Occupational Therapy and Trauma-Informed Care

Occupational Therapy and Trauma-Informed Care. Getty Images

For over a century, occupational therapists have been involved in mental health care. Occupational therapists bring a unique knowledge integration of physical, sensory, emotional and cognitive function, as well as a holistic attention to a person’s roles and their environment.

This combination of expertise has poised occupational therapists to take a unique role in facilitating trauma-informed care in the mental health care facilities and programs they work in.

Trauma-informed care has only gained prominence in the national mental health conversation since the 1990s, but OTs have been quick to recognize its potential in improving mental health care.

This article highlights some of the exciting work OTs have been doing in integrating trauma-informed care into their practices.

Seclusion and Restraint Reduction in Massachusetts

By far the most compelling advances in occupational therapy and trauma-informed care has happened in Massachusetts.

Massachusetts became an early leader in its efforts to reduce seclusion and restraint incidents. The state achieved this through an incorporation of Trauma Informed Care, The Recovery Model, and Sensory Approaches.

According to the report, Integrating Sensory and Trauma-Informed Interventions: A Massachusetts State Initiative, Part 1 and 2, since the inception of a statewide initiative, Massachusetts has reduced the use of restraint and seclusion by more than 87 percent in child and adolescent inpatient programs and approximately 60 percent in adult state hospitals.

The estimated cost savings of this reduction in Massachusetts between fiscal years 2000 and 2003 in adolescent inpatient services was $1,446,740. For the Massachusetts DMH long-term-care facilities from 1999-2008 it is estimated that there was a savings of more than $10 million in redirected staff time and resources.

What did occupational therapy have to do with this? A dedicated group of occupational therapists spearheaded the sensory interventions dimension of this initiative. Occupational therapists, Tina Champagne, Jean MacLachlan, and Karen Moore, provided statewide teaching, supported curriculum development, helped to create sensory-based crisis planning tools, and help spearhead a sensory modulation train-the-trainer initiative

The article also states: “To date, many occupational therapists are taking a leadership role in the direct delivery of sensory approaches as part of the occupational therapy services offered to mental health consumers as well as serving as consultants, advocates, and educators.”

OT’s Role in a Community Based Traumatic Stress Program

A column released by The Canadian Association of Occupational Therapists, Trauma Informed Practice: An emerging role of occupational therapy, highlights how OTs are integrating trauma-informed care into their community-based mental health groups.

The article highlights how the Canadian Model of Occupational Therapy Engagement, a common model used by occupational therapists, can be used in congruence with The Triphasic trauma model of practice.

In the featured program, occupational therapists work with clients who have undergone trauma to assess what areas of their life have been compromised by trauma and use this information to formulate goals for the program. In the last state of the program, occupational therapists work with clients to reshape their identity by engaging in health activities and health relationships.

OT’s Role in Childhood Trauma

The American Occupational Therapy Association released a guide of ways occupational therapists can be active team members in addressing childhood trauma.

Children who have experienced developmental trauma present with significantly higher levels of functional impairments and overall disregulation. Occupational therapists can be involved in their care in the home, school, and community settings.

Occupational therapists can work with the children to structure safe environments, teach cognitive strategies, and develop social and emotional skills.

The article also highlights that OTs with specialized training in sensory based intervention may offer trauma-informed sensory regulation interventions and be equipped to teach mindfulness strategies.

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