Christina Brown Fisher, MS, Veteran, United States Air Force
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Disclaimer: This article is for informational purposes only. Please speak with a medical professional before seeking treatment.

What can occupational therapy help with?

Regaining function you may have lost due to brain injury

Occupational therapists work with people to be as independent and as safe as possible. That can include anything from the basic things -- bathing, dressing, grooming, self-feeding, to any of the more complex things that people do.

Mark Chronis, OTRL, CBIS, Polytrauma Unit, Hunter Holmes McGuire VA Medical Center 

What is occupational therapy?

Following a traumatic brain injury (TBI), occupational therapy (OT) can help you regain the physical skills you need to participate in work, school, and daily life. It can sometimes take a long time to recover from a TBI, but your occupational therapist can help you make progress toward participating more fully in the activities of daily life.

Consistent and direct guidance from your OT, along with regular, targeted practice, will build new neural pathways, helping you redevelop old skills or develop new skills (a different way of doing things) until you become more adept again.

What is occupational therapy like?

There are potentially at least three different types of care that your OT may focus on, depending on what you need and how far you’ve come already in your recovery from a brain injury:

  1. Daily activities and basic self-care: This includes mobility activities like getting in and out of bed or reaching for an object; getting dressed, feeding yourself, taking a shower, or brushing your teeth; and coordinated movements like writing or fastening buttons.
  2. Your home and your community: This could cover cooking dinner, laundry, managing your finances, making and keeping appointments, tracking your medication, and getting around town safely.
  3. Your occupation: This might include functioning more successfully at a paid job, at a volunteer job, at school, or in a hobby. Or you might focus on the steps you need to take to return to school or a job.

Following an initial evaluation your occupational therapist (OT) will create a plan to improve your ability to reach specific goals. Depending on your specific needs, that plan might include:

  • Helping with daily life activities such as shopping, cooking meals, or caring for a child your OT may show you new strategies for getting those things done.
  • Using daily planners or checklists, using specialized apps and other digital tools, or setting up systems that can help you manage daily tasks more effectively. Learn more about memory strategy training.
  • Developing routines and schedules.
  • Recommending adaptive equipment and changes to the layout of your home and possibly labeling cabinets and drawers to help you stay as safe and independent at home as possible.
  • Working with your family to set up systems that work for everyone.
  • Helping you prepare to return to work or to school. Your OT can also help coordinate with your job or school to adapt the environment there to accommodate your needs.
  • Helping you with eye strengthening exercises and visual scanning activities if you experience vision problems or damage to the nerves that control eye movement.

What should I look for in an occupational therapist?

You should look for a licensed occupational therapist who has training and experience working with people with brain injury.

Effective occupational therapists collaborate with other health care providers to deliver holistic care. They might connect with your doctor, nurse, physical therapist, speech therapist, or respiratory therapist, among others, to help you develop or recover the physical skills needed to deal with daily life, work, or leisure.

In order to become an OT, your therapist must have a college degree and a graduate degree in occupational therapy, be licensed, and pass both a national certification exam and a state certification exam.

Here are two questions to ask a prospective occupational therapist:

  • What specific training and experience have you had in assessing and treating patients with brain injury?
  • Have you been mentored by an expert in OT with experience working with people who have had a brain injury?

How strong is the evidence?

Strong evidence indicates OT is beneficial in treating cognitive impairments and supporting the overall wellness of those with brain injury. Since it is often used in conjunction with other treatments, more studies are needed in which occupational therapy is the primary outcome.

In 2015 the journal OTJR: Occupation, Participation, and Health published a review by Jaclyn Stephens, Karen- Nicole C. Williamson, and Marian E. Berryhill of the evidence-based cognitive rehabilitation practices that could be applicable to occupational therapy.

What do patients say?

When patients can see tangible benefits in measurable improvements physically, they also gain pride in self-accomplishment & self-confidence.

— Edward Vickers, Brain Injury Survivor (personal communication, October 25, 2020)

 

Adam Anicich, who sustained a brain injury while serving as an Army sergeant in Iraq, describes different OT treatments.

 

OT got me to the point where I could be independent, drive myself, be in my own wheelchair, get up and down the hills, and use prosthetic legs. It was full speed ahead. The quicker you could start getting all this stuff and become more independent, you just feel like yourself again.

— Brandon, Marine Corps veteran who was injured by an IED in Afghanistan

What do experts say about occupational therapy?

My goal for you is to be as functionally independent as possible with what you love to do in life.

— Ryerson Stinson, MOT, OTR/L, CHT, Proflex, Waldorf, MD
“What Can Occupational Therapy Do for You?”
(Ryerson appears at the start of this video)

For me, OT is the ultimate problem-solving profession, because every day I have a chance to engage with somebody like Scott and I’m going to figure out how to break through.

— Kelsey Waters, OTR/L, Shirley Ryan Ability Lab, Chicago
Occupational Therapy: Recovering from Traumatic Brain Injury
What OT Can Do For You: Traumatic Brain Injury (TBI)

Sometimes people don't remember what medications they were taking. They don't remember appointments. Sometimes they can be very disorganized in their thought processes --- a lot of what we do is [set] them up on a routine or schedule.

— Charlene Woo, OTRL, Bellevue Hospital (October 23, 2020 phone Interview)

Where can I find more information?

Where can I go to get occupational therapy? (limited list)

  • Ask your primary care physician or neurologist for a referral to an occupational therapist.
  • Contact your local hospital to speak with someone from the rehabilitation or occupational therapy department.
  • Contact your local brain injury association [link] or brain injury alliance [link] for information on brain injury services providers in your area.
  • Visit the American Occupation Therapy Association (AOTA) website for a list of state Occupational Therapy Associations.

References

Kim, H., & Colantonio, A. (2010). Effectiveness of Rehabilitation in Enhancing Community Integration After Acute Traumatic Brain Injury: A Systematic Review. American Journal of Occupational Therapy, 64(5), 709–719.

Radomski, M. V., Anheluk, M., Bartzen, M. P., & Zola, J. (2016). Effectiveness of Interventions to Address Cognitive Impairments and Improve Occupational Performance After Traumatic Brain Injury: A Systematic Review. American Journal of Occupational Therapy, 70(3), 7003180050p1-7003180050p9.

Radomski, M. V., Davidson, L., Voydetich, D., & Erickson, M. W. (2009). Occupational Therapy for Service Members With Mild Traumatic Brain Injury. American Journal of Occupational Therapy, 63(5), 646–655.

Stephens, J. A., Williamson, K.-N. C., & Berryhill, M. E. (2015). Cognitive Rehabilitation After Traumatic Brain Injury: A Reference for Occupational Therapists. OTJR: Occupation, Participation and Health, 35(1), 5–22.

Disclaimer: This article is for informational purposes only. Speak with a medical professional before seeking treatment.

 

Reviewed by Amy Shapiro-Rosenbaum, PhD, Lyndsay Tkach, MA, CBIS, and Michelle Neary, March 2021.

The BrainLine Treatment Hub was created in consultation with TBI and PTSD experts.