Mental health occupational therapy

Mental health occupational therapy is the precursor to today’s occupational therapy which is synonymous with rehabilitation and fine motor recovery, it was rooted deeply in mental health care.

Summary

• The field of occupational therapy was founded on the belief that purposeful activity restores emotional balance and self-worth and is rooted in early “work cure” models by pioneers like Herbert Hall and Eleanor Clarke Slagle.

• Modern OTs address both prevention and treatment by helping clients flourish, not just recover and by integrating meaningful daily activities into therapy. Download my free fine motor skills activities sheet.

• Today’s mental health OTs work in diverse environments, including community centers, correctional facilities, and virtual care platforms.

• Using EHR systems, such as TheraPlatform can help therapists significantly streamline tasks like scheduling, billing, client communication, and documentation, while helping to expand their businesses through engaging telehealth options.

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Early occupational therapists believed that purpose-driven activity could restore balance, structure, and self-worth in people experiencing psychological distress.

In the early 1900s, Massachusetts physician Herbert J. Hall introduced a groundbreaking work-centered approach to treating patients with nervous system disorders.

Rather than prescribing rest, as was common at the time, Hall engaged clients in purposeful activities such as weaving, basketry, and pottery, a method known as the work cure.

His approach underscored the therapeutic value of meaningful activity in restoring mental and emotional health.

Building on this foundation, Eleanor Clarke Slagle, the “Mother of Occupational Therapy,” developed habit-training programs that utilized structured daily routines to strengthen both functional and emotional well-being.

Now, according to Johns Hopkins Medicine, “our updated approach emphasizes meaningful activities rooted in independent living and quality of life.”

The scope of occupational therapy continually evolves. In the post-pandemic mental health era, this evolution feels especially relevant.

According to the World Health Organization, the “COVID-19 pandemic triggered a 25% increase in prevalence of anxiety and depression worldwide.”

This highlights an urgent need for holistic, occupation-based approaches to mental health recovery.

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A brief history of mental health occupational therapy

Adolf Meyer and Eleanor Clarke Slagle created early models linking occupation, time use, and emotional stability, precursors to today’s psychosocial frameworks.

By the mid-20th century, world events shifted OT’s focus. During the polio epidemics and World War II, the profession turned toward physical rehabilitation and prosthetic training.

Still, mental health occupational therapy continued to improve. It adapted, shifting focus to meet the evolving needs of individuals and communities over time.

In the wake of COVID-19, with isolation, burnout, and grief reshaping daily life, occupational therapy is re-emerging as a vital bridge between mental and functional health.

Modern practitioners once again find themselves supporting clients in rebuilding structure, resilience, and connection, the core principles Hall and Slagle championed a century ago.

What is mental health occupational therapy?

The World Health Organization (WHO) defines mental health as “a state of well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community.”

This definition aligns seamlessly with the philosophy of occupational therapy (OT), which centers on helping individuals live meaningful, balanced lives through purposeful daily activity.

A psychologist, Corey Keyes, expanded this understanding with his concept called the mental health continuum, reframing mental health not as the mere absence of illness but as a dynamic spectrum ranging from flourishing to languishing, meaning the “presence of mental health, described as flourishing, and the absence of mental health, characterized as languishing.”

This perspective resonates deeply with OT’s holistic approach, emphasizing function, participation, and quality of life across all stages of well-being.

Occupational therapists distinguish between mental health promotion, which focuses on enhancing wellness and preventing distress, and mental illness treatment, which addresses specific conditions such as anxiety, schizophrenia, or trauma.

While the words mental health and OT may conjure up images of psych rehab units, mental health promotion occurs in every practice area of occupational therapy. Across every setting, OTs work to foster emotional regulation, cognitive clarity, and purposeful engagement, helping individuals not just to manage life but to thrive in life.

Populations that benefit from mental health occupational therapy interventions

• Unhoused individuals: Establishing routines, medication management, and transportation skills to promote stability.

• Veterans with PTSD: Identifying triggers, building coping mechanisms, and supporting reintegration into civilian life.

• Cancer patients: Using energy conservation, journaling, and mindfulness to sustain cognitive and emotional endurance during treatment.

• Disaster survivors: Reintroducing daily structure, group activity, and environmental safety after displacement.

• Clients in recovery: Supporting habit change, social participation, and relapse prevention through meaningful routines.

• People with dementia: Encouraging engagement through sensory-rich activities that maintain dignity and connection.

Each case reinforces that occupational engagement is a form of mental health care.

Where mental health occupational therapy happens

Occupational therapy’s mental health work happens far beyond hospital walls and may include:

• Clubhouses: Provide vocational opportunities, peer support, and graded tasks that rebuild confidence and community ties.

• Correctional facilities: Address occupational deprivation through self-regulation, time management, and life skill programs.

• Community-based organizations: Offer creative approaches to parenting stress, burnout prevention, or mobility barriers, meeting people where they are.

Best practices in mental health occupational therapy

• Therapeutic use of self: Empathy, validation, active listening, rapport-building. Building rapport through cultural humility and individualized communication fosters trust and engagement.

• Structured intervention approaches: The Bazyk Model (Awareness→Appraisal→ Action) guides clients to recognize emotions, assess their impact, and take purposeful steps toward regulation.

• Client-centered goal setting: Collaborative, value-driven goals using the SMART framework ensure clarity, accountability, and empowerment.

• Group vs. individual intervention: Groups offer powerful peer modeling and social connection, while one-on-one sessions allow personalized reflection and trauma-informed depth.

• Task analysis and activity grading: OTs break complex daily activities into manageable steps, adjusting tools and environments to rebuild mastery.

• Generalization of skills: True progress occurs when clients apply learned coping skills in real-world contexts, shopping, socializing, parenting, or returning to work.

Mental health occupational therapy trends and opportunities

Rising rates of anxiety, depression, and burnout highlight the urgent need for professionals who understand both the mind and daily function.

According to one National Health Statistics Report “During 2022, about one in five adults aged 18 and older experienced any symptoms of anxiety (18.2%) or symptoms of depression (21.4%) in the past 2 weeks.”

OTs are uniquely positioned to contribute by

• Trauma-informed care: Creating safe, empowering environments.

• Mental health equity efforts: Advocating for accessible, community-level services.

• Digital wellness tools: Leveraging telehealth platforms, apps, and virtual groups to extend reach and continuity.

As technology integrates more deeply into care delivery, the ability for OTs to personalize interventions across sensory, cognitive, and social domains will be invaluable.

Additional resources for mental health occupational therapy

• OTA School Mental Health Toolkit: Practical guides for psychosocial practice. 
• World Federation of Occupational Therapists (WFOT) Position Statement: Global advocacy for mental health OT. 

Recommended reading

• Wilcock, A., & Townsend, E. (2008). Occupational Justice and Client-Centered Practice. 
• Bazyk, S. (2011). Mental Health Promotion, Prevention, and Intervention in Children and Youth. 

Training opportunities

• Certified Psychiatric Rehabilitation Practitioner Credential (CPRP)-Specialty certifications in Psychiatric Rehabilitation or Trauma-Informed OT Practice. 

Digital tools

TheraPlatform: TheraPlatform for documentation, treatment planning, and teletherapy integration.

Documenting mental health occupational therapy

An essential component of mental health occupational therapy (and indeed nearly all therapeutic work) is accurate, timely documentation.

One common structure is the SOAP format:

• S (Subjective): What the clients report — emotional state, concerns, events since last session.

• O (Objective): What the therapist observes — interaction patterns, tone, nonverbal cues.

• A (Assessment): Therapist’s clinical interpretation — what the subjective and objective data suggest in terms of attachment needs, emotional blocks, and relational dynamics.

• P (Plan): What will be done going forward — interventions, new homework, focus for next session.

SOAP note example: Mental health occupational therapy

Client: Jane D. Date: 10/07/2025 Diagnosis: Generalized Anxiety Disorder (F41.1) Setting: Outpatient mental health clinic Therapist: Kate

S – Subjective

Client reported, “I’ve been feeling overwhelmed trying to manage my work schedule and home responsibilities. I can’t focus, and I end up avoiding tasks.” She expressed frustration about her lack of motivation and increased fatigue, rating her anxiety as 7/10 on most days.

O – Objective

Client participated in a 50-minute session focused on stress management and daily structure.

• Completed a task analysis activity to identify time management barriers.

• Engaged in guided mindfulness and grounding exercise using deep breathing.

• Collaboratively developed a daily planner prioritizing morning routines and self-care breaks.

• Demonstrated moderate difficulty maintaining focus but responded positively to visual planning aids.

A – Assessment

Client shows ongoing symptoms of anxiety impacting occupational performance in work and home management. Improved self-awareness observed through identification of triggers and coping strategies. Client benefits from structured interventions, visual organization tools, and mindfulness-based regulation. Progress noted toward goal of independently using coping techniques during stressful tasks.

P – Plan

• Continue weekly OT sessions focusing on executive functioning and self-regulation strategies.

• Introduce graded exposure to previously avoided activities.

• Assign home exercise: use planner daily and practice grounding techniques twice per day.

• Reassess anxiety levels and task follow-through next session.

How EHRs can help with documentation

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Modern EHR/practice management platforms (such as TheraPlatform) assist greatly with documentation by providing HIPAA‑compliant, integrated systems for note entry, storage, scheduling, and billing.

They allow therapists to:

• Use templates (e.g. SOAP, DAP, others) to speed note writing and ensure completeness.

• Link notes to treatment plans, goals, and session history so that therapeutic progress is more easily tracked.

• Securely access and share documents (with clients or other providers, where appropriate) and maintain confidentiality.

Meanwhile, AI‑assisted note tools are emerging which can further help clinicians by:

• Automatically transcribing session audio (if permitted) and highlighting key moments (e.g. emotional shifts, major themes).

• Suggesting draft notes or filling in objective or assessment sections based on observed data, freeing up clinicians’ time.

• Supporting consistency and reducing missing components in notes, which helps from both clinical, legal, and insurance perspectives.

Together, structured SOAP ‑ type notes plus good EHR platforms and smart AI tools support better therapeutic outcomes, more efficient workflows, and stronger accountability.

Streamline your practice with One EHR

• Scheduling
• Flexible notes
• Template library
• Billing & payments

• Insurance claims
• Client portal
• Telehealth
• E-fax

Learn More

Resources

TheraPlatform is an all-in-one EHR, practice management, and teletherapy software built with AI-powered notes for therapists to help them save time on admin tasks. It offers a 30-day risk-free trial with no credit card required and supports different industries and sizes of practices, including occupational therapists in group and solo practices.

More resources

• Therapy resources and worksheets
• Therapy private practice courses
• Ultimate teletherapy ebook
• The Ultimate Insurance Billing Guide for Therapists
• The Ultimate Guide to Starting a Private Therapy Practice
• Mental health credentialing
• Insurance billing 101
• Practice management tools
• Behavioral Health tools

Free video classes

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• 9 Admin tasks to automate in your private practice

References

Keyes, C. L. (2007). Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health. American Psychologist, 62(2), 95–108. https://doi.org/10.1037/0003-066x.62.2.95

Occupational Therapy for Mental Health. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/physical-medicine-rehabilitation/specialty-areas/occupational-therapy/mental-health-ot

Terlizzi EP, Zablotsky B. Symptoms of anxiety and depression among adults: United States, 2019 and 2022. National Health Statistics Reports; no 213. Hyattsville, MD: National Center for Health Statistics. 2024. https://pubmed.ncbi.nlm.nih.gov/39591466

World Health Organization. (2022, March 2). COVID-19 Pandemic Triggers 25% Increase in Prevalence of Anxiety and Depression Worldwide. World Health Organization. https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide

World Health Organization. (2025, September 24). Mental Health. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response