Recovering from a stroke or brain injury is not just about functional rehabilitation—it’s about healing the whole person. As an occupational therapist (OT) and psychotherapist, my goal is to bridge the gap between functional recovery and emotional well-being to support individuals in reclaiming their independence, confidence, and quality of life.
In this article, I explain what OT psychotherapy is and what an OT psychotherapist can do. In addition, I discuss why addressing mental health in neurological recovery is so important, how we approach holistic healing at Propel Physiotherapy, and who can benefit from this type of healthcare.
Table of Contents:
- What is an OT Psychotherapy?
- Supporting mental health through action and reflection
- Exposure therapy through an OT lens
- A regulated ethical profession
- Conclusion
What Is an OT Psychotherapy?
When most people think of psychotherapy, they often picture traditional talk therapy in a quiet office. But what if healing also involved rebuilding your routines, engaging in meaningful activities, and developing practical skills for everyday life? That’s where OT psychotherapy and an Occupational Therapist (OT) Psychotherapist comes in.
An OT psychotherapist combines the functional, skills-based approach of occupational therapy with the emotional and psychological focus of psychotherapy. This unique blend supports holistic healing, helping individuals who face mental health challenges that interfere with daily tasks and meaningful engagement.
Supporting Mental Health Through Action and Reflection
Occupational therapists are trained to address barriers that prevent people from fully participating in their lives, including the things that they need to but also the things that they want to be able to do. When working as a psychotherapists, OTs integrate therapeutic conversation with hands-on, practical interventions.
An OT Psychotherapy approach might include:
- Developing healthy coping strategies
- Supporting emotional regulation
- Rebuilding daily routines that support autonomy and recovery
- Facilitating engagement in meaningful occupations (activities that bring purpose and satisfaction)
This dual approach helps clients not only understand their emotional and functional challenges but also regain confidence and control in real-world situations.
Exposure Therapy Through an OT Lens
One area where OT psychotherapists often excel is in exposure therapy, particularly for individuals dealing with anxiety, OCD, or PTSD.
Exposure therapy is a function-based, gradual approach that helps individuals confront fears or triggers that are limiting their ability to participate in life. The OT works with the client to:
- Identify specific occupational barriers or fears
- Develop structured, goal-oriented exposure plans
- Provide a safe, supportive environment to face those challenges
- Teach coping strategies such as mindfulness, grounding, or breathing techniques
This process not only promotes desensitization to fear-inducing stimuli but also encourages functional engagement in daily life. By integrating psychological principles with occupational engagement, OT psychotherapists help clients reduce avoidance behaviors and reclaim their independence.
For example, if a stroke survivor avoids leaving home due to anxiety about falling, an OT psychotherapist could support with the gradual reintroduction of outings while teaching techniques to manage distress and anxiety when facing this fear. This approach helps reduce avoidance behaviours while restoring confidence in daily life. This support can occur in person or through virtual means.
A Regulated, Ethical Profession
In Ontario, Occupational Therapists are one of six health professions approved to perform the Controlled Act of Psychotherapy, as defined in the Regulated Health Professions Act (1991). This means that OTs can legally and ethically provide psychotherapy without needing to be registered with the College of Registered Psychotherapists of Ontario (CRPO).
Instead, OTs practicing psychotherapy are regulated by their own governing body—the College of Occupational Therapists of Ontario (COTO). As an OT psychotherapist, I adhere to COTO’s standards and am accountable to the public to provide high-quality, ethical, evidence-based care. This includes continuing education in psychotherapy on a yearly basis, maintaining up to date on current evidence and regular psychotherapy supervision.
I also maintain my own professional liability insurance and possess the skills, knowledge, and judgment required to safely and effectively deliver psychotherapy as part of my scope of practice.
Conclusion
OT psychotherapy is a powerful and unique approach to mental health care—one that doesn’t just focus on talking through problems, but also on doing, rebuilding, and re-engaging in life. By blending psychotherapy with practical occupational strategies, we help individuals find both emotional healing and functional freedom.
If you have questions about OT psychotherapy or would like to schedule a complimentary 15-minute phone consultation or assessment with an OT psychotherapist, contact our office.
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