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How Can Occupational Therapy Help Students' Mental Health?

Moni Keen, OTD, OTR/L

September 15, 2021



How can OTs help students' mental health?


What can OTs do? We are trained to recognize, assess, and treat mental illness. Again, this goes across the board, and there is no age stipulation on this. We are trained to be able to work with children all the way up through the geriatric population. The other thing that I want all of you to realize is that it does not require us to sit down and do a formal assessment. Every time that we work with a client, we should be actively addressing mental health needs. If they are having a down day, we should be working to encourage them and find ways to help them to better regulate themselves. We need to celebrate with them when great things happen, and we need to process with them when they are having times of difficulty.

We also have knowledge of programming. I know that this is a big one, especially for school-based practitioners. We are pros at environmental modification. I can go onto a classroom and immediately assess the "busyness" of it. What are on the walls? What is hanging from the ceiling? Is it overstimulating for the children? Is there something that we can put over the lights hanging from the ceiling that can dim the room just a bit? What is going on with air conditioning? Is that too loud? There are so many different factors that we can look at as practitioners to help modify a room to bring more self-regulation strategies into the classroom.

I have recommended making a quiet corner. Kids love little teepees or tents that they can go into if they are overwhelmed. They can go into that enclosed space, shut the door/flap, put on a timer for maybe five to 10 minutes, and this can help them to decompress and regulate themselves. This readies them to come back out so they are ready to learn.

You might want to put a rocking chair in the room. Rocking is a very soothing and calming thing to do. It can be used for kids who are having a hard time. Having fidgets in the room for kids who are feeling very nervous while they are listening to lectures and taking notes can help them to focus. You can put Velcro underneath the desk. You can give them the Move-in-Sits or TheraBand around their chairs so they can bounce their feet up and down. Physio balls are also great for them to roll around and bounce up and down. There are many environmental modifications to help with some sensory dysregulation in the classroom.

This brings us to point two, sensorimotor regulation. We need to instruct our teachers as well as our children some techniques and strategies to help when our children not only get revved up but also when they are very quiet, slow, and tired. We have to remember that having low sensory input is just as important as being overstimulated. We, as OTs, can come in and give recommendations like, "When Johnny is overwhelmed and you can see that he's starting to rev up, let him take a break. Maybe, he can go with one of your classroom assistants and take a walk around the school. Or, "If there are some library books that need to go back to the library, have him take those back to the library." It is important to remove him from the situation for a brief period of time. I can assure you that he'll come back more ready to learn. In the opposite scenario, Sally may have her head on her desk, and she's not paying attention. You might say to the teacher, "Put on some exercises on the smartboard and get the entire class up. Do some jumping jacks or some fun dances."

There are also plenty of programs out there, like Oodles of Noodles. I cannot remember the names of all of them, but there are plenty that we can use for the class to wake them up and get them ready for class. They also need to know how important it is to take those breaks throughout the course of the school day. As you know, our sensory systems are in constant flux, going up and down. Sometimes, kids need some quiet as well.

We are pros at doing life and social skills groups. What a wonderful opportunity we have to be able to sit down and talk to our kiddos about what it means to be overstimulated or what it means when we are feeling really sluggish. This is helping to identify within our own bodies what we need in order to regulate and get us back into a space of being ready to learn.

Lastly, I think that as OTs, the greatest tool in our toolkit is our therapeutic use of self. And of course, we can use this every time with our clients to help bolster emotional regulation and help open their eyes to strategies of what they can do in order to better handle situations and help their moods as well. 

moni keen

Moni Keen, OTD, OTR/L

Moni is a 1989 graduate of the Medical University of South Carolina.  She earned her Master’s Degree from Boston University and her doctorate degree from the University of St. Augustine. She is a school-based practitioner; however, she also has a private practice and employs 3 COTAs and one OTR. She is an adjunct professor at the Medical University of South Carolina and has also had adjunct responsibilities for the OTA program at Trident Technical College.  She has published two chapters for colleague’s books, one on handwriting and the other on Infant and School-Based Mental Health.  She resides in Summerville, SC where she loves to spend time with her amazing adult daughters and two Boston Terriers.

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