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The Occupational Therapist worked collaboratively with Freta, her manager and her union representative to develop a suitable return to work plan. The plan included a structured reintegration process, some retraining and use of memory tools and checklists 

October is Occupational Therapy Month in Canada. Occupational Therapists are among the health care professionals who support workers following a workplace injury, or a diagnosis of occupational disease or work-related mental illness. On behalf of the Ontario Society of Occupational Therapists, Nancy Gowan shares how Occupational Therapy can help.


Occupational therapy is a type of health care that helps to solve the problems that interfere with a person’s ability to do the things that are important to them – everyday things like:

  • Being productive -going to work or school, participating in the community,
  • Self-care – getting dressed, eating, moving around the house, and
  • Leisure activities – sports, gardening, social activities.

Occupational therapy can also prevent a problem or minimize its effects. (

In the workplace, Occupational Therapists assess the employee, the work tasks/processes and the workstation or work tools.  When an employee is struggling, the Occupational Therapist can provide a clear understanding of the employee’s abilities and support the employee and employer in knowing what tools or strategies can assist the employee in performing the work productively whether the barriers are physical, cognitive, psychosocial, emotional or environmental. 

In order to better understand how an Occupational Therapist may assist I will provide you with a brief scenario that comes from the real success an individual achieved in working with an Occupational Therapist.

Freta was a paramedic with over 15 years’ experience. After a particularly difficult call where she responded to a motor vehicle accident where a young mother and child had lost their lives, she was noticeably upset.  As she arrived home she noticed that she was more edgy with her family and had difficulty getting to sleep.  She awoke over the next few weeks with nightmares, and had difficulty focusing at work.  Her chief noticed that she was more withdrawn and in fact was not able to make simple decisions. She was reactive to her colleagues and started to have complaints from colleagues and the public about her curt responses and sudden outbursts.

She was diagnosed with Post Traumatic Stress Disorder and began outpatient treatment with a team including a psychiatrist, psychologist, and an occupational therapist. Following an assessment of Freta’s functional abilities and challenges, she worked with the Occupational Therapist to develop skills in emotional regulation, communication strategies and developed a scheduled routine.  Working with the Occupational Therapist to identify weekly exposure goals, a progressive structured program was started.  The Occupational Therapist started with Freta in her home to manage her routine, sleep hygiene and self care.  She learned ways to manage her anxiety with mindfulness, Cognitive Behavioural Therapy (CBT) and emotional regulation principles.  An exposure therapy program was implemented to begin integration into the community and eventually into the workplace.

The Occupational Therapist assessed the job demands of a paramedic and objectively assessed Freta’s functional cognitive and physical abilities through a Functional Assessment.  The Occupational Therapist worked with Freta to develop a cognitive rehabilitation program to improve her concentration, her problem solving and her ability to remember important processes for work.  Electronic and paper checklists and reminders were built into her daily living and applied into volunteer opportunities in the community.

When Freta demonstrated the physical, cognitive and emotional ability through the community-based programs the Occupational Therapist worked collaboratively with Freta, her manager and her union representative to develop a suitable return to work plan.  The plan included a structured reintegration process, some retraining and continued use of the memory tools and checklists in the workplace.  At first Freta was apprehensive but as the program progressed she was able to gradually resume some of her key functions which gave her confidence in the tools and her abilities. The Occupational Therapist, using work-focused CBT, assisted Freta in problem solving around workplace challenges with her manager and union. Adjustments to work tools and processes were implemented (physical ergonomic changes such as lifting tools and techniques, communication improvements such as ways to assertively communicate her needs and time management strategies such as using her electronic calendar to remember important tasks). The Occupational Therapist provided the team of paramedics with training on building resiliency skills to prevent PTSD. Through the program, Freta resumed her full work duties.

Note that although Freta’s story ended with her return to work many others may not be able to return to their own role and the Occupational Therapist can assist in exploring a good fit between the employee’s abilities and a new work role to provide success in other jobs that may be a better solution for the individual.

For more information or to find an occupational therapist, contact the Ontario Society of Occupational Therapists ([email protected]) or visit


Nancy Gowan
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