Patan Academy of Health Sciences

School of Nursing and Midwifery

Lalitpur Nursing Campus
Sanepa, Lalitpur

Presentation on
Occupational therapy

Submitted to: Submitted by:

Respected Madam, Isha Bhusal
Professor MN 1st year
Khagi Maya Pun Roll no. 18
 Unit 13: Psychosocial rehabilitation of psychiatric patients
 Types of rehabilitation:
 Vocational rehabilitation
 Occupational therapy

PRE-TEST
1. The occupational therapy for Mental Retardation children will most likely focus on:
 Kitchen tasks
 Packaging goods
 Metal works
 Solving puzzles

2. The aim of occupational therapy is to:

 Provide job to mentally ill patients.
 Facilitate rehabilitation with return of self-confidence.
 Make them work in rehabilitation center.
 Challenge patient by increasing complexity of works.

Introduction
Occupational therapy is a rehabilitation process. Occupational therapy interventions focus on
adapting the environment, modifying the task, teaching the skill, and educating the
client/family in order to increase participation in and performance of daily activities.

History
The belief in purposeful activity as therapy has roots in the earliest civilizations (Egyptians,
Romans and Greeks). The formal birth of occupational therapy occurred when Adolf Meyer
emphasized a critical balance of work, play and rest, which can be achieved through
organized, graded, purposeful activities involving on self-care, acceptable social behavior
and work skills.

Definition
 Occupational therapy is the application of goal oriented, purposeful activity in the assessment
and treatment of individuals with psychological, physical or developmental disabilities.
 It is the use of treatments to develop, recover, or maintain the daily living and work skills of
people with a physical, mental or developmental condition.
 Occupational therapy is a holistic and client-centered program with the aim of promoting
health and well-being through occupation. Occupation therapy interventions focus on
adapting the environment, modifying the task, teaching the skill, and educating the
client/family in order to increase participation in and performance of daily activities,
particularly those that are meaningful to the client.
 Main goal
 To provide skill based on the knowledge of his personality, background habits, psychological
problem and the diagnosis.

Aims:
 Promotion of recovery.
 Mobilization of total assets of the patient.
 Prevention of hospitalization.
 Creation of good habits of work and leisure.
 Rehabilitation with return of self-confidence.

Principles of Occupational Therapy:

 Select the activities based on interest IQ levels strengths and abilities of the client.
 Utilizes the client’s available resources.
 Select short duration activities to foster a sense of accomplishment and enhance self-
confidence.
 Provide good reinforcement for even small achievements.
 Plan and select activities that gives new experience for the client to meet the day to day
activities.

Indications:
 Depression
 Chronic schizophrenia
 Anxiety disorder
 Manic disorder
 Paranoid schizophrenias
 Catatonic schizophrenia
 Antisocial Personality
 Dementia
 Substance abuse
 Childhood Psychiatric disorders

Services:
 Independent living skills-self-care or self-maintenance.
 Task oriented treatment using creative expressive modalities, crafts, education, leisure time
play, socialization and other role related activities.
 Prevocational and work adjustment program-employment and academic preparation, home
making, child care or parenting.

 Sensory-motor including neuromuscular and sensory integrative assessment and treatment.

 Design fabrication and application of orthotic devices.
 Therapeutic exercise to enhance functional performance.
 Discharge planning and community reentry.
 Patient and family education and counseling.

Centers
The service is provided to children, adolescents, adults and elderly patients. These programs are
offered in:
 psychiatric hospitals,
 Nursing homes,
 Psychosocial and physical rehabilitation centers,
 special schools,
 group homes,
 Community mental health centers,
 Daycare centers,
 Home health agencies
 Sheltered workshops or clinics
 Industry and business establishments

Process of intervention
The process consists of 6 stages-
1. Initial evaluation- patient’s ability to do certain tasks in a variety of situations over a period
of time.
2. Setting immediate and long term goals- together by the patient and therapist.
3. Development of therapy plan- planning intervention.
4. Implementation of the plan and monitoring the progress.
5. Review meetings with patients and the team involved.
6. Setting further goals- when immediate goals have been achieved, modifying the treatment
program as relevant.

Precautions for occupational therapy:

 The initial act and the goal must not be too far from each other i.e. the patient should be
able to complete the work within a reasonable time.
 The work must be within the capacity of the patient but not so easy that interest is not
evoked.
  The work should be progressive in skills, difficulty and complexity so that the patient can
obtain a feeling of success and continued progress.

 The standard of the expected performance must be based on the capacity of the individual
patient.
 Encouragement (not criticism) should be used.

Types of activities
1. Diversional activities: These activities are used to divert one’s thoughts from life stresses or
to occupy time. E.g., organized games.
2. Therapeutic activities: These activities are used to attain specific care plan or goal. For e.g.,
basket making, carpentry, etc.

Advantages
 It maintains the normal habits of work.
 It stimulates interest.
 It aids focusing of attention and integration.
 It provides an incentive and a goal.
 It directs the patient’s energies to work.
 It diverts the patient’s attention from himself on to other things.
 It may teach the patient a new skill or hobby.
 It enables the patient to have a feeling of achievement when he completes the task.
 It enables a patient’s self-esteem as he feels doing something useful.
 It aids products of positive attitudes and helps ‘decision-making’ capacity.

Suggested Occupational Activities for

Psychiatric Disorders
1. Anxiety disorder: Simple concrete tasks with no more than 3 or 4 steps that can be learnt
quickly. For example, kitchen tasks, washing, sweeping, mopping, mowing lawn and
weeding gardens.
2. Depressive disorder: Simple concrete tasks which are achievable; it is important for the client
to experience success. Provide positive reinforcement after each achievement. For example,
crafts, mowing lawn, weeding gardens.
3. Manic disorder: Non-competitive activities that allow the use of energy and expression of
feelings. Activities should be limited and changed frequently. Client needs to work in an area
away from distractions. For example, raking grass, sweeping, etc.
4. Schizophrenia (paranoid):Non-competitive, solitary meaningful tasks that require some
degree of concentration so that less time is available to focus on delusions. For example,
puzzles, scrabble.
5. Schizophrenia (catatonic): Simple concrete tasks in which client is actively involved. Client
needs continuous supervision, and at first works best on a one-to-one basis. For example,
metal work, molding clay, etc.
6. Antisocial personality: Activities that enhance self-esteem and are expressive and creative,
but not too complicated. Client needs supervision to make sure each task is completed. For
eg. Leather work, painting, etc.
7. Dementia: Group activities to increase feeling of belonging and self-worth. Provide those
activities which promote familiar individual hobbies. Activities need to be structured,
requiring little time for completion and not much concentration. Explain and demonstrate
each task, then have client repeat the demonstration. For e.g. cover making, packing goods,
etc.
8. Substance abuse: Group activities in which client uses his talents. For example, involving
client in planning social activities, encouraging interaction with others, etc.
9. Childhood and adolescent disorders
Children: Playing, story telling, painting, poetry, music, etc.
Adolescents: Creative activities such as leather work, drawing, painting.
Mental retardation Repetitive work assignments are ideal; provide positive reinforcement
after each achievement. For example, cover making, candle making, packaging goods, etc.

References
 Reddemma S. A guide to mental health and psychiatric nursing. 4 th ed. New Delhi: Jaypee
Brothers: Medical Publishers (P) Ltd, 2018. 163-65pp.
 Bhatia MS. Essentials of psychiatry. 6th ed. New Delhi: CBS Publishers & distributors Pvt.
Ltd. 2010.723-24 pp.
 Sharma C, Sharma P. Essentials of Psychiatric & Mental health 3 rd ed. Kathmandu: Saurav &
Awish publishers, 2019.391-93pp.
 WebMD. What Is Occupational Therapy?.2021. |Weblink|

POST-TEST
1. The occupational therapy for Mental Retardation children will most likely focus on:
 Kitchen tasks
 Packaging goods
 Metal works
 Solving puzzles
Answer: b. Packaging goods

2. The aim of occupational therapy is to:

 Provide job to mentally ill patients.
 Facilitate rehabilitation with return of self-confidence.
 Make them work in rehabilitation center.
 Challenge patient by increasing complexity of works.
Answer: b. Facilitate rehabilitation with return of self-confidence.