What is occupational therapy?

Occupational therapy may be used for the following diseases or disabilities:

• Medical conditions affecting the brain (such as dementia, stroke, parkinson’s disease, traumatic brain injury, multiple sclerosis)
• Paralysis (following a spine injury, for example)
• Mental illness (such as depression, an anxiety disorder or schizophrenia)
• Muscle, joint or skeletal problems (such as rheumatoid arthritis, osteoarthritis or a broken bone)
• Amputations, prostheses
• Developmental disorders – for instance, related to motor (movement) disorders, autism or mental and physical disabilities

The goal of occupational therapy is to improve the skills that are needed to live life as independently as possible. This includes being able to take care of yourself and to work, for example – as well as being able to leave your home and meet other people.

Occupational therapy can help you to cope with a (new) mental or physical limitation and manage better in everyday life. This can improve your quality of life and health. Family members can also get useful tips and advice from an occupational therapist.

Depending on the type of limitation and your personal circumstances, occupational therapy may include the following:

• Re-training of everyday skills (getting dressed, preparing food, managing the household)
• Learning and practicing skills for school, work or free time
• Movement and perception exercises
• Concentration and memory exercises
• Manual and creative exercises
• Help in structuring your daily routine
• Modification of your home or workplace
• Using medical aids such as a walker or prosthesis
• Advice and, if needed, guidance for family members

The treatment goals are planned together with the therapist as much as possible, and the progress is also monitored together. For occupational therapy to succeed, you need to actively participate and use the techniques that you have learned in everyday situations as often as possible. Here are two examples of what occupational therapy might involve:

Carl was paralyzed on one side after a stroke and it was difficult for him to speak. He has already made major progress with physical therapy and speech therapy – but he can’t use his right arm like he could before and he is very unsteady on his feet. So he needs to use a walker.

His occupational therapist shows him how to use the walker and helps him to practice moving around with it. To help him grasp things better with his right hand and manage better in everyday life, she helps him to practice things like brushing his teeth and writing. He also learns various arm and hand exercises. His occupational therapist helps him and his wife to make changes to their apartment so that he can safely move around in it with his walker.

Mary has schizophrenia. This affects her motivation and she has a lot of trouble focusing on things. It’s difficult for her to organize and manage her daily routine. She quickly feels overwhelmed and is very insecure when dealing with other people.
With the support of her occupational therapist, she does concentration exercises. Manual and creative exercises help her to practice planning the different steps of a task and carrying out simple activities. She learns to set realistic goals for each day – like doing the shopping and cooking, for instance.

Occupational therapy is offered in:

• Hospitals
• Rehabilitative care centers
• Occupational therapy practices
• Outpatient clinics
• Nursing homes
• Early intervention centers
• Occupational therapy practices also offer home visits.

Note: The procedures and requirements for applying for and receiving occupational therapy may vary between countries. This information describes the current situation in Germany.

Occupational therapy is often part of a treatment plan at a hospital. It is then done in the hospital. To have outpatient treatment at an occupational therapy practice or in a home setting, you need a prescription from a doctor. You will need to pay a basic fee of 10 euros per prescription plus 10% of the treatment costs. If one treatment session costs 35 euros, for example, for ten sessions you would have to pay 45 euros (the basic fee of 10 euros plus 10 x 3.50 euros). These costs do not have to be paid for children.

For the medical conditions listed above, prescribed occupational therapy is often covered by statutory health insurers (apart from the above-mentioned costs you have to pay yourself). In rehabilitative care, an accident insurer or pension fund will cover the costs.

But occupational therapists may suggest treatments that you would have to pay for completely yourself. In Germany, these are known as individual health care services (individuelle Gesundheitsleistungen, or IGeL for short).

An initial prescription will typically include 10 sessions lasting 30 to 60 minutes each. Appointments are usually offered one to three times per week.

The German Association of Occupational Therapists (DVE)offers a search function on their website (in German) to look for occupational therapists in your area.