Occupational therapy

Also called OT, Occupational therapist

The profession that works on what somebody actually needs to do, rather than on the body part. Badly named and consistently under-referred.

What it is

Occupational therapists work on occupation in its old sense: everything a person needs and wants to do. Washing, dressing, cooking, working, getting out, being a parent.

The name is the reason they are under-used. People assume it is about jobs, or confuse it with physiotherapy. Physiotherapy is largely about the body's capacity; occupational therapy is about the fit between a person, a task and an environment, and it changes any of the three.

That includes equipment and home adaptation, but the good work is usually less visible: breaking a task down, changing the order, changing the timing, teaching fatigue management, or adjusting a workplace so somebody keeps their job.

They work across the whole of this library. After stroke and brain injury; in dementia; with autism and sensory processing differences; in ME/CFS and long COVID where pacing is the treatment; in rheumatoid arthritis for joint protection; and in mental health, where getting a day back into shape is the intervention.

Signs you might notice

Signs an occupational therapist is the right ask: struggling to wash or dress, using the stairs unsafely, no longer cooking, repeated falls, a person doing less and less at home, or a carer doing more and more.

At work: unable to keep going through a shift, needing adjustments nobody has assessed, or a phased return that has not been planned.

In children: difficulty with handwriting, dressing, cutlery, or being overwhelmed by noise, texture and light.

Sitting or lying in one position, pain from a chair or bed that does not fit, or pressure areas beginning. See pressure ulcers.

How it can affect day-to-day life

The wait for an assessment is often long, and the wait for the equipment afterwards is often longer, which is why asking early matters more than asking precisely.

Equipment delivered without teaching gets abandoned. A frame that arrives with nobody showing how to turn with it becomes a clothes horse.

Some of the highest-value work is refusing equipment. Where a task can be relearned or restructured, that is better than a device, because it gives the person the doing back rather than a workaround.

Social care and health each employ occupational therapists and they do different things. Adaptations and daily living usually come from the local authority; rehabilitation after illness usually comes from the NHS. Being sent between the two is common and worth naming.

Supporting someone well

Ask for an occupational therapy assessment by name, through the GP for health needs and through adult social care for home and daily living.

Describe the task, not the diagnosis. "Cannot get out of the bath alone and has stopped washing" gets a better response than "has arthritis".

Ask for teaching with any equipment, and ask for a review a few weeks later.

For work, ask about Access to Work as well as an occupational health referral; they fund adaptations employers often will not.

For a child, ask the school what they have already tried, and ask for the OT's advice in writing so it survives a change of teacher.

Take photographs of the doorways, the bathroom and the stairs to the assessment. It saves a visit.

Where to get help

Adult social care at the local council for daily living and home adaptations; most accept self-referral.

A GP practice or hospital team for rehabilitation after illness or injury.

Royal College of Occupational Therapists publish practical advice and hold a directory of independent practitioners.

Health and Care Professions Council register for checking anybody's credentials.