Occupational Therapy and Mindfulness in Health and Social Care Settings

Updated: Nov 15, 2023

Did you know that, in 2022, close to a million people took sick leave due to stress, anxiety and/or depression in the UK? These alarming figures would appear to indicate a growing need to find effective strategies to reduce sick leave and increase the wellbeing of workers.

The following article provides an explanation of occupational therapy and mindfulness and the relationship between them. There is strong evidence in favour of the use of mindfulness in reducing burnout in the workplace amongst health professionals and teachers (Luken and Sammons, 2016). On the other hand, mindfulness is frequently used in social health care settings as an effective treatment for patients.

What is Occupational Therapy?

There are many and varied definitions of occupational therapy (OT) and mindfulness.

The following definitions are my personal favourites within the context of this article:

"Occupational Therapy is a profession concerned with the promotion of health and wellbeing through occupation. The main objective of Occupational Therapy is to enable people to participate in activities of everyday life. Therapists achieve this outcome by working with people and communities to enhance their ability to engage in the occupations they want to, need to, or are expected to do, or by modifying the occupation or the environment, to better support their occupational engagement."

World Federation of Occupational Therapists (2012)

Occupational therapy assessment: Prepare a cup of tea

Case Study (CS): Mary

I met Mary three decades ago. She was an outwardly happy and fun person. No one could imagine then that she cried and had suicidal thoughts whenever she was alone. Her depression and anxiety manifested itself in severe eczema on her face and neck. Mary visited more than eight dermatologists, an endocrinologist and a naturopath, but nothing was effective. Mary was desperate; her sense of isolation increased, due to her reluctance to go out, in turn due to what she saw as unsightly eczema.

A friend told her about a local meditation group 30 years ago and she decided to give it a try. After only four sessions, Mary began to see physical and emotional benefits. She had found a new occupation (meditation), which began to help her improve her health (mental and physical) and her general sense of wellbeing.

What is mindfulness?

"Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgementally."

Kabat-Zinn (2013)

Purpose

We could define it as the intentions/attention that correspond to our goals, in our interventions as Occupational Therapists and/or in our personal lives.

CS: Mary Mary's goal/purpose was to make her eczema and depression disappear. She focused her attention on meditation which, in turn, aided to heal both her body (eczema) and her mind (depression and anxiety).

Present moment

"Paying attention involves observing moment-to-moment processes, internal processes, and external experience."

Shapiro et al. (2006)

Our experiences are what we choose to pay attention to. Accepting the present moment as it is, without resigning ourselves to acting in the future because we believe it will be useless.

CS: Mary Mary said that, although she began to feel better from the fourth session, the process was very slow, with many setbacks and crises. Those moments led her to practise mindfulness meditation, accepting the present moment. By learning to live moment by moment, Mary began to experience more moments of inner peace, fewer moments of anxiety about the future, and fewer moments of depression relating to her past.

Non-judgmental

"It is the attitude that one brings to the act of paying attention."

Brach (2003); Kabat-Zinn (2003); Kornfield (2008)

CS: Mary Through her practice of meditation, Mary began to develop an ability observe each emotion with greater objectivity, instead of judging them in terms of them being good or bad, interesting or boring, etc. Mary says that she continues to work very hard trying to experience the present moment without judgement, or feeling a need to change it.

What is the relationship between mindfulness and occupational therapy?

Mindfulness in Occupational Therapy intervention aims to support the individual to achieve their full capacity, by adopting a holistic approach.

Mindfulness-based interventions fit well within the strong holistic emphasis advocated by Occupational Therapy practice, where mind and body are integrated as a whole and valued.

Let's remember the definition of Occupational Therapy as being "a profession that deals with the promotion of health and well-being through occupation..." (World Federation of Occupational Therapists, 2012). Occupation is related to health and well-being, and we practise mindfulness to achieve a full life of (physical and mental) health and well-being.

According to Yerxa (2009), occupations are a synthesis of 'being', 'doing' and 'becoming'.

The 'being' represents the here and now of the occupations (Wilcock, 1998). We could define 'being' as the set of feelings, emotions and thoughts that make up the essence of the present moment. Health professionals need to experience mindfulness through the senses (feelings, thoughts and bodily sensations) in order to relate to stress, thoughts, and emotions in clinical practice (Teasdale et al., 2007; Reid, 2009).

CS: Mary Practising meditation and being more mindful in every activity of her day-to-day life, Mary began to know herself. She is kind, cheerful, dynamic, disciplined, affectionate, irascible, intolerant, insecure... She approaches her work, relationships and everyday life with authentic passion and enthusiasm. However, being mindful is not about being positive and calm in all situations. There are likely to be times when we are sad, tired, irritated... we need to cry. Would you be kind to someone who is stealing from you, mistreating you, insulting you, etc?...

The 'being' will impact the occupational process of 'doing'.

People are constantly doing things out of necessity (working, eating, etc) out of obligation (cleaning, cooking, etc), or for leisure (swimming, dancing, singing, etc). That is why it is very important to find the balance in our 'doing' and to develop an understanding and coherence in our 'being' and 'doing'.

Reflect on a daily activity that you like to do and another that you dislike. Are you being consistent with your emotions? Do you have a balance in your occupations?

CS: Mary Mary changed jobs and hobbies as she began to understand herself better. She started going to dance classes - since she discovered that the only reason she liked going to clubs was to dance.

She changed her professional career - since she discovered that the only thing she liked about her profession in tourism was travelling; now she travels only for pleasure. Thus, she found more coherence and balance between her emotions, feelings and occupations.

'Becoming' yourself means becoming authentic, less anxious, and living in a calm and more empowered way, in the chaos of modern life. By consciously 'becoming', we transform ourselves inwardly and begin to develop inner goodness, inner compassion towards ourselves and others, freeing ourselves from the limitations of judgement and criticism.

CS: Mary After more than a decade of practising mindfulness meditation, Mary decided to leave her career in the tourism industry - and she qualified as an occupational therapist. Before finishing her degree, she knew she had found her vocation and personal passion. Like OT, she felt that her interventions and her personal practice of mindfulness were inseparable.

For Mary, this coherence and balance between the 'being' and 'doing' has led her towards a fuller life, with greater inner peace and corresponding improvements to her mental and physical health. Mary says that her eczema has disappeared completely and that she has been able to live a life free of depression, anxiety and panic attacks for many years.

Mary feels that the practice of mindfulness is the most powerful tool she has, both in her personal life as well as in her work as an Occupational Therapist. Thanks to this daily practice, she feels has been able to live a more fulfilling life.

Mindfulness is a practice that helps people to live happier and healthier lives, by exploring and establishing greater balance and coherence between their 'being' and 'doing'.

You don't learn to swim by reading a book!

I invite you to choose and practise two or three exercises below on a daily basis, for 21 days.

Invest a few minutes each day in transforming your inner 'being', your life 'doing' and 'becoming' to feel more inner peace:

Mindfulness Meditation - 30 seconds of practice a day: Choose an activity that you do every day. For example, preparing a cup of tea, brushing your teeth, showering, driving, etc. Before beginning your chosen activity, spend 30 seconds remaining still whilst focusing your attention on your breath. At the end of the day, see how many times you have done your 30 second meditation. More importantly, consider the benefits of your meditation each night before bed. It is as important that you meditate as it is that you reflect upon its benefits.
Perform 30 seconds of conscious meditation before your interventions, where you only observe your breathing (inhale and exhale).
Every day, write three things for which you are grateful.
Conscious eating: Make a mindful meal a day, paying attention to each bite (i.e. the taste, the texture, the smell, etc).
The art of listening: When we are listened to we feel connected with ourselves and with the other person at the same time. Listen actively, without judging.

Please share your experience with me (sensations, resistance, emotions, benefits, etc) after 21 days of practising these exercises: info@healthyandindependent.net

About the author

María N Gómez Lacalle worked in London as an Occupational Therapist and graduated from Brunel University in 2007.

"I am committed to the dignity, empowerment and safety of people among the ageing population and anyone in need of support. I use mindfulness as a powerful tool in my work and personal life, to train myself to be present in the here and now at all times.

I am the founder and director of Healthy and Independent Limited and author of 'A Dignified Approach to Moving and Handling People: as a Pathway to Empowerment' and 'Techniques for Moving and Transferring People with Dignity: the Path to Empowerment' [Spanish language]."

References

Christiansen, C. and Baum, C. (1997) Occupational Therapy: Enabling Function and Wellbeing. Thorofare, NJ: Slack.
Kabat-Zinn, J. (2013) Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness (rev. ed), New York, NY: Bantam Dell.
Luken, M. and Sammons, A. (2016) Systematic Review of Mindfulness Practice for Reducing Job Burnout. American Journal of Occupation Therapy. 70(2): pg 1-10.
Reid, D. (2011) Mindfulness and Flow in Occupational Engagement: Presence in Doing. Canadian Journal of Occupational Therapy. February 2011 78 (1) 51.
Shapiro, S.L., Carlson, L.E., Astin, J.A. and Freedman, B. (2005) Mechanisms of Mindfulness. Journal of Clinical Psychology. Volume 62, issue 3, pg 373-386.
Wilcock, A. (1998) Reflections on Doing, Being and Becoming. Canadian Journal of Occupational Therapy. Volume 65, issue 5.
Yerxa, E. (2009). An Introduction to Occupational Science, A Foundation for Occupational Therapy in the 21st Century. Occupational Therapy In Health Care. Volume 6, 1990 - Issue 4, pg 1-17. (Brach, 2003; Kabat- Zinn, 2003; Kornfield, 2008). (Teasdale et al., 2007; Reid, 2009).