Oct 5

Integration of NLP & Occupational Therapy


Edited: Oct 7




Topic of the month- Integration of NLP and Occupational Therapy

Facilitator for the month- Nidhi Kuvadia Shah, Occupational Therapist, Certified NLP Practitioner, Mumbai, India.


The following article is an open access article published in the researchgate.net. The link is provided for the same at the end of the post.



Aims and issues addressed by this article:

The given article draws attention towards a new approach for Occupational therapist in conjunction with Neuro Lingustic Programming as the holistic approach used in different domain of life of an individual.

What is NLP?

A very little is known about ‘Neuro Lingustic Programming’ (NLP), its techniques and tools.

To start with, NLP was developed in USA by John Grinder and Richard Bandler. NLP is a multi-dimensional process that involves the development of behavioural competence and flexibility, but also involves strategic thinking and an understanding of mental and cognitive process behind behaviour. Hence, the article tries to correlate NLP with OT that can help clients with psychological disorder to get back in their lives.

Integration of NLP and OT might be used for understanding cognitive and psychosocial performance such as self- awareness, self –direction of roles, self-management including (personal, educational, Social) and internal adaptation (belief, values, interests) which is the basic aim of all the occupational therapist working with the clients. NLP describes the fundamental dynamic between mind and language and how their interplay affects body and behaviour.

Objective of this study is “To compare the outcomes of MHR-OT (composed of OT, Neuro-linguistic programming (NLP), and integrative NLP & OT in Thai clients with mental health experiences or diagnosed chronic psychosis.”


Design of Study and Methodology:

Level of evidence –III, Non randomised, single group, pre and post intervention, descriptive study

Ten clients with mental health experiences were recruited with a subset programming named ‘Mental Health Recovery of OT (MHR-OT)’ which was created by a set of three serial modules: 3-week of OT, 3-week of NLP and finally 3-week integrative NLP & OT.

The OT module included OT assessments, psychoeducation of mental health recovery, cognitive skills training of individuals, group dynamics of social skills training, and self-management skills (time, fatigue, and leisure) training whereas NLP module included C.U.R.E. model which has shorted by conversational frames, understanding, rapport-connect, and empowerment (reconstruction of S.C.O.R.E. model – symptoms, causes, outcome, resource, effects) as well as reframing and anchoring

Outcome assessed on cognitive levels and self-efficacy scores














Main findings:

The article provides a tabular format to understand the effects of OT, NLP and OT-NLP in the cases with 3 weeks intervention respectively in areas of cognition and self- efficacy. Though the scores in self -efficacy remained more over same in NLP intervention but there have been vast increase in the score when NLP and OT were used in coordination. The study gives a direct view on the use of NLP in OT and its effect on individual’s cognitive level.



NLP incorporates and draws idea from ones cognitive, biological, social, behavioural psychology, sociology, anthropology, body- language, expressions, neuroscience etc.; all these factors are considered by an occupational therapist while interacting with client and their family members, thus understanding these factors on larger terms and working on these factors using tools and techniques of NLP not only of clients but of their care takers will have a greater impact on the goal settings.



· The study does tell about NLP but the models or tools used are not specified in length.

· There is very limited information on the combine use of NLP and OT.

· A certified NLP practitioner is required to carry out the NLP techniques.


Thus as an Occupational Therapist our motto is to bring the best of the given situation and provide at most independence to our clients. The authors have sustained to this thumb rule and tried using a method to which very few studies have been done with a commendable success.



The article gives an over view of adjunct therapy with a good success rate in the clients, which can help therapist to formulate models in different domains of ADL.


Felicitator’s comments:

I have been certified as a NLP practitioner and have been using NLP as an adjunct to my therapies since a year and have found success with it. The most important thing is to understand the Human Behaviour as to why it is been done by the specific person, the need of best option available to them at the given point and finally the meaning of your communication is the response that is elicited. So if these basic assumptions as said in NLP are understood one can easily understand the patterns seen in adults and individuals.


LINK TO THE ARTICLE https://www.researchgate.net/profile/Supalak_Khemthong/publication/293821280_Integration_of_Occupational_Therapy_and_Neuro-Linguisting_Programming_for_Thais_with_Mental_Health_Experiences/links/56bc1ddf08ae2481ab6ae9dc/Integration-of-Occupational-Therapy-and-Neuro-Linguisting-Programming-for-Thais-with-Mental-Health-Experiences.pdf?origin=publication_detail

Oct 9Edited: Oct 9

Interesting topic to be explored by us Occupational Therapists .. Though this article needs to be cautiously interpretated considering small sample size and no specifications to any particular psychosocial disorder or condition given.

Well appraised @Nidhi Shah

Yes I agree with you regarding the interpretation on the article. But again like I said it's a new approach for us to look at our clients needs and goal. Thanks :)

This article is intetesting, the visual images really helped me understand the concept. I feel as OTs we may use some aspects of this approach to support our practice. I was reflecting on my role as an OT, thinking about how we support people to engage in health promoting behaviours by changing the way they think/ talk and ultimately expeience/ see the benefits of an occupation. I have just listened to a podcast on intuitive eating, focus on changing our habits by considering the following; e.g. I have the 'thought' that I need food and so can get rid of a thought. Mindful eating allows us to fully engage in the sensory experience (flavour, appeal and texture) and recognise when we are full.

Did anyone else see any correlations with practice?

New Posts
  • Hosted by Abigail Matthews - Occupational Therapist, UK Aims and issues addressed This article seeks to explore the evidence behind Sensory Integration Intervention for Children with Autism, in order to ensure quality of practice. Intervention takes place within a context of play, involving a collaborative relationship between therapist and child - and focusing on participation-oriented outcomes, that are collected at regular intervals throughout the duration of the intervention. The focus is on developing sensory motor skills, due to evidence that some people with autism have difficulty processing everyday sensory information and can experience a lack of, or sensory overload. Too much information can cause stress, anxiety and possibly physical pain. Abstract Sensory integration is one of the most highly utilised interventions in autism; however, a lack of consensus exists regarding its evidence base. An increasing number of studies are investigating the effectiveness of this approach. This study used the Council for Exceptional Children (CEC) Standards for Evidence-based Practices in Special Education, to evaluate the effectiveness of research, from 2006 to 2017, on Ayres Sensory Integration (ASI) intervention for children with autism. What is already known how can it help solve important problems for practice? ASI is an individualized intervention designed to address the specific underlying sensory-motor issues that may be affecting children’s performance during daily routines and activities, including participation within the classroom and in other contexts of the school. Consequently, occupational therapists play a key role in developing sensory motor skills in schools, due to their role in enhancing daily living skills, through meaningful occupation. However, the evidence behind such practice has been criticised, which is problematic when implementing evidence based practice. This systematic review is critical of past systematic reviews and meta-analyses of studies, claiming to evaluate sensory integration intervention. Concerns are based around inconsistence use of ASI principles (Case-Smith et al., 2015) and lack of participant engagement and outcomes in the interventions (Lang et al., 2012 and Barton et al., 2015). Outcome measures in existing studies also vary widely, meaning that it is difficult to synthesise the findings of these systematic reviews to identify a useful outcome measure (Case-Smith & Arbesman, 2008; Case-Smith et al., 2015; May-Benson & Koomar, 2010; Watling & Hauer, 2015). Research Design To answer this question, we conducted a systematic review of available research studies: The first stage involved a series of electronic database searches, to locate potentially relevant studies. The second stage involved selection of studies using specific inclusion criteria related to methodology and description of the intervention. The third stage involved evaluation of the quality of each included study, to explore the reliability of findings and remain evidence based. The diagram below shows the search strategy. Data was analysed using the CEC Criteria, to ensure that interventions were based on similar outcomes. Three of the six reviewed papers were excluded from further analysis, because the intervention description was inconsistent or insufficient to be confidently considered ASI intervention, or because of significant methodological issues. Main findings ASI has strong evidence for positive outcomes on individual goals, moderate evidence supporting improvements in autistic behaviors and caregiver assistance for self-care activities - and emerging but insufficient evidence for outcomes related to play, sensory-motor skills, language, and social skills. Reliability and validity The diagram above shows the PRISM diagram used to show the search strategy, detailing the search process can improve the reliability of the study, as it can be replicated at a later date to consider any new research. This study also demonstrates that it has sought knowledge from a number of different electronic databases, in order to give a valid representation of ASI from the literature. Limitations The lack of relevant studies identified of a good quality mean that conclusions were formed based on three articles; findings may have lost quality as well as reliability. It could be argued that, while this article has achieved rigour, validity and reliability due to its focus on reducing bias, the paper lacks exploration around the role of occupational therapy using a sensory integration approach. It would be necessary to explore the literature to understand the core principles and focus under study. Facilitator’s comments Across my career, I have worked in learning disabilities and mental health, as a mental health practitioner. I found a passion for supporting this client group, focusing on skill development and increasing independent living. I valued the challenge of weaving my OT skills into my generic role, to promote the value of OT across healthcare roles. I choose this article because I wanted to understand more about autism, due to the differences between learning disabilities and those on the autistic spectrum. I was inspired to choose this article after reading the last Journal Club article on autism. I learnt a lot from this and wanted to explore the evidence behind the use of sensory integration as a well-known approach, when working with clients with autism. Given the level of scrutiny the authors undertook, the recommendations around future practice appear valid and reliable. It provides a good base for development of further research, in line with principles of AI, ASI and CEC standards of practice as an outcome measure. Open-access link to the journal article: www.researchgate.net/publication/329613236_A_Systematic_Review_of_Ayres_Sensory_Integration_Intervention_for_Children_with_Autism/fulltext/5c1251c5299bf139c755a8d6/329613236_A_Systematic_Review_of_Ayres_Sensory_Integration_Intervention_for_Children_with_Autism.pdf?origin=publication_detail A note from the Hub Team Thank you to @Abi Matthews for an excellent contribution to The Journal Club! What are your thoughts on this article? Do you have comments or feedback on host Abigail's critique? Members: Get involved in the conversation - and print off your input for your CPD/CEU files!
  • Facilitator of the Month| Pooja Jethani, Missouri, U.S.A. The following article is an open access article published in Canadian Journal of Occupational Therapy in 2015. The link is provided for the same at the end of the post. Aims and issues addressed by this article: The above article emphasizes the introduction of “sustainable practices” into the environmental aspect of occupational therapy employment. The article hopes to instill a sense of awareness amongst current Occupational Therapists to develop a “sustainability lens” in everyday practices. Occupational Therapists and Occupational Therapy organizations (WFOT, SAOT, COT) address the need for global outreach to understand the gravity of global health issues and collaborate to overcome them. This vision is the need of the hour as it is a major influence on health, both individually and as a community. Search Strategy: Recommended by a professor in a class on contemporary issues in OT, searched via Google Scholar Issues addressed by the article, Why does it matter? How it fits to what already is known? How can it help solve important problems for practice? The issue addressed in the article is that human beings are responsible for the environmental degradation, considering this aspect; it is our responsibility to take measures to improve environmental health by introducing sustainability. Unknowingly, we, as OT’s may harm the environment while providing treatment interventions by using materials or measures that are not conducive to environment. Sustainability blends into OT practices and can help improve the global environment. Addressing and taking charge of changing the global environmental conditions by creating awareness and modifying the way we practice is one of the substantial ways OT's can help solve the problem. Design of the study Descriptive; ecological Main findings Canada’s Federal Sustainable Development Act (2008) defines sustainability as ‘‘development that meets the needs of the present without compromising the ability of future generations to meet their own needs’’. The article introduces the concept of sustainability in environmental practices in OT and talks about the relevance of including this concept as a part of the basic models of OT. If our literature includes notions of sustainable OT practices, the concept will be more effective. Further, the article helps us adapt a sustainability lens and look at everything around us from a sustainable aspect. The authors believe that a change at the micro level by millions of people could bring about transformations at macro level. The article successfully describes ways to implement sustainability in everyday application of OT through examples and clinical reasoning strategies for everyone. It stresses on how Occupational Therapists are most suitable for this role to bring a change within the environment. Generalizability The article hopes to develop better living conditions for our future generations by implementing modifications in the present. The examples mentioned in this article can easily be put into practice if considered each time we treat and generalized for OT in all settings and sub fields. Implications Adapting sustainability is easy; all we need to do is have a sustainable outlook for every time we practice. Some of the interesting methods mentioned in the article include recycling adaptive equipments, use of technology and tele-medicine to make paper less treatment sessions possible, use of local products, arranging public transport to enable access and improving environmental living conditions by planting plants. Use of these methods may not necessarily be time consuming; instead some of them may give us occupations and activities for our clients to incorporate in our therapy sessions. Occupational Therapists have a major role to play in environmental upliftment and helping create better conditions for the future. Limitations 1- The author talks about how sustainability could be a part of our models as an aspect in environment but further information is required as to how and where is its place in our literature. 2- The article mentions various examples on implementing sustainable practices but a structured resource will be necessary in near future in order to include sustainable practices in OT interventions. Conclusion Although the concept of sustainability is crucial, it is not yet implemented by most countries of the world. In order to successfully bring sustainability in practice, it needs to be introduced at the root level, which is possible if we include it in our educational resources and advocate it to current and future OT’s. The authors insist that we think globally and act locally for our OT interventions. The authors believe that occupational therapy practitioners have the power to initiate change in their personal actions, their workplaces, their communities, and their governments to promote a sustainable and resilient future. By studying and researching, discussing, presenting articles on this topic, spreading awareness to other health professionals, Occupational Therapist can positively incorporate sustainability. Facilitator’s comments The concept of sustainability is relatively new and needs to be introduced in the basic practice models of OT, like Model of Human Occupation, Person environment occupation, Person environment occupation performance, ecology of human performance. It definitely has a place in everyday OT. Certain sustainable occupations like gardening or farming, planting trees, helping recycle, healthy habits like walking or biking can be a part of the treatment process of clients. Sustainability can be adapted in each and every thing if you develop an outlook for it. Organizations around the world are trying to make Earth a better place for us and our future generations. Let's join hands and work towards it. Link for the article: https://journals.sagepub.com/doi/pdf/10.1177/0008417414566925?casa_token=Y6F5eWJ60nkAAAAA:WR-2WIiyiz7dFMWD3HlzvBo7M2xL73liFlwMMaCXATRAzZtN4aYgZ8-IV6N22c7r0GnOe_LFsXaH Open access link for the article: A call for sustainable practice in Occupational Therapy Link for WFOT's Guiding principles in sustainability in Occupational Therapy Practice, Education and Scholarship: https://www.wfot.org/resources/wfot-sustainability-guiding-principles A special Thanks to the author Carole Dennis for providing us access to her article. Hope you like the new perspective of Occupational Therapy in Environment!! Please share your comments and ideas below! About the facilitator - Pooja Jethani is a Master's in Occupational therapy( Neurosciences) from Mumbai and is currently a PPOTD candidate at Washington University in St. Louis.
  • Facilitator of the Month| Tasneem Rangwala, Mumbai, India The following article is an open access article published in Hong Kong Journal of Occupational Therapy in 2017. The link for the article is provided at the end of the post. Aims and issues addressed by the article: The article intends to find out the effectiveness of the program that was designed to provide information to the parents of children with ASD about factors of food preferences and approaches for coping with problems of selective eating. The said article not only discusses the eating behaviors of the children but also addresses the self-efficacy of the parents, degree of difficulty experienced by parents to feed their child and parental recommendations. Firstly, the article shortlists the factors that lead to selective eating behaviors in children with ASD. Next, the article describes about approaches undertaken to tackle selective eating in children with ASD. Why does it matter? How does it fit to what it already known? The awareness for ASD has increased in the past few years. Selective eating is often reported by parents and discussed with the Occupational therapist but it is not given much priority as providing with primary intervention. The authors of this study claim that it is the first ever study done to address selective eating behaviors in children diagnosed with ASD that involves parental discussions and training. Moreover, the study provides with a comprehensive view of the factors that lead to selective eating and approaches that can be undertaken to combat specific food preferences of children diagnosed with ASD. Study design: Single group, self-controlled trial that compared variables at baseline and before and after the intervention. Study methods and Intervention design: The participants were 23 Japanese speaking parents of children diagnosed with ASD, recruited from 2 out-patient development support centers in Osaka. The eligibility criteria were that the parent had attended all program conducted in the study (2 sessions and 2 discussions), their respective child is diagnosed with ASD/scored more than 15 on social communication questionnaire and lastly had difficulty with their child’s selective eating behaviors. Outcomes : a) The changes in parental attitudes b) Changes in eating patterns of children with ASD. Main Findings: The most common approaches used by parents were to change the disliked texture, gradually mix the preferred texture and change to favored flavors and tastes. Results: The results included significant decrease in the level of difficulty perceived by the parents in feeding their child with ASD, a significant increase in the degree of self-efficacy of the parents and in number of recommendations carried out by the parents which were provided/taught to them. There was also an increase in the number of food items that were acceptable to the children with ASD who demonstrated selective eating. Implications: 1) The authors mention that in their next trial, they would increase the number of approaches that can improve the degree of self-efficacy and decrease the difficulty perceived by the parents to feed their children with ASD who report selective eating. 2) Further development of this program can aid Occupational Therapists in implementing better intervention strategies in order to increase the amounts/varieties of food for children who demonstrate selective eating. Limitations: 1) No significant change was found in the degree of dietary imbalance or the number of foods acceptable to the children 2) Some parents found it difficult to follow/implement the recommendations to improve selective eating in their children with ASD which led to decrease in number of parents who participated in each session. 3) It was taxing to address selective eating in children that demonstrate strong preferences for only one to two food items. Conclusion: The results of this study showed that the proposed intervention can be used as an introductory program for parents who experience difficulty with regard to selective eating behaviors in their children and resulted in short term improvements in quality of life both of parents and their children. Facilitator's Comments: The process of eating is a part of basic activity of daily living that help us humans remain functional. Having a limited a food repertoire, a child with ASD may be deprived of essential nutrients necessary for growth and development of body and brain. The said article based on selective eating behaviors which are common in children with ASD is a detailed interventional study that not only focused on the limited food preferences but also addressed parental views, perceptions, difficulties and their efficacy. The interesting part in this study was that the parents shared their own experiences during the discussions that helped the author and the other participants (parents) to either relate to the issues or provide a better approach to tackle the same. Though a level 4 study, the intervention program proved to be effective to deal with the concerned issue of selective eating. However, the article could not give significant evidence as to the dietary imbalances and for the required approaches to adopt for children who demonstrate a strong liking to 1 or 2 food items. Link for the article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092012/ PMID: 30186077 PMCID: PMC6092012 The article is available at www.sciencedirect.com Please share your comments, knowledge and ideas below!!! Happy Autism Awareness Month!

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