Occupation Based Practice: The Missing Link in Concussion Care!
Concussion rehab is often stuck in the world of symptom management...
Occupational Therapists know this better than most. Concussion isn’t just about headaches, dizziness, or cognitive fog. It’s about the disruption of daily life and occupations—not being able to work, parent, drive, cook, exercise, or even enjoy social time without feeling completely drained. That’s why Occupation-Based Practice (OBP) is the secret to great concussion management. But applying OBP to concussion is surprisingly difficult.
Why is Occupation Based Practice so hard?
1. Time Constraints!
Lack of Time: OTs often don’t have the time to plan, conduct, and document OBP effectively. In busy clinical environments, quick interventions are often preferred over more
complex, occupation-based approaches.
Perception of OBP as Time-Consuming: OBP is often seen as too complicated and impractical, especially in acute settings where we're expected to deliver rapid, measurable
improvements.
2. Logistical Challenges: Spaces and Equipment Aren’t Built for OBP
Lack of Dedicated Space: Most workplaces aren’t set up for occupation-based interventions. Trying to simulate real-world conditions in a small clinic room isn’t always realistic.
Equipment Barriers: Clinical environments are often stocked with tools for impairment-focused treatments (e.g., Therabands, exercise machines) rather than the diverse, real-life
tools needed for OBP (e.g., office setups, kitchen spaces, job-related environments).
3. Institutional and Cultural Barriers: The Biomedical Model Still Dominates
A System Geared Toward Impairment-Based Treatment: Most healthcare settings prioritize
biomedical models of care over functional rehabilitation. This means OBP isn’t always valued—or even understood.
Limited Management and Administrative Support: While OTs see the value of OBP, healthcare administrators often don’t, leading to a lack of resources.
Professional Tension: Many newly graduated OTs enter the field trained in OBP but are met with workplaces that expect traditional, impairment-based therapy. This disconnect
forces them to either conform or push back.
4. Reimbursement Challenges: OBP Doesn't Fit the Traditional Model
OBP is Harder to Bill For: Medically oriented interventions are more likely to be reimbursed than OBP, which is harder to justify financially, especially when it requires
more time or a community-based approach.
Pressure to Show Quick Outcomes: Healthcare systems prioritize fast, measurable improvements. Since OBP’s effects can be subtle and take longer to unfold, it’s often overlooked
in favor of impairment-based methods that produce immediate results.
5. Education and Training Gaps: OTs Aren't Always Prepared for OBP
Limited Training in OBP: Many of us don’t receive practical training in OBP, leaving them unsure of how to apply it in real clinical settings.
Cognitive Load: OBP requires critical thinking, adaptation, and problem-solving in real-time—skills that can be overwhelming, especially for those of us new to practice.
Lack of Standardized OBP Assessments: Until recently, no tools existed to measure how OBP a practice was. The
Dynamic Model of Occupation-Based Practice is changing this, but awareness is still low.
OBP is Harder to Research: Traditional randomized controlled trials (RCTs) don’t fit OBP well, making it difficult to build the same level of
high-quality evidence that supports more structured, biomedical approaches.
6. Client Expectations: Patients Want What They Know
Clients Expect "Traditional Therapy":
Many people associate therapy with structured exercises, not occupation-based interventions. This can lead to resistance when OTs introduce
OBP approaches.
Lack of Client Education: Patients often don’t understand
what occupational therapy actually is or how OBP can benefit them. If OTs don’t clearly explain it, clients may dismiss OBP in favor of conventional methods.
7. Misunderstanding What OBP Really Is
Therapists Think They’re Doing OBP—But Aren’t:
Many OTs self-report using OBP when their interventions remain impairment-focused. This
false confidence means there’s no internal push to change practice.
Underutilization Weakens the Movement: Even though OTs recognize the value of OBP, it’s not widely seen in practice. The less it’s used, the harder it is to establish it
as the standard of care.
Why is Occupation Based Approach in Concussion Care Critical?
#1 It Focuses on Real Life, Not Just Symptoms!
A headache or dizziness score doesn’t tell us if someone can successfully grocery shop, teach a class, or have dinner with friends. OBP makes sure interventions are directly relevant to the patient’s life.
#2 It Builds Long-Term Resilience, Not Just Short-Term Relief
Avoidance is one of the biggest risks in post-concussion recovery. Patients often pull back from normal activities to avoid discomfort—but that only reinforces disability. OBP helps reintroduce real-life activities safely and effectively.
#3 It Creates a More Motivating and Engaging Rehab Process
Patients don’t care about “doing exercises” as much as they care about getting back to the things that matter—their job, family, hobbies, and social life. OBP aligns therapy with what’s actually meaningful to them.
How Can We Apply OBP in Concussion Rehab?
The challenge is to design interventions that are safe, effective, and occupation-based—not just exercise-based. Here’s how we do it...
The Future of Concussion Rehab is Occupation-Based!
Reclaim Your OT Superpower!
Are you an OT feeling constrained by traditional, symptom-focused concussion rehabilitation methods?
It's time to pivot! An Occupation-Based Approach to Concussion empowers you to harness the full potential of occupation-based therapy.
This self-paced course is tailored specifically for OTs, emphasizing the unique value you bring to concussion rehabilitation.
You will gain hands-on strategies to implement occupation-based interventions across various domains, including vision, vestibular function, and cognition!