses participation in work, education, and leisure. Therapists assist adults with returning to employment after an injury or illness, which may involve ergonomic assessments of the workplace. They also facilitate engagement in social roles and hobbies, ensuring that meaningful leisure activities are accessible and manageable despite physical or cognitive changes.
The OT Approach: Assessment and Intervention Methods
The process begins with an initial assessment where the therapist identifies physical, cognitive, and environmental barriers to participation. This evaluation often involves observing the client performing the tasks they find challenging, such as using a standardized tool like the Katz Index for ADLs or the Lawton-Brody Scale for IADLs. The therapist uses this data to develop a highly individualized intervention plan.
A primary strategy involves the use of adaptive equipment, which includes devices like specialized utensils, dressing aids, or grab bars installed in the shower. The therapist ensures the client can use these tools safely and confidently in their daily routines. Another common method is task modification, where a complex activity is broken down into smaller, manageable steps, a process known as activity analysis.
Environmental modification is also an intervention, focusing on making the client’s living space accessible and safe. This may involve adjusting furniture arrangement, improving lighting, or recommending a ramp installation to enhance home navigation. OTs implement cognitive retraining strategies to address impairments in memory, attention, or visual perception, which are often impacted by conditions like stroke or traumatic brain injury.
Where OT Happens: Practice Environments
Occupational therapy services for adults are delivered across various settings, often determined by the client’s immediate medical needs and level of function. Acute care hospitals focus on immediate functional assessments and discharge planning following a sudden illness or injury. Following discharge, many adults transition to inpatient rehabilitation facilities or skilled nursing facilities (SNFs) for intensive, short-term therapy.
For those who are medically stable but still require ongoing services, outpatient clinics provide scheduled therapy sessions. Home health services are delivered directly in the client’s residence, allowing the therapist to conduct realistic safety assessments and implement modifications in the living environment. This is particularly beneficial for maximizing independence within the context of a client’s own home.
Occupational therapists also practice in community-based programs, mental health facilities, and specialized clinics, addressing vocational, social, and psychological challenges. They facilitate the client’s ability to engage in their chosen occupations in the environment where they live, work, and socialize.