Occupational therapy

Occupational therapy supports people whose physical or mental health, environment or social circumstances make it difficult to take part in the activities that matter to them.

An occupational therapist will work with you to identify strengths and difficulties you may have in everyday life. This might include tasks like dressing or getting to the shops. They’ll work with you to find practical solutions.

Techniques and equipment to help you

Your occupational therapist will work with you to find practical solutions that can help you maintain, regain, or improve your independence and participation in daily activities. These solutions might involve changing your environment, or using different techniques and new equipment.

Many different techniques and equipment can be used as part of occupational therapy. Your occupational therapist will recommend techniques and equipment and discuss options.

Using special equipment

Occupational therapists will suggest tools or pieces of equipment you may find helpful, like:

a walking stick, walking frame or wheelchair
electric can openers or electric toothbrushes
knives with large handles and chunky pens
a non-slip mat for the bath
a special keyboard or mouse to help you use a computer
voice-controlled lights
voice-controlled software on a computer
a special comb
a device that turns the pages of a book
two-handled cups, tap turners and kettle tippers
bed raisers and hoists
specialist seating

You should mention any difficulties you have to your occupational therapist. No matter how small they seem, there may be all kinds of adapted equipment that can help.

Equipment cost

If your occupational therapist thinks you need equipment to help you, it can usually be provided free of charge on a long-term loan. However, different local authorities may charge for some pieces of equipment.

Equipment for employment

If you need equipment to help you carry out your work, the Access to Work scheme may be able to provide funding. Contact the disability employment adviser at your local Jobcentre Plus for advice and assistance, or see the GOV.UK website for information about Access to Work.

Buying your own equipment

You may choose to buy your own equipment rather than use the equipment provided by your local council. If you’re going to buy your own equipment, it’s still a good idea to have an assessment by an occupational therapist. They can provide guidance on what equipment is most suitable and advise you on what is available.

Getting equipment on loan

You might need some equipment on a short-term basis – for example, because someone with a disability is visiting you. Your local British Red Cross can often lend you wheelchairs and other equipment for short periods of time.

Adapting your environment

Part of occupational therapy may involve making an environment suitable for your needs. This could be your home, workplace or where you’re studying, and may involve changes such as:

putting in ramps to allow access in a wheelchair
fitting a stairlift
installing grab rails by the stairs or beside the bed
providing a raised toilet seat, bath lift or shower seat
clearing up clutter, reorganising cupboards or providing visual cues so you can safely move around and reach what you need

The cost of adaptations to your house

You may need adaptations made to your house. These changes may be carried out free of charge, but this will depend on your local authority.

Larger, more expensive items and major adaptations may be the responsibility of the housing department. You may also need to contribute towards the cost of these items.

Grants may be available to help with the cost of adaptations. You should contact your local authority to find out if you’re eligible to receive these grants. The amount paid by a grant will depend on your income and outgoings. Visit the GOV.UK website for more information on Disabled Facilities Grants.

Activity grading and graded exposure

Sometimes an occupational therapist may use activity grading to help you take part in an activity.

Activity grading is a way of breaking down an activity into more manageable steps.

For example, if your goal is to walk to work, but it is too far for you to do at once, this can be broken down.

On your first day, you could get the bus most of the way and then walk the last part. Each week, you could get off the bus a stop earlier and increase the distance you walk. The activity becomes increasingly difficult as you gradually reach your goal of walking to work.

As you become more confident with an activity, you can progress to the next stage and eventually reach your goal.

Graded exposure is similar to activity grading but is more focused on dealing with the emotional and psychological element of rehabilitation. It’s used to help gradually build your confidence and establish meaningful routines that you may have otherwise avoided.

Workplace rehabilitation

Workplace rehabilitation, or vocational rehabilitation, means helping someone with a physical or mental health condition return to work or start working. It can also mean helping someone to carry on working. “Work” includes jobs that aren’t paid, such as being a full-time parent or a volunteer.

An occupational therapist can help by:

assessing your workplace
assessing your role at work
assessing your ability to complete work activities, and finding ways to assist you
finding ways to manage your condition while at work
providing additional training
finding a way to cope with problems like discrimination and prejudice
helping your employers manage your return to work and increasing awareness of your condition
monitoring your progress
completing fit notes where appropriate

Leisure rehabilitation

Leisure rehabilitation covers any fun activity, such as your hobbies and social events.

Taking part in leisure activities can stop you feeling isolated because of your condition and improve your quality of life. While you need to be able to care for yourself and work, being able to take part in activities for fun is also important.

An occupational therapist may discuss what activities you enjoy and find practical ways to help you continue those activities.

For example, if you like going out to the shops but find it tiring, an occupational therapist may suggest a wheeled walker with a seat and basket. If you enjoy gardening but find some tasks difficult, an occupational therapist can identify easier ways of carrying out those tasks using different techniques and specially adapted gardening tools

If your mental health impacts your participation in leisure activities, occupational therapists may work with you to improve motivation, concentration and energy levels.

Thinking about activities differently

An occupational therapist will look at the activity you’re finding difficult and see if there’s another way it can be completed.

For example, if you’re finding it difficult to peel and chop vegetables, perhaps you could buy vegetables that are already prepared, or perhaps there’s a small piece of equipment to help with chopping and peeling.

If you’re finding it difficult to walk to your local shop, there may be a bus that runs past your house, or you may be able to do your shopping on the internet.

If you’re finding it difficult to do the ironing, perhaps you could sit down while you iron.

Who can benefit from occupational therapy?

Occupational therapists work with people of all ages, including children. They look at all aspects of daily life, from the home, to school or the workplace.

Occupational therapy is used to treat and manage a wide range of conditions and needs. Some of these conditions include those that:

are present from birth
develop with age
are the result of an accident
are the result of a change in mental wellbeing

Occupational therapy is also used as part of a rehabilitation programme (a treatment programme that helps someone recover from illness or injury), for example after surgery or to treat depression.

Health conditions

Occupational therapy may be used to treat lots of health conditions, for example:

arthritis
depression
multiple sclerosis (MS)
Parkinson’s disease
schizophrenia
dyspraxia (developmental co-ordination disorder)
chronic pain
chronic fatigue syndrome
cerebral palsy
Down’s syndrome
learning disabilities
autism

Ageing

Occupational therapy may be used to address problems that develop as a result of getting older. You may find certain movements are not as easy as they used to be, like getting out of bed in the morning. An occupational therapist can suggest equipment and adaptations to your home, or new techniques that may be helpful.

Occupational therapy also includes providing devices and strategies to help your memory and improve your functions. This can help people living with conditions associated with aging, like dementia and Alzheimer’s disease.

Rehabilitation and recovery from an accident, illness or operation

Rehabilitation aims to improve your ability to carry out the everyday activities that have been affected by illness, injury or surgery.

Occupational therapists are key members of the rehabilitation team. You might see an occupational therapist after an accident, illness or operation to support your recovery and help you regain as much independence as possible. For example, occupational therapy may be used after:

a hip fracture
a severe head injury
a stroke
an addiction
a diagnosis of dementia
experiencing changes to mental wellbeing

Occupational therapy for children

Occupational therapy can help your child in many ways. For example, a therapist may aim to improve your child’s:

hand strength
concentration
social skills
participation in school
sensory skills

To do so, an occupational therapist may develop a game or activity that your child can complete each day. Focusing on a small goal, such as improved hand strength, may eventually help your child to hold a spoon, a pencil or dress themselves.

Occupational therapy and mental health

Occupational therapists can play a key role in the recovery of those with mental health problems. Occupational therapy is an approach that uses activity to promote good mental health and assist recovery. It can help people achieve outcomes that are important to them, like self-care and leisure activities. It can also support working adults and help them keep their jobs during an episode of mental illness.

Occupational therapy for mental health should be activity focused. It aims to establish daily routines that are health promoting. It will also support individuals to develop the skills and techniques needed to participate in everyday life.

How to access occupational therapy?

How you access occupational therapy depends on your condition and where you live.

Short-term conditions

A short-term condition is one that’s likely to improve with time, such as recovery after an operation.

If you require occupational therapy because of a short-term condition speak to one of the health care professionals working with you. They can discuss an onward referral to occupational therapy.

At your assessment, your occupational therapist will discuss if you need any equipment or training. It may be provided free of charge by the NHS, but this does depend on what is available from your local Health and Social Care Partnership (HSCP).

Long-term conditions

A long-term condition is one that is not likely to improve with time, such as a permanent disability.

If you’ve a long-term condition affecting your ability to carry out everyday activities, you may be able to access occupational therapy through your local Health and Social Care Partnership (HSCP). They may work with local NHS providers, local authorities and other organisations.

You can contact occupational therapy services for an assessment via your local authority, or you can be referred for an assessment by:

your GP or consultant (specialist doctor)
a nurse
another healthcare professional
a social care professional

You can search for your local authority on the GOV.UK website.

Local authorities have eligibility criteria they use to decide if someone can receive social care services such as occupational therapy. These criteria are based on legislation called the Care and Support (Eligibility Criteria) Regulations 2014.

Each local authority may have slightly different criteria, but all should include the following points:

You need help because you have a physical or mental impairment or illness.
As a result of this impairment or illness you’re unable to carry out necessary tasks, such as washing yourself, getting dressed or going to the toilet.
Being unable to complete these necessary tasks has had a negative impact on your health and wellbeing.

Private occupational therapy

If you don’t want to access occupational therapy through the NHS or your local authority, you can contact an occupational therapist directly. If you decide to see a private occupational therapist, make sure they’re fully qualified and a member of a recognised body, such as the Royal College of Occupational Therapists (RCOT).

Only healthcare professionals registered with the Health and Care Professions Council (HCPC) are allowed to use the title of “occupational therapist”. You can see if your occupational therapist is registered by checking the HCPC online register.

Further advice

RiDC is a consumer research charity that produces information for disabled and older consumers. All reports are based on independent research carried out by Rica. This includes user trials, technical tests and survey work.

Help is also available from the Disabled Living Foundation. This national charity provides free, impartial advice about all types of home adaptation and the different mobility products available for disabled adults, disabled children, and older people.