The Holistic Model of Occupational Therapy
-A Talk with Ophelia Xerri, Occupational Therapist-
About Ophelia:
Qualified Occupational Therapist and Ashtanga yoga teacher
Ophelia's Expertise:
Sensory Integration certified practitioner experienced in residential adult and child homes for learning disabilities, autism and ADHD, neuro brain injury rehab, hip and knee elective, community paediatric, brain injury rehab acute and community and acute mental health.
What if the key to a more fulfilling life is understanding the connections between our thoughts, emotions, and actions? How can we tailor support to truly reflect the unique needs of every person, especially those on the autism spectrum? And what does it mean to approach therapy with empathy, creativity, and collaboration? Occupational therapists’ role is all about encouraging people to find their strengths and challenges, overcome barriers and live a life that truly matters to themselves.
How Occupational Therapy Makes a Difference
The demand for occupational therapy services in the UK has been steadily increasing. According to a workforce survey report by the Royal College of Occupational Therapists (RCOT), 86% of respondents indicated that the demand for occupational therapy services had increased over the previous 12 months.
At its core, occupational therapy is about empowering people to live their best lives. Whether it’s helping someone overcome sensory challenges, build social confidence, or regain independence in daily tasks, the focus remains on person-centred, holistic care. Ophelia shares:
‘Occupational therapy is holistic in its nature of theory and practice, and this is outlined in lots of our models of practice such as the model of human occupation (MOHO), or Canadian model of Occupational Performance and Engagement (CMOP-E) and many more! The theory that underpins our practice addresses a person (physical, cognitive, mental, spiritual) within their environment (social and physical) and helps us tailor our process (assessment, intervention, evaluation) to each person’s needs, values and goals.
We use assessments to understand challenges and strengths in a person’s activities of daily living (ADLs), and this helps us focus on meaningful activities that promote functional, sensory and psychological well-being. I also find that collaborating with other professionals like speech and language, the PBS team, the provider of the care team, social workers, physiotherapists, etc., helps me clinically reason and evidence the occupational therapy input and empower the people we support through education and skill building. Occupational therapy plans are dynamic and always developing in practice around the person and their individual life circumstances.’
A Short Guide to OTs’ Main Responsibilities
The impact of OTs on people’s lives remains significant, with 88% of supported people showing improvements in their activities of daily living after receiving occupational therapy interventions. While 97% reported an improved quality of life.
‘I am setting up the occupational therapy service from scratch within our therapy team, running and managing the service, and organising my work in processes through my caseload, service development and management. We have developed a tiered approach of universal, targeted and specialist support to create and manage the content of occupational therapy education. Targeted support focuses on creating and delivering training for assessments and interventions, alongside providing oversite for service providers. Specialist support is offered via telecommunication or in-person consultations, ensuring input from a qualified occupational therapist. I attend internal and external meetings and create reports to support the assessment findings and recommendations, which help evidence needed when decision-making for MDT planning and funding.’
Tailoring Therapy to Each Person’s Needs
No two people are the same, and that’s where occupational therapy truly shines. For autistic people, their cognitive, sensory, and emotional needs often require a more person-centred approach.
‘My approach focuses on a person-centred delivery of care throughout the whole process (assessment, intervention, evaluation) with each person by tailoring assessments and interventions to the person’s unique needs, strengths, goals and challenges. Building trust is central to my work, as is collaborating with the person to set meaningful goals that incorporate their sensory needs and personal interests. My greatest aim is to empower each person I support by respecting their own autonomy and choices and for this to be reflected in their goals. Collaborating with families a lot and advocating for inclusion within the person’s community is essential when it comes to promoting meaningful engagement, well-being, and quality of life.’
Services across Catalyst are committed to reducing restrictive practices. One way services do this is by conducting audits to review and identify ways to minimise restrictions while safeguarding people and their clinician teams. Therapies Team PBS leads and practitioners, as well as the RP lead, can assist services to do this on request. Audits and plans can also be done sensitively and supportively with the individual involved.
Incorporating Evidence-Based Practices
Evidence-based practice is characterised by integrating the best available research evidence with clinical expertise and the preferences of the person receiving care to make informed and collaborative decisions.
‘All occupational therapy input relies on applying research to support interventions through teaching, frameworks and training and tailoring to the unique needs of every person I support. Staying informed on current research, like attending the Royal College of Occupational Therapy OT show annually, collaborating with internal and external multidisciplinary teams and using standardised assessment and evaluation tools to monitor outcomes and make data-driven adjustments, is the fundament. I prioritise the person and their family’s involvement, ensuring their goals and preferences are most important to them and their current situation. I keep myself engaged in CPD (continued professional development) and advocate for best practices to ensure my support is effective and grounded in research.’
Cognitive Behavioural Approach
It’s easy to find yourself drawn to the intricacies of how our thoughts, emotions, and behaviours intertwine, shaping our everyday experiences. It’s a bit like piecing together a puzzle that reveals how seemingly small patterns can create significant barriers or opportunities in daily life.
One of the most effective tools in Ophelia’s practice is the cognitive behavioural approach (CBA).
‘I would use a cognitive behavioural approach (CBA) to address the interactions between a person’s thoughts, emotions, and behaviours and focus on how this impacts their daily functioning. Through observation, conversation, and assessments, this approach could help identify unhelpful thoughts or behaviours and link them to the challenges the person and their support staff face when engaging in what the person needs, wants and has to do. I would work with the person, their families and care teams to set meaningful goals and use strategies to challenge negative thoughts, such as creating opportunities for graded exposure to reduce avoidance and activity scheduling to encourage engagement in a range of occupations (self-care, leisure, productivity).
The CBA approach in an occupational therapy service applies to all I aim to ensure they are delivered in a way which works for everyone. An autistic person may have unique cognitive, sensory, and emotional processing needs, and I would work with the person, families, and care team to learn how best to support everyone on my caseload with a person-centred approach. I may rely on visual aids or encourage structured communication, concrete examples, and step-by-step methods rather than having abstract discussions with the person to adapt. I may use emotion identification tools with the person, like emotion charts, to address difficulties with labelling feelings. We could apply calming tools or sensory breaks alongside cognitive interventions for sensory regulation techniques.’
Social situations can be challenging for some, but they also hold incredible growth opportunities when working with the right tools.
‘Social challenges could be addressed using social scripts, role-playing and structured scenarios emphasising specific and practical skills and highlighting the person’s interests in this process can enhance motivation and engagement! No matter what approach we are utilising or person specifically, occupational therapy will be tailored to a person-centred way of engaging, ensuring it is accessible, relevant and effective in supporting a person’s occupational performance and quality of life.’
At the end of the day, my goal is simple: to help people live fulfilling lives. Whether it’s empowering someone to re-engage with a favourite activity, providing tools to manage sensory challenges, or fostering confidence in social interactions, every step forward is a healing journey.
Through compassion, patience, and flexibility, I aim to make occupational therapy a person-centred, accessible, and meaningful experience. Because every person’s story deserves to be heard, celebrated, and supported.
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