Ergotherapy is an independent recognized professional field in Germany and is prescribed as a medical remedy by medical professionals (Greek. : ἔργον; ancient Greek pronunciation érgon: “work; labor”; therapeía: “service; treatment”). Translated, ergotherapy means “work or occupational therapy“; it assumes that “being active” is one of the basic needs of human beings. The German Association of Occupational Therapists (DVE) defines occupational therapy as follows: “Occupational therapy supports and accompanies people of all ages whose ability to act is limited or threatened by limitation. The aim is to strengthen them in carrying out activities that are meaningful to them in the areas of self-care, productivity and leisure in their personal environment. Here, specific activities, environmental adaptation and counseling serve to enable the person to act in everyday life, participate in society and improve his or her quality of life.” With the help of occupational therapy, impaired people acquire skills for action so that they can participate in life again in an individually adapted way. This form of therapy is based on sociological, medical and action-oriented aspects. The occupational therapist addresses the patient’s need to cope with everyday life at work, at home and at home, despite illness or disability. This is achieved by improving functional abilities and by learning compensatory skills, e.g. with the help of aids and adaptation of the environment. Another very important aspect is participation in society. In foreign countries (e.g., USA), occupational therapy is referred to as occupational science.
Indications (areas of application)
The indication for prescribing occupational therapy does not arise from the diagnosis of a specific disorder. If a disorder or loss of ability leads to an individual need or need for therapy, occupational therapy may be prescribed as a therapeutic agent. Some medical specialties, such as geriatrics, particularly benefit from the option of occupational therapy.
Medical fields of application/fields of work
- Geriatrics (medicine of aging)
- Neurology (medicine of the nervous system)
- Orthopedics / traumatology
- Pediatrics (Pediatrics)
- Palliative medicine (euthanasia)
- Psychiatry
- Rheumatology (branch of medicine that deals with the diagnosis and treatment of mostly chronic inflammatory diseases that belong to the rheumatic group).
The procedure
The design of occupational therapy is, among other things, further defined by the remedies guidelines in the Social Code (SGB). According to this, the measures of occupational therapy serve the restoration, development, improvement, maintenance or compensation of disease-related disturbed motor, sensory, mental and cognitive abilities and functions. According to these guidelines, the focus is on complex activating and action-oriented methods and procedures, using adapted exercise material, playful, functional, manual and creative techniques, as well as practical life exercises. The learning of substitute functions and the improvement of independent living, also with the inclusion of technical aids, is a central component of occupational therapy (Remedies Guidelines § 92 SGB V). Occupational therapy measures according to the therapeutic appliances guidelines (§ 92 SGB V) are:
- Motor-functional treatment – Targeted treatment of disease-related motor disorders with and without involvement of the peripheral nervous system or the resulting ability disorders. For example, building and maintaining physiological functions and improving fine and gross motor skills.
- Sensorimotor-perceptive treatment – Targeted treatment of disease-related sensorimotor disorders (e.g., in diseases of the central nervous system) and the conditional ability disorders. For example, coordination, implementation and integration of sensory perceptions, improvement of balance function and improvement of oral and eating motor skills.
- Brain performance training/ neuropsychologically oriented treatment – Targeted therapy of disease-related disorders of neuropsychological brain function, especially in cognitive impairment.For example, improving and maintaining attention, concentration, orientation, memory, and action planning or problem solving.
- Mental-functional treatment – Targeted treatment for mental stabilization. For example, stabilization of basic mental performance functions such as drive, endurance, resilience, flexibility, motivation and independent daily structuring.
- Therapy supplementary measures – Z. For example, occupational therapy splints.
- Medical diagnostics for occupational therapy measures – Z. E. Entrance diagnostics for initial prescription of occupational therapy and further diagnostics if the therapy goal is not achieved.
The implementation of occupational therapy is easily divided into three main phases:
- Evaluation – Diagnostics and assessment of findings allow the establishment of therapeutic goals, this process continues during therapy.
- Intervention – planning therapy and implementation of occupational therapy measures.
- Outcome – evaluation and critical review of the results of therapy.
A wide variety of treatment concepts are available to achieve the goals of occupational therapy. The competence-centered method takes on the restoration or improvement of (basic) work skills such as work rehabilitation. In doing so, action skills for the targeted use of activities and a connection to reality are strengthened. The interactional method focuses on process-oriented discussion within a group so that the members of a group therapy can communicate with each other and share their experiences. The expression-centered method, on the other hand, makes it possible to deal with one’s own feelings and desires through creative activities. The occupational therapy approach serves (in contrast to the competence-centered approach) the primary attainment of basic working skills, this includes training concentration, coordination, technical skills or independence. Occupational therapists work mainly in occupational therapy practices, in preventive, rehabilitation and specialized clinics or in health centers. Other platforms of occupational therapy can be found in nursing homes, residential homes for people with disabilities, special schools, early intervention centers or at outpatient social services.
