Trauma work therapy
What Is Trauma-Focused Therapy? | Center for Child Trauma Assessment and Service PlanningWhat is Therapy?
Therapy provides a safe and confidential place for a person to talk to a professional about personal experiences, thoughts, feelings, or problems. People who go to therapy may have experienced a situation that that disrupts and/or impacts his or her thinking, mood, feelings, or ability to relate to others. A person may also seek out therapy because they want a neutral and safe place to talk about general life experiences. Many people seek out therapy: adults, youth, teens, even therapists themselves. Everyone needs somewhere they feel safe and supported.
The role of the therapist is to help the person understand his/her situation, teach strategies to express him/herself, and cope with potentially stressful situations. The therapist can also offer the individual or family tools to help them manage difficult feelings, and/or negative thoughts and behaviors.What is Trauma-Focused Therapy?
Trauma-Focused Therapy is a specific approach to therapy that recognizes and emphasizes understanding how the traumatic experience impacts a child’s mental, behavioral, emotional, physical, and spiritual well-being. This type of therapy is rooted in understanding the connection between the trauma experience and the child’s emotional and behavioral responses. The purpose of trauma-focused therapy is to offer skills and strategies to assist your child in better understanding, coping with, processing emotions and memories tied to traumatic experiences, with the end goal of enabling your child to create a healthier and more adaptive meaning of the experience that took place in his/her life.SAMHSA’s Definition of a Trauma-Focused Therapy
“A program, organization, or system that is trauma-informed:
- Realizes the widespread impact of trauma and understands potential paths for recovery
- Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system;
- Responds by fully integrating knowledge about trauma into policies, procedures, and practices; and
- Seeks to actively resist re-traumatization. ”
For more information, click HERE.Benefits of Trauma-Focused Therapy
Trauma-Focused Therapy can be beneficial to youth who have experienced a traumatic event . By engaging in trauma-focused treatment, your child can learn more about what he/she is experiencing,how to address the concerns, and develop healthier ways of coping. The following are a few examples of the benefits of trauma-focused therapy:
Learn About Trauma.
Trauma-focused therapy provides a space for children and their families to learn about normal responses to trauma and specifically how a traumatic event has impacted the child and family. This type of discovery and learning helps you and your child to digest why certain thoughts, feelings, and behaviors might occur, gives names and explanations to his/her experiences, and reminds your child that he/she is not alone in his/her experience.
A traumatic experience by definition results in a violation of your child’s sense of safety. This includes violations of physical, emotional y, psychological, and/or relational safety.. A benefit of trauma-focused therapy is to assist your child in re-developing internal (emotional, psychological, relational) and physical (touch, the environment) senses of safety, through activities and discussions that target these domains.
Participating in trauma-focused therapy can help your child learn to identify, understand, explore, and express memories and feelings related to the trauma. Often times, children may show reactions that appear to “come out of nowhere” or are out of proportion for an experience, but it may be that these are actually reactions to trauma reminders. Another benefit oftreatment is that your child can learn to recognize what experiences or feelings may be associated with traumatic reminders (also known as triggers) and work to be able to more appropriately adapt his/her response over time.
Develop Healthy Coping Skills.
Trauma-focused therapy sessions aim to help youth discover skills and improve coping strategies to better respond to reminders and emotions associated with the traumatic event. Some of these skills include anxiety management and relaxation strategies that are taught in youth friendly ways. Developing these types of skills in response to trauma supports resiliency or assists your child in “bouncing back” from his/her traumatic experience.
Decrease in Traumatic Stress Symptoms.
Engaging in trauma-focused therapy and working closely with the therapist can help your child develop and practice skills that help decrease traumatic stress symptoms and other mental health symptoms associated with the trauma. Your child may experience decreases in depression, anxiety, dissociation, trauma-related shame or guilt, and/or intrusive symptoms such as flashbacks and nightmares.
Practice Trauma Processing or Integration.
One goal of a trauma-informed therapy is to help the child regain power and control over past experiences by sensitively assisting the child to re-narrate his/her story. Over time your child has the opportunity to “process” or organize these unique experiences into his/her everyday life and ,make meaning of the event(s) and how they relate to your child’s view of him/herself and the world around.Trauma-Focused Treatment Activities
There are a large variety of different activities or strategies that used within the trauma-focused treatment process. These trauma-focused activities may look different based on age, trauma experience, setting, or location. Therapists may use creative strategies and activities to address memories, emotions, or problematic behaviors associated with traumatic experiences as part of the therapy process. These are conducted in a way that is sensitive and unique to your child’s experience and are often used in conjunction with relaxation skills.Types of Trauma-Focused Treatments
Many different types of trauma-focused and trauma-informed treatments exist today. These may also be referred to as trauma-focused interventions. One intervention type is not “better” than another, but rather each was developed to meet the different needs of individuals and families. Trauma-focused treatments may look different based on age, trauma experience, setting, or location.
To find specific trauma-informed interventions based on your child’s needs, visit the National Child Traumatic Stress Network Empirically Supported Treatments and Promising Practices by clicking HERE.How Do I Know if a Therapist is Trauma-Informed?
Currently there are no state or national regulations defining “trauma-informed provider” or “trauma-informed therapist.” However, some states are working toward “credentialing” or ensuring that clinicians have minimum education and training around trauma-informed practice. No matter where you live or what a professional’s background may be, there are questions you can ask a therapist to learn more about his/her training and experience working with children exposed to trauma. Some questions you may consider asking include:
- What is your educational background (degree, professional title)?
- What are your specialties?
- How long have you been conducting therapy?
- What is your experience in working with youth who have experienced trauma?
- What is your approach to working with youth who have experienced trauma?
- Have you had any type of specialty training in the treatment of childhood trauma?
- Do you consider yourself a “trauma-informed therapist”? How?
For more tips on choosing a trauma-informed provider, visit SAMHSA’s Trauma-Informed Approach and Trauma Specific Interventions webpage or visit NCTSN’s Empirically Supported Treatments and Promising Practices webpage.
How does it work and what are the success rates?
Up to 70% of adults will experience a traumatic event in their lives. 20% of those adults will go on to develop a trauma-related response or mental health disorder from these adverse events. The memories and emotions that stem from a traumatic event can be debilitating. They can trigger alcohol or drug abuse, and the distressing symptoms of a mental health disorder. Although trauma and trauma-related disorders and emotional problems can be debilitating, there is hope for victims. Many different types of therapy can treat the distressing symptoms of trauma-related disorders. Trauma therapy is one such technique that is highly beneficial for trauma victims.
What is trauma therapy?
Trauma therapy is just that – a form of talk therapy aimed at treating the emotional and mental health consequences of trauma. In clinical terms, a traumatic event is one in which a person’s life was threatened, or they witnessed another person’s life being threatened. Experiencing the death of another person can also trigger trauma-related problems for vulnerable individuals. It is unclear how and why people react to trauma differently. A combination of genetics, temperament, and repeated exposure to traumatic events can all play a role.
Some people can move on from a traumatic event and not experience adverse reactions to it for years after the fact. Others may be more susceptible to psychological wounds. If a person can cope with a severe threat, they are not traumatized. When someone has issues coping after the danger has passed, they are suffering from trauma. Women are more likely than men to experience trauma-related psychological wounds. Up to 20% of combat veterans will struggle with the symptoms of PTSD and psychological trauma.
Trauma therapy refers to specific types of therapy geared toward treating the effects of trauma. Also called trauma-informed care, it’s more of an umbrella term that calls upon mental health clinicians and other professionals to be mindful of a person’s life experiences when providing treatment. Trauma-informed approaches provide guidelines for giving the best care possible to patients with trauma histories, which includes screening patients for trauma, training professionals in the best approaches for treating trauma and working with other organizations. These organizations can include schools and workplaces to ensure they are equipped to utilize guidelines from trauma-informed care. Trauma therapies, such as eye movement desensitization and reprocessing, fall under the umbrella of trauma-informed therapy.
There are several different types of effective trauma therapies that patients can utilize:
- Trauma-focused cognitive behavioral therapy
- Psychodynamic Psychotherapy
- Eye movement desensitization and reprocessing
- Critical incident stress debriefing
Before a patient attends a trauma therapy session or any type of treatment for their emotional issues, it’s critical for them to understand their goals and objectives for the therapy. With help from a team of doctors, counselors, or social workers, patients can decide on what type of trauma therapy will be the most beneficial for their particular needs and goals. When it comes to effectively treating mental health conditions and emotional issues, highly customized, tailored approaches will give patients the best chances of recovery. Trauma therapy is patient-focused and centers around specific goals the patient has for their improvement.
What are the success rates of trauma therapy?
Studies have found that between 77% and 100% of patients who attend regular, customized trauma therapy sessions will see a reduction in their symptoms. This is on-par with studies on trauma patients who used medications to treat their symptoms.
What does trauma therapy treat?
While trauma therapy can treat general symptoms of trauma, people who seek this type of therapy may have a specific diagnosis that has led them to seek treatment. Perhaps the most common condition that is treated with trauma therapy is post-traumatic stress disorder (PTSD), which falls under the category of “Trauma and Stressor-Related Disorders” in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). There are several disorders under this category, but all of them include experiencing a traumatic or stressful event as part of their diagnostic criteria.
Given that 3.6 percent of American adults experience PTSD in a given year, and 6.8 percent are diagnosed at some point during their lives, this disorder is commonly associated with therapy for trauma. The symptoms for PTSD, according to diagnostic criteria, are as follows:
- Exposure to a traumatic event, such as actual or threatened death, severe injury, or violence, either by experiencing it oneself, witnessing it happen to another person, learning that a traumatic event has happened to a loved one, or being exposed to it through work as a law enforcement official or first responder
- Experiencing at least one intrusive symptom, such as unwanted memories or recurring dreams of the event, flashbacks related to the event, and intense psychological or physiological reactions when exposed to reminders of the event
- Avoiding memories, thoughts, people, or locations linked to the traumatic event
- A negative impact on thoughts and emotions following the event, which can be manifested in the form of at least two of the following: loss of memory pertaining to the event, pessimistic view of self and the world, distorted thoughts leading a person to blame themselves for the event, ongoing negative mood, lack of interest in usual activities, disengagement from other people, and inability to feel positive emotions like happiness
- At least two symptoms of changes in emotional arousal and reactivity, such as irritability, outbursts of anger, reckless behavior, hypervigilance, being easily startled, difficulty concentrating and disrupted sleep
To be diagnosed with PTSD, a person must display symptoms for a month or more, and symptoms must cause significant distress or difficulty with daily functioning. Unfortunately, over one-third of adults with PTSD experience serious impairment, making therapy for trauma important for individuals with this condition.
Those with other disorders related to trauma, such as reactive attachment disorder, acute stress disorder, and adjustment disorders may also benefit from learning, “What is trauma therapy?” as this method of treatment is relevant for them.
A person who does not meet full diagnostic criteria for PTSD or another condition in that realm, but still experiences significant distress and shows some symptoms of trauma, may be diagnosed with “other specified trauma and stressor-related disorder.” Trauma therapy may be utilized for this condition as well.
If you or a loved one are suffering from trauma-related symptoms, it’s critical to reach out for help. Psychological wounds rarely heal on their own, but with time and guidance from a caring and experienced therapist, trauma-related symptoms can be alleviated for good. Please contact the counselors and clinicians at Mission Harbor Behavioral Health to explore your treatment options.
The facilities at Mission Harbor are staffed with trained experts to best assist patients with their mental health issues. We are capable of dealing with any and all cases with a licensed staff, equipment, and approved techniques. Our mission is to help those who want to help themselves, and we support your decision in seeking help.
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Home, Occupational Therapy - Sobe Innovative Rehabilitation
Did you know that occupational therapy can make everyday tasks easier?
Occupational therapy can make your life easier!
Do you have an injury or illness that is causing you pain, limiting your daily activities, and preventing you from enjoying the things you love?
Are you looking for relief from a condition that is holding you back?
Want to learn more about how occupational therapy can help you relieve pain and improve your productivity? nine0007
In this case, occupational therapy can help you get back to your old life. Contact Sobe Innovative Rehabilitation today to schedule an appointment!
Have you heard of manual therapy?
Occupational therapy is a different area, one of which is manual therapy. Hand therapy aims to treat orthopedic diseases of the upper extremities in order to optimize the functional use of the arm and hand.
Hand therapy is used to treat several conditions surrounding the upper extremities, including but not limited to:
● Carpal tunnel syndrome.
In general, manual therapy focuses on the biomechanical aspects of diseases of the upper extremities. It is a patient-centered approach that meets the needs of the patient, such as the ability to lift objects, open a jar, or button up a shirt. nine0007
A hand therapist can perform a number of interventions to help you comfortably carry out daily activities.
This may include any combination of therapeutic exercises, mirror therapy, orthosis design, pain management, manual therapy, taping, ergonomics, or compression therapy.
There are several activities a hand therapist can suggest that you do to strengthen your upper limb after an injury, such as puttingty work, using a grip, or using dumbbells. nine0007
Manual therapy has several benefits, including:
● Conditioning before returning to work.
● Sensory re-education after a nerve injury.
● Desensitization due to nerve damage or injury.
● Making a custom splint to prevent or correct injury.
● Prophylactic, non-operative or conservative treatment.
● Life skills training using adapted methods and equipment. nine0007
● Develop and implement home exercise programs to improve movement, agility and/or strength.
● Management of acute or chronic pain.
Physiotherapy and occupational therapy - what's the difference?
Although occupational therapy is similar to physical therapy, there are several differences. Physical therapy focuses on the patient's ability to perform certain movements in general, while occupational therapy focuses on the patient's ability to perform certain movements during daily activities. nine0007
For example, a physical therapist will work with a stroke patient to build back muscle strength, and a physical therapist will work with a stroke patient to practice basic skills such as walking, eating, bathing and dressing.
Physiotherapy and occupational therapy tend to overlap as a patient may begin treatment with a physiotherapist and then move on to work with an occupational therapist once their pain has subsided and they have regained sufficient strength/physical function. nine0007
So how can occupational therapy help me?
Occupational Therapy is more than just trauma care. At Sobe Innovative Rehabilitation, our Hallandale Beach occupational therapists focus on the functional needs of each patient through specific exercises and activities that promote physical and psychological well-being.
Occupational therapy is a form of treatment deeply rooted in science and supported by numerous medical journals.
Our Hollandale BEACH Occupational Therapy works hard to help people recover from injury and regain functional skills. Occupational therapy can benefit people of all ages, from helping children with disabilities participate in school and social life to helping older adults improve their physical and cognitive health.
Our occupational therapy plans at Sobe Innovative Rehabilitation include:
● Evaluate results to determine if goals have been achieved and make changes to the plan if needed. nine0007
● Individualized interventions to improve the daily tasks and activities of the patient.
● Individual assessment to determine patient goals.
According to the American Occupational Therapy Association (AOTA), in addition to working with an individual's physical well-being, occupational therapy practitioners address psychological, social, and environmental factors that can interfere with an individual's functioning in a variety of ways.
For example, occupational therapy for a young patient may involve using a special tool to make cupcakes at home. If it is necessary to adjust the utensils, the occupational therapist will do it. This unique approach makes occupational therapy a vital part of healthcare. nine0007
Find relief and return to your normal life today!
If you think occupational therapy can help you, don't hesitate to make an appointment today.
You feel emotionally better when you can comfortably go about your hobbies and daily activities.
Sobe Innovative Rehabilitation is ready to help you start your journey towards a more pleasant, comfortable and functional life!
What is occupational therapy and why is it good
Occupational therapy helps the disabled, the elderly and the sick not only physically but also mentally. But the practice of treatment through employment can be borrowed into everyday life to reduce anxiety and relax the brain
Many perceive work as a routine duty - without it, you can’t even catch fish from the store and put it on the table. And there is the idea of using labor for therapeutic purposes, which is successfully used not only for those who need inpatient treatment, but can also be adapted in order to put themselves in order, relieve anxiety, and “relax the brain”. nine0007
This method of treatment and maintenance of quality of life is called occupational therapy. From the name it is easy to guess that this is the use of labor forms of employment for therapeutic purposes. With its help, it is possible to develop, restore or maintain physical and mental activity and productive activity both in individuals and in groups and communities of people.
Occupational therapy is also a profession in the healthcare industry. If autotherapy with the help of some forms of labor to reduce the level of stress or depression can be used by a person even intuitively (someone begins to wash dishes, iron shirts, knit or chop wood), then in the case of rehabilitation after injuries, high professional requirements are imposed on the therapist. Therapists in this field often work with people who have mental health problems or developmental disabilities, people with congenital or acquired disabilities, or various injuries, both physical and psychological. nine0007
Occupational therapy may include helping children with disabilities adjust to school and social situations. For adults and children, occupational therapy can be helpful in rehabilitating from injuries. It can provide support to older adults experiencing physical and cognitive changes.
Occupational therapists often work closely with professionals in physical therapy, speech and language pathology, audiology, nursing, social work, psychology, medicine, and assistive technology. nine0007
Angelica Jolly, psychologist: “Occupational therapy is the use of activities adapted for patients in the rehabilitation process. Occupational therapy has a wide range of applications, it can be used both for teaching self-care, assistance in socialization, and in order to develop real work skills with the prospect of subsequent employment.
In the process of occupational therapy, the patient is selected a load that is suitable specifically for his situation, so that the activity is proportionate and can bring not only development, but also satisfaction from the process. Occupational therapy works only on a voluntary basis, any pressure or coercion can backfire and worsen the condition, as well as cause additional symptoms to the existing ones. The most important thing is the motivation of the patient himself. nine0007
How did the idea come about
Examples of the use of employment for therapeutic purposes can be found in late Hellenism. Greek physician Asklepiades at the turn of the 2nd and 1st centuries BC. e. used therapeutic baths, massage, music and exercises to treat mentally ill patients. Similar methods were used by the Greek physician of the 2nd century Celsus. But with the decline of ancient civilization, the relatively humane treatment of the mentally ill has sunk into oblivion and was limited, at best, to their cruel isolation. nine0007
The reform of psychiatry in 18th century Europe laid the foundation for the further development of occupational therapy - Philippe Pinel and Johann Christian Reil stopped using chains and other severe restrictions in their medical institutions. Instead, in the late 18th century, they began to enforce strict work and rest schedules. This was the era of "moral treatment", corresponding to the spirit of the European Enlightenment. These reforms of psychiatry laid the foundation for occupational therapy. The movement was actively developing in Europe, but interest in it in the United States fluctuated throughout the entire 19century. In Russia, supporters of the widespread introduction of occupational therapy were the life physician under Empress Maria Feodorovna (mother of Alexander I and Nicholas I) Ivan Ryul, psychiatrist, neuropathologist and reformer of the system of keeping psychiatric patients in Moscow hospitals Vasily Sabler, psychiatrist, organizer of the psychiatric patronage system Nikolai Bazhenov and doctor - Psychiatrist Petr Kashchenko.
Occupational therapy was influenced by the Arts and Crafts movement of the 1880s-1910s. Its participants followed the ideas of the art theorist and artist John Ruskin and the English writer, artist and designer, the founder of the movement William Morris about the superiority of manual labor over machine. In the United States, which was then in a stage of rapid industrialization, similar societies opposed the monotony of factory labor and the loss of autonomy due to its mechanization and standardization. In applying these ideas to therapy, followers of the movement believed that learning the craft and arts through action avoided the boredom of long hospital stays and provided a creative outlet. nine0007
Eleanor Clark Slagle (1870–1942), an American, is considered the founder of occupational therapy. Her ideas were based on the belief that participation in meaningful routine activities creates a person's well-being. An attentive reader of the literature of that time can see how such ideas shape the moral and ethical image of the older generation in such classic works of North American literature as "The Adventures of Tom Sawyer" and "The Adventures of Huckleberry Finn" by Mark Twain and Lucy Maud Montgomery's series of novels about Anne Shirley - "Anne from Green Gables. Slagle has proposed work skills training as the main model for occupational therapy. The training was aimed at creating structure and order in time and achieving the best balance between work, rest and leisure. Her model of occupational therapy was focused on the treatment of people with mental disorders, but the potential of the core principles seemed to expand its application to a wider audience. nine0007
The first occupational therapy training program was started by Eleanor Slagle in 1915 in Chicago. In the United States, the E. K. Slagle Lecture Award is presented annually. It is awarded to that member of the Association of Occupational Therapists "who has made a creative contribution to the development of the body of professional knowledge through research, education or clinical practice."
In the Soviet Union, where occupational therapy corresponded to the basic idea of Marxism-Leninism, therapeutic labor workshops were opened in psychiatric hospitals. Their goal was precisely treatment through the process of occupational therapy. However, researchers note that in Soviet psychiatry there were a number of shortcomings associated with the use of occupational therapy in practice. In particular, in the medical and labor workshops there was a very limited set of activities, all of them were monotonous and routine (for example, in the Oryol Special Psychiatric Hospital of the USSR Ministry of Internal Affairs, occupational therapy consisted of weaving nets-avosek or potato sacks). This ruled out the possibility of the progressive development of the patient's skills and the implementation of a phased rehabilitation through employment. nine0007
Victims of Soviet punitive psychiatry left memoirs, which give far from the most flattering description of occupational therapy in medical and labor workshops: there was a violation of sanitary standards, the violent nature of therapy, exceeding the permissible load standards to obtain economic benefits from the work of patients and the inadmissibility of refusing such a " therapy. "
With the development of the dispensary system, it became possible to slightly reduce the dependence of mental health care on hospitals and transfer some patients to outpatient treatment, which could use a wider range of rehabilitation work activities. However, it was not possible to significantly expand the list of activities and thus individualize the approach to the treatment of each patient. nine0007
With the collapse of the USSR and the accompanying systemic crisis, almost all such workshops were closed, and the point existence of medical and labor workshops was supported solely by the enthusiasm of doctors and social workers.
How it works
There are many variations of the occupational therapy process, which vary by school, country, tradition. However, in general, they all contain in one form or another three basic components: an assessment by a specialist of the current state of affairs to determine the strategy and tactics of future therapy, the actual process of intervention (therapy) and evaluation of results. Such a relatively unified approach allows for the continuity and consistency of therapy among different specialists. nine0007
The structure of occupational therapy practice consists of two parts: domain and process. The domain is the environment, factors of the patient himself, such as motivation, state of health, status of performing professional tasks. This is the context that helps to understand how to diagnose and treat a patient. The process is the actions taken by the therapist, his strategy and tactics.
One of the most important elements is to identify the strengths and resources of both the patient and the therapist to develop a treatment plan. nine0007
Angelica Jolly : “Occupational therapy is used in a wide range of situations. For example, with addictive behavior, it helps to switch attention from the object of dependence. It is also used in working with children with developmental disabilities, for whom it is important to learn to independently perform feasible daily activities.
The mechanism of work of occupational therapy consists in gaining greater autonomy, independence and additional support in life, which makes it possible to feel control over one's life and take responsibility, which has a beneficial effect on all mental processes in general. nine0007
In contrast to the usual work activity, where the goal can be a financial component, occupational therapy can only be considered the load that benefits the mental state of a person and contributes to its development. Activities must be carefully planned in such a way as to avoid overstrain, stress and burnout.
Why it is needed
Occupational therapy helps to maintain independence and activity in older people. Regular employment provides an opportunity to continue to participate in society and lead an active lifestyle. For example, occupational therapist assessments are used to determine the degree of safety when driving a car. In the event that the patient has already begun to undergo some age-related changes, the professional can choose what measures will help preserve driving skills, reactions, motor skills and, therefore, protect both the elderly driver and pedestrians. nine0007
In addition to maintaining life skills in good shape, people with low vision turn to occupational therapy, it can help with senile dementia and Alzheimer's disease.
Occupational therapists can also help assess older people's safety on their own, in terms of their ability to do household chores and get around. Their purview includes recommendations for specific modifications to the home to suit the patient's condition. The use of employment for therapeutic purposes can combat depression in older people. nine0007
In rehabilitation, occupational therapy can be useful for people with low vision - and this already applies not only to the elderly, but also to those who have lost their sight as a result of injury or in connection with professional activities. In addition, rehabilitation through therapeutic employment is applied to people with various physical and mental disorders and injuries. This may include working with children and adults with autism spectrum disorders to increase their socialization and independence. Occupational therapy has been successfully used for people with cancer in order to reduce anxiety and stress levels and avoid depressive states. In addition, cancer survivors are more likely to develop comorbid chronic diseases, so occupational therapy helps them improve their quality of life while maintaining and rehabilitating skills that are useful in everyday life. nine0007
An important role is played by training in the use of one hand due to amputation or loss of a limb, or training in the use of a prosthesis or myoelectrically controlled limb.
Angelica Jolly : “Occupational therapy ideas are often incorporated into psychotherapeutic techniques for working with depressed people. Since depressive states are characterized by a decrease in volitional activity, and difficult cases seem overwhelming, the treatment includes the principle that one complex and difficult task is divided into several simple and easy ones so that they can be completed. This helps a person to distribute the load evenly and more often to bring the matter to the end, which has a good effect on self-esteem.