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  • Writer's pictureMonica Jones

PDF PowerPoint and email template for referring provider education

Updated: Apr 12

Occupational Therapy and the Cognitive Behavioral Approach
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Here is an example of the email I send to providers who would like more information on OT and cognitive behavioral therapy in the mental health outpatient setting or who have referred for a diagnosis that is not descriptive of a functional deficit:

Good morning/afternoon [insert provider (s) name (s)],

Here is some more information on occupational therapy services for individuals with a mental health condition:

Cognitive Behavioral Therapy and Occupational Therapy

Cognitive behavioral therapy (CBT) is an evidence-based psychological approach to self-management that can help people with a mental health condition improve psychological and physical functioning and prevent disability. It involves not only education but also practice and monitoring of health behaviors, with a focus on physical activity, relaxation, and activity pacing.  Several studies have shown that CBT can be an effective approach for improving mental health and addiction issues as well. 

Sessions are 30-60 minutes 1x/week and usually patients can expect to attend 10-12 sessions, although this varies person to person. 

What patients are appropriate for referral: 

In order to qualify for occupational therapy services, the mental health condition must be affecting the individual's ability to carry out daily activities, roles, and routines successfully.

Patients must be stable mentally, either through medication management or by nature of their mental illness.  Patients with uncontrolled mental illness, suicidal ideation or aggression will not benefit from occupational therapy cognitive behavioral programming.  Patients cannot be a danger to themselves or others to attend sessions, so referrals from the emergency department or those having an acute mental breakdown/psychotic break would not be appropriate.  Referrals should come from the patient’s primary care provider.

The following codes support the services that occupational therapy can provide treatment for.  If the patient and chart documentation meets one of the diagnoses codes listed below, please refer/write new referral to occupational therapy for ‘Evaluation and treatment’. 

Anxiety, mood disorder, depression, bipolar disorder, PTSD, perinatal mood or anxiety disorder and other mental health diagnoses may lead to:

Difficulty concentrating, planning, organizing, managing time, working memory, metacognition, response inhibition, emotional control, sustained attention, task initiation, flexibility may fall under:

  • R41.844 Frontal lobe and executive function deficit: Cognitive deficit in executive function

  • R41.840 Attention and concentration deficit: Cognitive deficit in attention or concentration.

Derealization or depersonalization may fall under:  

  • R41.82 Altered mental status, unspecified

Trembling/shaking/shortness of breath/feelings of choking/chest pain or discomfort/nausea/dizziness/chills or heat sensations/tingling sensations may fall under:

  • R44.9 Unspecified general sensations and perceptions or R20.8 Disturbance of Skin Sensation

A significant maladaptive change in behavior related to panic attacks (e.g., behaviors designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations) or obsessive thoughts of harm to self or baby may fall under struggling with ADLs/IADLs or:

  • R41.844 Frontal lobe and executive function deficit: Cognitive deficit in executive function

Additional codes that may relate to mental health issues associated with difficulty completing daily occupations/routines: 

  • F89 Unspecified Disorders of Psychological Development (pediatric patients only)

  • R53.83 Other fatigue

  • R52 Pain unspecified

Warm regards,

[therapist name and credentials]

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