The Domain & Process in Occupational Therapy

Image from: American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010. https://doi.org/10.5014/ajot.2020.74S2001

The domain and process of occupational therapy is the overarching goal of the profession, “achieving health, well-being, and participation in life through engagement in occupation” (AOTA, 2020).

The domain describes what occupational therapy practitioners are “in charge of” and what they make decisions about. The domain is based on the profession’s knowledge of the client.

The domain of occupational therapy includes:

• Occupations (e.g., activities of daily living, rest and sleep, work, and education)

• Contexts (i.e., environmental and personal factors)

• Performance patterns (i.e., habits, routines, roles, and rituals)

• Performance skills (i.e., motor skills, process skills, and social interaction skills)

• Client factors (i.e., values, beliefs, spirituality, body functions and body structures) (AOTA, 2020).

The process describes the actions when providing services. The process is always client-centered, focuses on function, and used to provide intervention and services to persons, groups, and populations.

The process has three distinct parts: Evaluation, Intervention, and Outcomes.

Important features of the process include:

• Service delivery approaches

• Practice within various settings

• Therapeutic use of self

• Clinical and professional reasoning

• Occupational and activity analysis (AOTA, 2020).

Reference

American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010. https://doi.org/10.5014/ajot.2020.74S2001

Integrative Health in Occupational Therapy

What is Integrative Health?

• Healthcare can be categorized into two primary types: conventional biomedical healthcare, which adheres to the principles of Western medicine, and integrative healthcare, which adopts a holistic approach.

• In May 2001, the terminology shifted from "complementary and alternative" to "integrative" to highlight the importance of collaboration over competition (Kearney et al., 2007, p. 2).

Definitions of “Integrative Health”

• Integrative health refers to the combination of conventional medical care with complementary and alternative medicine (CAM), as well as behavioral and lifestyle medicine (Jonas & Rosenbaum, 2021).

• In the context of occupational therapy, integrative health employs holistic practices to meet patients at their current state, thereby utilizing a client-centered approach.

How is Integrative Health used in Occupational Therapy?

• (AOTA) recognizes integrative health approaches as effective treatment methods for occupational therapy practitioners (Graham & Plummer, 2018).

• According to AOTA, an occupational therapy practitioner can use integrative health approaches as a preparatory method/ technique or purposeful activity when providing occupational therapy services (Graham & Plummer, 2018).

• Integrative health approaches in occupational therapy involve blending conventional therapy techniques with complementary and holistic methods to address the physical, emotional, mental, and spiritual well-being of clients. This multidimensional approach aligns with the profession’s focus on promoting health, function, and participation in meaningful activities. Below are examples of integrative health approaches used in occupational therapy:

• Yoga Therapy: Incorporating adaptive yoga to improve flexibility, strength, and mental focus.

• Meditation and Mindfulness: Teaching mindfulness practices to reduce stress, improve emotional regulation, and enhance focus.

• Breathwork: Guiding clients in breathing techniques to manage anxiety, improve pulmonary function, or enhance relaxation.

• Stress Management: Addressing lifestyle changes to reduce stress, including ergonomics and time management strategies.

• Tai Chi: Incorporating gentle movement practices to improve balance, strength, and mindfulness.

• Yoga Therapy

Why It Matters in Occupational Therapy

Integrative health approaches align with the client-centered philosophy of occupational therapy by addressing not just specific impairments but the whole person. These approaches are particularly beneficial for:

• Clients with chronic pain or stress-related conditions.

• Those seeking non-pharmacological interventions.

• Populations interested in improving overall quality of life through sustainable and personalized strategies.

By integrating conventional and holistic practices, occupational therapists can provide comprehensive care that encourages resilience, self-efficacy, and engagement in meaningful life roles.

References

Graham , J., & Plummer , T. (2018, June 20). Perceptions of occupational therapists and yoga practitioners of the effects of yoga on health and wellness. SLACK Journals . https://journals.healio.com/doi/full/10.3928/24761222-20180620-01

Jonas, W. B., & Rosenbaum, E. (2021). The Case for Whole-Person Integrative Care. Medicina (Kaunas, Lithuania), 57(7), 677. https://doi.org/10.3390/medicina57070677

Kearney, G., Cioppa-Mosca, J., Peterson, M. G., & MacKenzie, C. R. (2007). Physical therapy and complementary and alternative medicine: an educational tool for enhancing integration. HSS journal : the musculoskeletal journal of Hospital for Special Surgery, 3(2), 198–201. https://doi.org/10.1007/s11420-007-9055-2

Lawrence, M., Celestino Junior, F. T., Matozinho, H. H., Govan, L., Booth, J., & Beecher, J. (2017). Yoga for stroke rehabilitation. The Cochrane database of systematic reviews, 12(12), CD011483. https://doi.org/10.1002/14651858.CD011483.pub2

Schmid, A., Van Puymbroeck. (2019). Yoga therapy for stroke. A handbook for yoga therapists and healthcare professionals. Singing Dragon.