By Mandy Lubas, OTR/L, RYT and Emmy Vadnais, OTR/L
The article was originally posted on July 23, 2014 in ADVANCE Magazine for Occupational Therapy Practitioners
Download a PDF of this article here: How to Become a Holistic OT
We would like to support you in becoming a holistic OT. What does this mean? Aren’t OTs already holistic? Well, yes we are. However, we’re talking about integrating holistic therapies into OT practice; what has been commonly referred to as complementary/alternative medicine (CAM), prevention, and wellness approaches. Integrative medicine is another term for holistic therapies when combined with current mainstream health care, and it is sweeping health care as research continues to demonstrate its efficacy.
Did you know that 76% of all health care practitioners have tried some type of CAM therapy according to a 2011 study? What we do as health care practitioners significantly affects how we choose to provide care and services to the people we serve. Most health care professions already have or are moving toward having a specialty in holistic care. Perhaps, one day, it will all simply be considered health care. Physicians have a specialty in integrative medicine and the American Holistic Medical Association. The nursing profession has the American Holistic Nursing Association with a special certification to become a Certified Holistic Nurse Clinician.
OTs are well-suited to integrate holistic therapies in to their practice. OTs have a holistic perspective, are trained in psychology and biology, and understand the mind-body-spirit connection. OTs address the whole person, and understand contexts that influence the whole person.
We are often asked questions on how to become a holistic OT and where to begin. We suggest becoming educated in the holistic — mind, body, spirit medicine, prevention and wellness approaches that you are most interested in. To start, it is a good idea to have a working knowledge of and training in meditation, the relaxation response, a form of bodywork, energy healing, spirituality, and nutrition. We suggest that you experience these holistic approaches for yourself for a deeper understanding of how beneficial they can be, and how they can be easily applied into many lives.
It can be helpful to have a vision or intention of how you would like to integrate holistic approaches into your practice. Creating a mission statement of how you want to help others and “Be the change you wish to see in the world” can be very powerful for achieving your goals and essential if you intend to have a private practice.
AOTA Supports CAM in OT Practice
The AOTA mentions on their website an emerging niche for occupational therapists to get more involved in their communities, emphasizing health care cost containment. The Patient Protection and Affordable Act is requiring insurers by law to cover preventive medicine. As of 2009, the federal government has been dispensing money into preventive services such as community prevention and prevention research through the American Recovery and Reinvestment Act, health care reform, and the Centers for Disease Control and Prevention (CDC). As holistic occupational therapists we can use holistic therapies to get at our clients “root” cause of the areas of concern impacting occupational performance.
In 2005, AOTA created a position paper on the use of CAM in OT practice. In summary, it supports the use of CAM in OT practice as long as the practitioner has proper training, education, and can skillfully integrate it in to OT practice to improve a person’s long-term goals and quality of life. We, as OTs, make up our associations. What we find meaningful and important to our profession will be reflected in our associations.
Holistic Therapies Gaining Popularity
Research continues to demonstrate efficacy of the following holistic approaches that are gaining popularity. Research shows they can improve healing, recovery, and prevent disease.
• Meditation and Relaxation Techniques
• Guided Imagery
• Yoga Therapy
• Body Work/Manual Therapy
• Energy Healing
• Acupuncture/Traditional Chinese Medicine
• Music Therapy/Listening Programs
• Health & Wellness Coaching
• Nutritional Counseling
How Holistic Approaches Fit
A wonderful reference for understanding how holistic approaches fit into the OT scope of practice is the Occupational Therapy Practice: Domain and Process, 3rd Edition. Once you have studied the holistic approach you’re interested in, and understand the mind, body, and spirit benefits, you can then more easily relate to how it fits into OT practice. If it can improve a person’s functioning and quality of life, it is OT. OTs know that certain kinds of activities (i.e., ADLs, IADLs, rest, sleep, education, work, play, leisure, and social participation) can be effected for various reasons. Integrating holistic therapies has been proven successful in influencing a client’s overall health and well-being.
Consult with OTs to discover how they use specific approaches in their practice. There is a growing body of evidence demonstrating the efficacy of mind, body, and spirit approaches. Reviewing research literature can also enhance your understanding of holistic approaches and how they can be integrated in to OT practice. The more educated we become on holistic therapies — ourselves as practitioners, our clients, supervisors, and insurance companies — the more we can further help people.
Both authors of this column integrate holistic approaches into our OT practices and offer holistic continuing education. Emmy teaches a variety of holistic healing classes in groups and individual tutoring. Topics include Intro to Holistic OT, The Power of the Mind in Healing, meditation, relaxation, intuition, spirituality, energy healing, guided imagery, Emotional Freedom Technique (EFT), reflexology, and massage therapy. Emmy also provides holistic health care business consulting. With the intention of creating a holistic OT community and expanding holistic education in the OT profession, she created the HolisticOT.org website and Holistic OT social media on Facebook, Twitter, and LinkedIn. The HolisticOT.org website has a list of holistic research, frequently asked questions (FAQs), and a Holistic OT Practitioner Directory. Emmy and Mandy host monthly Holistic OT Conversations, where OTs come together to share holistic topics and learn and grow from one another.
Mandy offers classes and workshops privately and within a group setting using yoga therapy, Ayurveda, and Ayurvedic body work. She uses mind-body connection therapies (i.e. craniosacral therapy, sensory integration, and listening therapies) in her traditional and holistic settings. When using yoga therapy with a client she is able to complete a structural analysis of a client’s body to provide a yoga practice that may entail meditation, breath work, and yoga asana to get at the “root” cause of the area of concern.
Ayurvedic wellness counseling focuses on getting at the “root” of a client’s area of concern using diet, herbs, and lifestyle modifications. In addition, she presents at local colleges on holistic OT and continuously educates the public and medical professionals on this emerging trend through in-services and health fairs.
Holistic OT Reimbursement
Be clear with your documentation about what interventions were used, and what changes they produced in your client — i.e., education in progressive relaxation resulted in decreased physical pain and increased emotional regulation, with reduced worry and anxiety. Relate the intervention and results back to the goals.
You may choose to bill under neuromuscular re-education, cognition, ADLs, or therapeutic activity, depending on the focus of your session and the client’s overall goals. If for some reason these services are denied, contact the insurance company and educate them on these skilled services and the research behind them. They may not be as familiar with the terms, and you will help them better understand these approaches and their therapeutic effects, which will continue to pave the way for integration of these approaches in OT practice.
To learn more and connect with OTs interested in mind, body, spirit medicine, prevention, and wellness, visit the www.HolisticOT.org website, the Holistic Occupational Therapy Page, Group on Facebook, LinkedIn, and HolisticOT on Twitter, and join the Holistic OT e-mail list.
Authors’ Note: Please complete the following survey questions and post them to the comment sections below.
1. Are currently integrating holistic approaches in to your OT practice?
Which holistic approaches do you use?
2. Would you like to learn how to integrate holistic approaches in to OT practice?
Which holistic approaches would you like to learn?
Mandy Lubas, OTR/L is a holistic occupational therapist and Certified Panchakarma Technician who has been in the field of medicine for 12 years, working with the pediatric, adult, and older adult population. She is the owner of Holistic Therapies 4 Life, where she treats individuals in own home, in the community, in yoga studios, and in health and wellness centers. Lubas consults for The Nashoba Learning Group and practices as an OT at Braintree Rehabilitation Hospital in Lynnfield. She is a graduate of Quinnipiac University, Kerala Ayurveda Academy, and Yogaspiritstudios® 200- and 500-hour Advanced Yoga Teacher Certification programs, and is working toward her 1,000-hour Yoga Therapy certification, as well as her certification in Craniosacral Therapy. Lubas is certified in sensory integration and the Integrated Listening Systems (ILS). She can be contacted at firstname.lastname@example.org or www.holistictherapies4life.com.
Emmy Vadnais, OTR/L, is a holistic OT who combines holistic healing approaches into her private practice in St. Paul, MN. She is certified in several holistic healing approaches and teaches holistic continuing education to health care professionals. She can be contacted at email@example.com. Visit www.emmyvadnais.com or www.HolisticOT.org.
Photo Credit: Jeffrey Grossman
1. American Occupational Therapy Association. (2011). Complementary and alternative medicine. American Journal of Occupational Therapy, 65, (Suppl.), S26-S31. doi: 10.5014/ajot.2011.65S26
2. American Occupational Therapy Association. (2005). Complementary and Alternative Medicine (CAM) Position Paper. American Journal of Occupational Therapy, Vol. 59, 653-655. doi:10.5014/ajot.59.6.653
3. American Occupational Therapy Association. (2008). Occupational therapy practice framework: Domain and process (2nd Ed.). American Journal of Occupational Therapy, 62, 625-683.
4. American Occupational Therapy Association. Prevention. Retrieved from www.aota.org/Practice/Health-Wellness/Emerging-Niche/Prevention.aspx
5. Christianson, Charles & Baum, Carolyn (1991) Occupational Therapy: Overcoming Human Performance Defecits. Thorofare, NJ: SLACK Incorporated
Merriam-Webster: An Encyclopaedia Britannica Company. Holistic definition. Retrieved from http://www.merriam-webster.com/medical/holistic