How Occupational Therapy Advances Mental Health and Substance Use Recovery: Dr. Sarah Anderson

Occupational Therapy’s Role in Mental Health 

OT in mental health focuses on helping individuals participate in activities that give their lives meaning and structure. For individuals experiencing mental illness and/or substance use disorders, it can be challenging to maintain daily routines or manage the demands of work, school, and relationships. OTPs help clients identify activities that are important to them and develop strategies to overcome barriers that prevent participation⁵. 

Before working with a client an occupational therapist will evaluate a client’s current abilities to perform a variety of daily activities and work with them to set realistic and achievable goals. These goals often focus on improving self-care, building coping strategies, addressing sensory processing challenges, developing executive function, enhancing social skills, and establishing routines. For example, a client struggling with depression may find it difficult to get out of bed in the morning or prepare meals. An OTP can help by working with the client² to develop a morning routine, break tasks into smaller steps, and use strategies to overcome fatigue or lack of motivation.

OTPs also focus on helping clients develop coping mechanisms to manage symptoms related to mental illness. For individuals with anxiety, this may involve teaching relaxation techniques or helping them use sensory-based strategies to reduce stress and dysregulation. For people with ADHD, it may include creating structure and organizational strategies to help them stay on track with tasks. 

It’s important to know that OT doesn’t stop at skill building; one of the core focuses of the profession is ensuring integration of learned skills into daily life. It’s not just about teaching and having clients practice skills in therapy; it’s about helping them take the skills and apply them in real time. The ultimate goal of OT is to help clients build and implement the skills they need to lead fulfilling, balanced lives.

Working with Clients in Substance Use Settings

Substance use disorders often co-occur with other mental health conditions such as trauma, anxiety, depression, and ADHD. OT can play a vital role in helping individuals with substance use disorders rebuild their lives⁵ by focusing on establishing healthy routines, improving self-care, and finding new ways to experience joy and fulfillment without the use of substances.

One of the key ways in which OTPs help individuals in substance use treatment is through exploration and development of leisure skills⁵. Clients with substance use disorder often lose the ability to engage in healthy, fulfilling leisure activities. Additionally, boredom is frequently reported as a significant trigger for relapse⁶ as it can lead to feelings of restlessness, isolation, and frustration. These are feelings that many people seek to reduce through the use of substances. 

Additionally, OTPs help clients in substance use recovery develop practical skills⁵ for daily life in recovery. This includes managing finances, preparing meals, finding and maintaining employment, and self-care. For many people in recovery, these are areas that are often neglected during substance use, and relearning how to manage them can be overwhelming. OTPs work with clients to break these tasks into manageable steps, build confidence, and develop the skills needed to maintain independence.  

In substance use recovery, OT empowers clients to explore new hobbies, interests, and activities that bring joy and meaning to their lives. By nurturing independent living skills and establishing structured routines, OT not only promotes a journey of healing but also lays a foundation for long-term recovery.

A Brief Overview of Mental Health Occupational Therapy Interventions 

OT interventions vary depending on the specific mental health condition a person is experiencing. For individuals with anxiety disorders or those who have experienced trauma, interventions might include developing coping strategies to manage symptoms⁷, such as deep breathing, progressive muscle relaxation, or sensory modulation techniques. If a client were experiencing depression and struggled to engage in self-care tasks, an OT would likely focus on establishing a daily routine², setting small, achievable goals, and finding ways to increase motivation and energy. Clients with ADHD require an approach that focuses on creating organizational systems, such as using a planner, breaking tasks down into manageable steps, and using visual supports, like a timer, to stay on track. 

Additionally, OTPs are specially trained to assess and address sensory processing challenges, which are common among people with mental health conditions like anxiety, ADHD, OCD, bipolar disorder, SUD, and trauma. This is one of the most unique aspects of the profession. Sensory processing refers to how the nervous system receives and organizes sensory information⁸ from the environment so that individuals can respond appropriately. 

Dunn’s Sensory Processing Model helps occupational therapists understand a person’s unique sensory preferences by categorizing these preferences into four patterns: Sensory Sensitivity, Sensation Avoiding, Sensation Seeking, and Low Registration. Someone with sensory sensitivity patterns will likely become more easily overwhelmed with stimuli⁹ such as bright lights or loud sounds, which can lead to feelings of anxiety or agitation. In contrast, someone who has sensation seeking patterns will crave more intense input, such as jumping, pushing, or spinning, to feel calm and focused. 

By identifying a client’s sensory profile, occupational therapists can tailor interventions to support their nervous system needs so that they are more regulated and able to engage in their daily life (Pfeiffer et al., 2018). 

Summary

OT plays an essential role in the recovery journey for those with mental health disorders and substance use issues. While the profession may not be as well-known in mental health settings as other types of therapy, its unique focus on helping people engage in daily life makes it an essential part of the recovery process. Whether working on establishing a morning routine, building coping strategies, or developing new leisure skills, OTPs help clients regain a sense of purpose, independence, and fulfillment in their daily lives.