Many people assume occupational therapists work in hospitals and nursing facilities along with many other healthcare professionals who physically rehabilitate patients. However, occupational therapists are also found in any setting where psychiatric patients are seen. Mental health occupational therapists work in a variety of outpatient and supported living settings. One of the most common psychiatric settings where these practitioners are found is mental health units in hospitals.
While any job as an occupational therapist brings a fair amount of variety, this is especially true for a mental health occupational therapist.
The day of a mental health occupational therapist typically starts by attending a morning meeting. Doctors, nurses, counselors, social workers, and therapists review each patient on the unit. This allows each professional to collectively share a patient’s therapeutic progress, interpersonal relations, medical status, psychiatric status, and other pertinent changes to their condition. These changes may include incidents such as self-harm, violence, or altercations which may have occurred since the last working day. Professionals will also share updates regarding discharge and a review of newly admitted patients. This gives each professional the information they need before starting the day and beginning patient interactions.
The next step is patient chart reviews, which provide a detailed look at the progress and status of each patient. This also allows the therapist to check in with the goals on each patient’s treatment plan and receive a snapshot of their condition to inform note-taking and daily interactions.
Once the therapist is up-to-date, they can begin patient treatments. The main goal of a mental health occupational therapist is to assist the rest of the healthcare team in stabilizing a patient’s mood and behaviors. The main way in which mental health occupational therapists do this is through group therapy sessions.
Patient populations change over time with discharges and new patient admissions. Thus, the content covered in these groups also changes to meet these needs. This is where a mental health occupational therapist most uses their clinical reasoning, judgment, and adaptive thinking skills.
Educational group therapy sessions focus on a variety of recovery and wellness-based topics including:
- Life skills
- Coping strategies
- Relaxation and stress reduction skills
- Emotional regulation such as anger management
- Symptom management
- Medication management
- Communication skills
- Disease education
These groups are typically small. Small groups allow a therapist to spend time ensuring that each patient is participating and understanding the content being reviewed.
In addition to educational group therapy sessions, occupational therapists may hold activity-based groups. Activity-based groups provide subtle ways to address areas such as communication, emotional regulation, behavior management, and life skills. These groups may directly focus on purposeful leisure including crafts, yoga, exercise, gardening, reading, and writing. They may also address employment by practicing job simulations and skills-based tasks.
Group therapy is often followed by and supplemented with individual therapy sessions. While individual sessions are more common for psychologists or licensed mental health counselors for the purposes of direct counseling, there are instances where a mental health occupational therapist will use individual sessions to achieve a patient’s goals.
These are needed if a patient is behaviorally unable to attend group therapy sessions for the safety of other patients. Individual sessions may also be a necessity due to a medical condition with isolation or contact precautions which prevent a patient from being in any group environment. Individual sessions often work best for benefit patients who need more focused work on life skills or job simulations. Occupational therapists in this setting may also practice activities of daily living (ADLs) with patients who also experience physical impairments due to a medical condition.
In such instances, a mental health occupational therapist must develop a plan specifically for those individual sessions. Typically, the occupational therapist creates this plan along with other documentation at the end of the work day.
Documentation includes daily notes describing patient participation in group and/or individual sessions and progress notes indicating patient improvement or incidents preventing goal achievement. Occupational therapists also write lengthier evaluation and discharge notes to discuss goals specific to patient needs and behavioral presentation.
Another important piece of documentation mental health occupational therapists may spend time developing is a group proposal. The occupational therapist drafts a group proposal prior to beginning a new group. The proposal requests required supplies and space to complete the group sessions along with detailing the objectives of the group, number of patients, and skills to address.
Documentation in mental health settings is not as detailed or structured as occupational therapy documentation in other settings such as nursing facilities and home health care. This allows for more freedom to add pertinent notes to documents as they occur and to incorporate therapeutic progress in any document as the therapist sees fit.
Mental health settings are where the field of occupational therapy began. However, this is just one of the places where occupational therapists work to improve the function of their patients. Most mental health settings house patients who have a range of diagnoses, presenting problems, and co-occurring medical problems which can make a mental health occupational therapist’s day both exciting and rewarding while allowing for ample experience in the field.