Occupational Therapy with Emphasis on Patient's Experiences and Emotional Well-being
In today's educational landscape, it is crucial to address trauma-based responses school-wide, recognising that perceived trauma can trigger the same physiological responses as real threats, leaving individuals feeling hopeless, helpless, or fearing for their safety [1]. To tackle this issue, the National Center for Safe, Supportive Learning Environments offers an online training package for trauma-sensitive schools, while the American Occupational Therapy Association (AOTA) provides guidelines for trauma-informed occupational therapy [2].
The AOTA's guidelines are grounded in best-practice standards from the Substance Abuse and Mental Health Services Administration (SAMHSA), focusing on the principles of trauma-informed care. These principles, commonly applied in occupational therapy practice, aim to create a safe, supportive, and empowering environment that acknowledges the widespread impact of trauma [3].
The 6 principles of trauma-informed care, endorsed by the National Association of State Mental Health Program Directors (NASMHPD), are integral to this approach. These principles include ensuring safety, building and maintaining trust, encouraging peer support, collaborating and fostering mutuality, recognising empowerment, and being sensitive to cultural, historical, and gender issues [3].
In occupational therapy, these principles translate into strategies that create a safe and supportive therapeutic environment, promoting healing and recovery. For instance, Sydney Thorson, OTR/L, a new occupational therapist working in school-based therapy with a background in Human Development and Family Studies, employs these principles in her practice.
Recently, Thorson encountered a resistant 5-year-old named Thomas, who had a traumatic history. Instead of focusing on the behavioural issues, Thorson recognised Thomas's need for safety and support. She created a safe space for Thomas, built trust through consistent communication, and encouraged peer support by involving Thomas's classmates in his therapy sessions [4].
Moreover, Thorson utilises various interventions, such as Cognitive Behavioral Intervention for Trauma in Schools (CBITS), a Tier 1 intervention for addressing trauma in school settings, and Trauma-Focused Cognitive Behavioral Intervention (TF-CBT), a Tier 3 intervention that includes students and their families in collaboration with community mental health providers [4].
The AOTA emphasises the importance of assessing trauma, addressing safety, building strengths and resilience, and providing opportunities for success in trauma-informed occupational therapy [2]. By adopting a trauma-informed approach, occupational therapists can extend compassionate support, foster trust, and empower clients like Thomas to regain control and engagement in meaningful activities, ultimately contributing to a safer and more supportive learning environment for all students.
References: [1] National Child Traumatic Stress Network. (2021). Understanding Trauma in Children and Adolescents. Retrieved from https://www.nctsn.org/resources/understanding-trauma-in-children-and-adolescents
[2] American Occupational Therapy Association. (2019). Trauma-Informed Practice: Occupational Therapy's Role in Healing. Retrieved from https://www.aota.org/-/media/corporate/files/practice/pediatrics/trauma-informed-practice-aotas-role-in-healing.pdf
[3] Substance Abuse and Mental Health Services Administration. (2014). SAMHSA's Concept of Trauma and Guidance on Trauma-Informed Care in Behavioral Health Services. Retrieved from https://store.samhsa.gov/system/files/sma14-4888.pdf
[4] Thorson, S. (2021). School-Based Occupational Therapy: A Trauma-Informed Approach. Retrieved from https://www.aota.org/-/media/corporate/files/practice/pediatrics/school-based-occupational-therapy-a-trauma-informed-approach.pdf
In the context of empowering school-wide responses to trauma, the principles of trauma-informed care endorsed by the National Association of State Mental Health Program Directors play a key role in the practice of occupational therapy. For instance, a trauma-informed approach can help therapists like Sydney Thorson, OTR/L, build trust, create a safe space, and foster peer support for individuals like Thomas, a resistant 5-year-old with a traumatic history.
