After an emotionally difficult experience you may find it challenging to fully participate at work, at home or in social situations. Exposure therapy is a treatment Occupational Therapists use to increase a client’s ability to function after trauma. OTs use exposure therapy to address anxiety, fear and discomfort so that you can actively engage in you community and life again.
What is Exposure Therapy?
Exposure therapy helps clients improve their ability to differentiate between safe and unsafe situations. With an OT’s help, they can reduce the physical, emotional, cognitive and social symptoms of trauma. Early intervention along with repetition empowers clients to better manage their response to triggers.
When someone experiences anxiety about specific people, places or things, they often avoid those situations. While this can reduce the discomfort in the short term, longer-term solutions are better. Interrupting the cycle of fear, through exposure therapy, allows a person to better recognize which beliefs are accurate and which have become overrun by emotions and difficult memories.
How is Exposure Therapy done?
- Education: Discuss how avoidance behaviours fuel anxiety.
- Which safety habits does the client use in order to reduce anxiety in the triggering situation?
- What thoughts and beliefs about the situation may be inaccurate or not helpful?
- Develop a structured plan to overcome the anxiety.
- The OT and their client develop an exposure hierarchy by grading all the aspects about the situation that causes anxiety. They assign each a score that ranges from 0/10 (no anxiety) to 10/10 (most anxiety ever).
- Based upon these scores, the OT and client develop a step-by-step plan to address each aspect of anxiety. Initial sessions should work through less anxious tasks and later sessions should address those that cause more anxiety.
- In the final sessions, the client aims to manage their anxiety effectively so that they can engage in the formerly stressful situation with a calm and clear mindset.
- During each session: Consider how long to continue with the session before it is complete.
- Researchers suggest that the client and OT stay in the situation until their level of fear drops by 50%. If the client considered their anxiety to be a 8/10 initially, they should wait until it is a 4/10 before concluding that exposure step.
Meet Kadie: A Case Study in Exposure Therapy
After an isolated and traumatic event occurred during her work as a social worker, Kadie feared her safety whenever she came near the site of the incident. Jennifer MacDonald, a senior therapist with OT Works! started working with Kadie after she had been off work for 6 months. They used a team-based approach to organize the exposure plan with the rest of Kadie’s healthcare team and social network. They had one-on-one sessions that gradually reintroduced her back into her work role. At discharge, Kadie was able to return to work independently, equipped with the tools and skills to work effectively without tirelessly worrying about her safety. With exposure therapy, Kadie built up confidence in her ability to manage feelings of anxiety.
How can OT Works! help?
Our occupational therapists are experienced in exposure therapy. They have helped many clients face their fears and reduce their anxiety. Our clients are able to return to their daily activities and enter unfamiliar situations equipped with the tools that are gained from exposure. All of our therapists are certified with the College of Occupational Therapists of British Columbia (COTBC) and many have additional training in mental health treatment.
If you or anyone you know could benefit from exposure therapy, contact us at firstname.lastname@example.org or 604.696.1066 ext. 1000. We can connect you with one of our therapists and make recovery more attainable for everyone.
To learn more about exposure therapy, check out these resources:
You may benefit from occupational therapy (OT) following a car accident, even if it is not initially included as a part of your treatment plan. All injured claimants are eligible to receive OT services under Part 7 Benefits. Ask your doctor about OT as they can provide you with a referral to pass onto your ICBC adjuster. The earlier you start occupational therapy, the more likely you are to successfully return to the activities that are important to you.
How do I know if occupational therapy would help me?
OT focuses on what its clients can and want to do. Questions to ask yourself include “Can I do everything I did before my accident?” and “Am I succeeding at work right now?”. If your answer is no to either question, OT might be right for you.
Here are some examples of how occupational therapy helps:
- Coordinating a smooth, safe discharge from hospital
- Reviewing equipment and strategies to improve walking and home safety
- Improving pain management
- Facilitating better memory for daily tasks
- Promoting better sleep, more energy and lighter mood
- Decreasing driving (or other) anxiety
- Providing education and empowerment while connecting you to other health resources and services you may need
- Getting back to dressing, bathing, cooking and cleaning (taking care of yourself or your loved ones), as well as getting into the community again
- Finding ways to safely get back to your work, as comfortably as possible
- Helping you return to your meaningful leisure activities
What should I expect from my occupational therapist?
OTs are university educated healthcare providers and are required to be licensed to practice in BC. You can expect them to:
- Provide objective and medically supported assessments and treatments
- Address your physical, emotional, and cognitive needs
- Use interventions to get back to life
- Focus on activities of daily living (ADLs) including personal care, productivity (at work or school) and leisure
What is the home assessment like?
The assessment begins with a clear understanding of your medical status, prior to meeting you. The OT then meets with you in your home for your comfort and privacy and to understand your specific, individual needs. The OT will do the following, during a 2-hour visit:
- Introductions, answering any questions you might have about OT or the recovery process, and ICBC’s involvement in that process
- A thorough interview to understand your symptoms, concerns, abilities and goals
- Use standardized tools to assess physical, cognitive or emotional impairments
- Observe you doing tasks around the home to ensure safety and/or explore ways to make them easier on your body
- Review the physical safety of your home
- Review treatment options with you
The OT has your safety and comfort in mind at all times; you can ask for breaks or stop the assessment and continue at another day or time at any point.
Read more about what OT can do for you and your ICBC claim – CAOT-BC Briefing Note (May 2018)
Occupational therapists (OTs) support you during your transition back into the worker role after an injury or accident. OTs facilitate realistic and proactive return to work planning that considers all of the factors that impact success. Our OTs partner with you to develop plans that enable you to re-build your specific work skills, and the confidence needed for long-term success.
Location of Services:
Our OTs meet you at your home and workplace to develop a return-to-work plan and to facilitate your progress.
Examples of Services:
- Job Site Visit
- Job Demands Analysis
- Assistive Technology
- Ergonomic Assessments
- Assessing Function in relation to Work Demands
- Gradual Return-to-Work (GRTW) Planning
- Gradual Return-to-Work (GRTW) Monitoring
- Vocational Assessment
How can OT help me return to work?
- Assess return to work readiness
- Provide education, strategies and coping tools
- Facilitate symptom management
- Prescribe and organize appropriate assistive and ergonomic equipment
- Develop personalized plans with attainable goals
- Advocate for return to work options with your employer
- Provide on- and off-site coaching
Who can refer me?
There are many professionals who can refer you to RTW Occupational Therapy. These include:
- Medical providers, such as your GP, physiotherapist, psychologist, etc.
- Public services, such as WorkSafe BC, ICBC, health authorities and hospitals.
- Other professionals involved in your recovery, such as your insurance specialists, adjuster or lawyer.
OT services are typically funded by WorkSafe BC, ICBC, your extended health insurance coverage, health authorities or legal settlements. You or your family can also pay for your treatment privately.
Why OT Works?
We have assisted clients as they returned to work and other meaningful activities since 2001. At OT Works!, treatment is client-centred. Every assessment and intervention is individualized so that your goals are in mind. While our knowledge is extensive, we have a particular focus on cognitive challenges (mental health and concussions) and ergonomics. Regardless of the nature of your challenges, we will partner with you to develop a plan built for your success. We help you return to work so that you can stay at work.