Occupational Therapy (OT) is a big, broad field that often is not understood by clients as well as the health care providers that recommend the service. Often times if you have met an occupational therapist as a client or as a caregiver to a family member, you have only learned a small part of what we typically do. Each population that accesses OT will experience different goals, strategies and outcomes as we cover a huge range of support.
Occupational therapy revolves around engagement and participation in meaningful activities (aka the jargon-y buzzword “occupations”). These meaningful activities are anything that you need to do, want to do or are expected to do in your life, from attending school, working your job to bathing, eating, playing sports etc. Check out the linked post below I have written to explore occupation a bit more 🙂
In the past few months of practice, my colleague/friend and I have been discussing our particular “brand” of OT and how we support our clients. Both her and I work with neurodiverse individuals, she specifically works with kids and teens with Pathological Demand Avoidance/Pervasive Drive for Autonomy (PDA – I have a post about this if you are curious, https://beyourownsunshinee.ca/2025/03/22/i-wonder-if-youre-curious-about-pathological-demand-avoidance/) and I work with autistic folks, majority of who have alternative communication needs and experience high anxiety and higher needs. When reflecting on the learning we received in school around SMART goals and progress in sessions, we realized that often times our role looks very different with our population vs what we expected from school. This conversation really changed my outlook on my role and I wanted to share this with you
In my role with my clients, often times I am working on specific activities, but my approach is less traditional where I am focused on building specific skills. Often times my clients experience the most challenge in taking down the barriers to their participation before even making it to the activity skill itself.
In our conversation, my friend and I reflected on our role as capacity builders over skill builders. What does this mean? I’ll give an example of reframing goals in this way –
Goal setting scenario
The mom of one of my clients wants him to work on typing so he can access learning at school as we have agreed after observation that handwriting is not functional for him. He does not want to pick up a pencil and when he does it’s for a very short amount of time. With the amount of practice that would be required to improve his handwriting, it won’t be functional to focus on handwriting to allow him to succeed at school. Mom is advocating for a computer at school, so she wants him to learn to type. From my observations of this client, he often jumps right to “help me help me” when he is asked to do something. This could be interpretted as laziness, but from my observation it seems like a bit of learned helplessness, lack of confidence and fear of lack of skill. So in our sessions together, we aren’t doing typing lessons like you would imagine in elementary school (if you’re much younger than me maybe I’m aging myself with that statement!). Instead, I use his interest of specific Youtube videos and try to encourage him to help me type in the search bar for what he wants. This is much slower of a process than you may imagine as he does not have the capacity yet to type. We go back and forth taking turns typing the words in the 5 word phrase and often he uses my finger and directs it to the keys. I provide a lot of affirmations, celebrations and prompting to “scan the keyboard” and “use your eyes!”. After weeks of this he finally typed the whole phrase, still using my finger. This is an increase in his confidence and trust that he is able to do this. Of course he is not ready to be independent in the classroom with a computer, but he and I are building his capacity to engage with a computer in the future. Building his confidence in knowing he can do things that are hard or intimidating, that he can ask for help and that he can enjoy things he loves easier if he knows how to type! This confidence then becomes capacity building for other activities he loves as well like cutting out pictures of his favourite animals and colouring.
Another example of capacity building is in the area of mental health. In a mental health session where you are talking about challenges for an hour or so and then don’t see your client for a period of time, you are building their capacity to help themselves. One of my clients started her sessions wanting to only rant and complain about her mental health, and after working so long on problem solving, perspective taking and strategy building together within our sessions, she is now taking on more of the lead in these things. Now SHE has more of the capacity to problem solve on her own, so she is leading the conversations and seeking more of my confirmation that she is on the right track.
Discussing with my friend about this, we talked about how this should be the overall goal for complex areas of learning for clients. There is known proverb “Give a man a fish, and you feed him for a day; teach a man to fish, and you feed him for a lifetime” – I think this is a great reflection on how OT can really become a capacity building role. By working on deeper areas of growth like confidence building, emotional and sensory regulation, problem solving, perspective taking, etc, we can start our clients on the path to building their capacity for engagement in activities and pursuing new activities! With my client who is now leading more of the conversation in our sessions, she is also taking on more trial of new things (leisure activities, taking on new responsibilities etc) on her own and sharing them with me with pride! This will forever be my goal as an OT moving forward, as it gives empowerment to your client and shows them that they are the expert of their lives and are able to be supported to live the way they want to live as best as possible
What do you think about this approach to therapy? Do you practice this way if you are an OT? If you are a client do you think this is a helpful mindset for your therapist? 🙂
Be Your Own Sunshine 
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