Occupational Therapy’s Role in Brain Injury Recovery

By Jacqueline Bouillin, OT, CBIS 

 When most people hear the term occupational therapy, they often assume it involves helping individuals find jobs. However, in our field, an occupation is so much more. Occupational therapists (OTs) focus on rehabilitating the activities that people choose to occupy their time with — the daily tasks, hobbies, and roles that give life meaning. 

 Occupations are not just about employment. They encompass everything we do in a day: getting dressed, preparing a meal, playing a game, caring for a loved one, or engaging in community activities. 

 The beauty of occupational therapy is that it is highly individualized. Everyone chooses to occupy their time differently, which means no two OT journeys ever look the same. 

How Occupational Therapy Supports Brain Injury Recovery 

After a brain injury, individuals often face a wide range of challenges — physically, cognitively, and emotionally. Occupational therapists help brain injury survivors re-engage with meaningful activities by addressing these areas holistically. Some of the most common areas we support include: 

• Activities of Daily Living: Bathing, dressing, eating, grooming, and more 

• Instrumental Activities of Daily Living: Meal preparation, cleaning, shopping, managing finances, caring for pets or children, and medication management 

• Return to Work or School: Assisting individuals in returning to previous roles or exploring new vocational or educational opportunities 

• Leisure and Play Participation/Exploration: Helping individuals re-engage with old hobbies like sports, crafting, and board games, or encouraging them to explore new interests that bring joy 

• Sleep: Establishing healthy routines that support brain healing and emotional well-being 

• Social Participation: Rebuilding social skills and confidence to re-engage with family, friends, and the community 

• Fall Prevention: Implementing strategies and adaptive tools to ensure safety during movement and reduce the risk of falling 

• Caregiver Support and Education: Equipping caregivers and families with tools and strategies to assist the recovery process while encouraging the individual’s independence 

• Environmental Modifications: Adapting home, work, and community spaces to promote safety, ease of movement, and greater independence 

• Assistive Technology and Adaptive Equipment: Recommending tools that make daily tasks more accessible while recovery is ongoing 

A Holistic Approach to Healing 

Occupational therapists treat more than just a person’s injury — we treat the whole person within the context of their life. 

When we evaluate and treat someone with a brain injury, we carefully consider: 

• The Individual: Their prior level of function, and their current physical, visual, cognitive, and emotional abilities 

• The Environment: Where they live, work, and engage in activities, and how we can adapt these spaces for optimal participation and safety 

• Social and Economic Contexts: The support systems, financial resources, and external factors that can either support or hinder recovery 

One of our greatest tools is activity analysis — the detailed breakdown of any occupation into its physical, cognitive, and emotional components. For example, getting dressed in the morning includes physical, cognitive, and emotional components:  

• Physical Skills: Vision, balance, functional hand grasp and release, range of motion, and shoulder strength 

• Cognitive Skills: Knowing left from right, spatial awareness, attention, memory, initiation, and sequencing steps 

• Emotional Readiness: Motivation to start the day, confidence to sit at the edge of the bed, and strategies to manage anxiety 

We also analyze environmental factors. For example, is the bed the right height for safe dressing? Would they benefit from a handrail for support? Is the lighting sufficient to clearly see clothing? 

By examining all these elements, we create targeted, personalized treatment plans that meet the client where they are and help them move forward. 

While restoring movement and cognitive function is always a goal, we also use adaptive equipment and creative modifications to bridge the gap between injury and independence. 

How to Choose an Occupational Therapist 

Finding the right occupational therapist – especially one with experience in treating people with brain injury – is crucial. When searching for an occupational therapist for yourself or your loved one, here are some things to consider: 

• Experience with Brain Injury: Look for occupational therapists who have experience treating people with brain injury. The Certified Brain Injury Specialist (CBIS) certification from the Brain Injury Association of America shows a demonstrated commitment to treating people with brain injury. The American Occupational Therapy Association also offers specialized training programs and certifications. 

• Specialized Services: Choosing a therapist with experience treating brain injury-specific challenges, such as cognitive difficulties, emotional dysregulation, or fatigue, will be helpful in ensuring your therapist has a solid understanding of your struggles. 

• Trust and Communication: Having a good relationship built on trust, solid communication, and a good rapport is critical to making progress. Choose an occupational therapist that you feel comfortable with and who listens to your concerns. 

• Insurance and Costs: Make sure the therapist accepts your insurance, or that you can manage the cost of therapy without insurance. 

Occupational Therapy Treatment: Meaningful, Engaging, Empowering 

Occupational therapy treatment is centered around meaningful engagement, not just isolated exercises. We prime the brain for real-world tasks through warm-up activities like stretching, cognitive strategies, vision exercises, balance exercises, deep breathing, electrical stimulation, and more — all with the goal of increasing participation in the occupations that matter most.

Recovery happens through doing — through participating in the very activities that give life purpose. Our role is to facilitate that process, safely and effectively, until individuals are once again empowered to live their life to the fullest. 

Occupational therapy is not just about rehabilitation; it’s about restoring identity and purpose after a brain injury. 

Jacqueline Bouillin, OT, CBIS, is the Founder of Holistic Life Skills. She can be reached at jacki@hlskills.com