Hi there,

I am from Australia. I practised for several years as a mental health OT in Adult Mental Health (public system mainly, community and acute)... the above that you talk about are generally thought of as "frames of reference" that influence OT as a profession (theory) and OT's in mental health should be familiar with those.

However, we generally use "OT Models" in Occupational Therapy in general (including in mental health) to guide clinical practice, e.g., MOHO (Model of Human Occupation) by Kielhofner, or CDM (Cognitive Disabilities Model) by Claudia Allen....

In addition, Ayres Sensory Integration (ASI) approach to assessment and intervention, used quite a lot in pediatrics, is also used with adults to address sensory processing and sensory modulation (e.g.: in autism, also mental health).

I think the above 3 are probably the most used, based on my experience. Depends on what type of clients you have as well. Many psychiatric patients (especially in the public system) have cognitive impairments and dual diagnoses (e.g., drug and alcohol abuse, etc.), and many models and frameworks that involve "discussion, exploration" may not be suitable.

I suppose in Australia we are influenced by UK and USA. In Europe, your clinical practice may be guided differently.

I am interested in how do you actually connect psychodynamic models and psychoanalytic theories to "Occupation and Occupational Performance" in clinical practice, and what assessments and interventions do you use ?

The above is just my experience, but another Australian mental health OT may offer a different perspective.

Hope my experience is of some help to you.

Kindest Regards,

Bojana (OT, Australia)

You are doing great work in preparing kids for school. Congratulations! I would focus on sensory modulation and motor skills to build a foundation in the lower functioning group. In my experience many ASD level 3 people have extensive issues with sensory modulation (over- and under-responsivities). Addressing these calms the body and brain for longer and focusing and learning. However, in most of this population I identify extensive motor planning difficulties (dyspraxia and DCD) once modulation have been addressed. These impact learning and funtioning extensively. Would it be possible to embark on CoordiKids Home Course (developmentally sequenced exercises on videos) to build foundational skills? You might need to adapt the course to match their participation or skill level. Let me know if you want to chat or need more information. www.coordikids.com

@Mosa Bluejay - We've collated a number of replies to your query - gathered from our Facebook page/group posts. Take a look below:

• "My son is autistic and turning 10 this summer. He uses the Zones and is able to tell me what zone he is in. So I'd say that is a success!" - Crystal

• "I've used Zones and Sensory Ladders. Both useful. At the moment I use Sensory Ladders; it works better with my interventions. I'm trained in Ayres' Sensory Integration WISE, which is working really well in my school OT role. With autism and SEMH children, 8 to 18 years old." - Kerry

• "I have used it with higher functioning children with great success. It's pretty easy to implement and adaptable and can be done individually or in groups." - Leslie

• "I use Zones in combination with other frameworks. It's a great starting space." - Molly

• "I like this style of format. Thinking of something similar for young man with LD/ADHD." - Lorraine

• "This is so outdated. Zones of Regulation (ZOR) is a template; our kids are definitely not templates! Modernising Approach: Newer iterations emphasise that all zones are 'okay', moving away from the sole goal of forcing students back to the 'Green Zone' to, instead, managing their feelings within any zone. Neurodiversity and Trauma-Informed: Updated materials and digital curricula now aim to be more inclusive of neurodivergent learners and trauma-informed practices." - Marsi

• "Universally, red is known as an indicator of STOP. Even if the curriculum is not teaching red feelings are bad feelings, there is an implied 'STOP' that goes with anything in the red zone. Being overjoyed is in the red zone; I hope I never stop being overjoyed. I also hope I never stop being angry about important issues in the world, as a means of pursing justice." - Alex

• "I love it, outdated or not! Our whole way of teaching is outdated. It is simple for teachers and parents to incorporate; anything more complicated will sit on a desk collecting dust. Once you take a quick look at the colour they are in, you can quickly look at the colour-coded activities! Simple is best… Life is crazy!" - Jenn

• "Zones of Regulation is not an evidence-based practice for autistic individuals - there is insufficient empirical research. A widely used alternative is an Interoception-based Curriculum... I'm a fan of the South Australian Interoception Program (Ready to Learn Kit). This is a whole-school framework" - Kimberley

• "I really don't like ZOR. Regulation needs to be body-based and should be taught through co-regulation. If it's too cortical, it missed the whole point, in my opinion." - Nancy

• "Zones of Regulation is compliance-based and training children to meet other people's expectations, whilst their needs go unmet." - Laura

• "Check out Kelly Mahler and her resources; she also has done research on this subject that you can read. I think though the biggest issue with the Zones of Regulation is that it teaches that they have to be in the green zone and the reality is that life isn't that simple." - Kerry

Hi I am unsure how to private message you. How much are you selling for? Thank you

neonatal OT can shape so much of that early bonding and development period. hope you get a strong response, especially from families whose experiences were a few years back and can reflect with hindsight.

Your research on spirituality in inpatient mental health care is very intriguing. It is essential to explore how spirituality can influence the therapy process, particularly in mental health settings. The integration of spiritual care may provide a holistic approach to supporting patients' overall well-being. Best of luck with your study, and I hope it provides valuable insights for occupational therapists working in this area!