How an Occupational Therapy Approach Helps With Executive Function Challenges

Have you ever known exactly what you needed to do, but struggled to get yourself to do it?

You might assume you need to get better at planning, time management, or organization. While that may be true, often times that is only part of the reason you are having trouble starting and following through on tasks.

Our ability to plan, organize, and get things done doesn’t happen in isolation. It is influenced by who we are, the environments we work and live in, and the demands of the tasks we’re trying to complete.

This is where occupational therapy offers a different lens. The OT framework I use is called the PEO (person, environment and occupation) model.

In order to help people turn intention into action you need to be able to identify exactly what is getting in the way of task competition. Executive functioning challenges are only part of the picture. It is my job to understand the whole picture- what about the person, their environment and the task (also known as occupations) are influencing getting tasks done. 

What does this look like in practice?

A senior software engineer came to me because he felt like he wasn’t getting enough done at work. 

At first, this sounded like an executive functioning problem.

• Challenges with
  • Task initiation- I’m having trouble getting started
  • Planning/ organization- what should I do first
  • Time management- managing time to get all the things done

As we talked I discovered that he was sitting and staring at his screen and not getting his work done. He was only able to get his work done under a deadline. 

Still sounds like executive functioning doesn’t it? 

Upon digging deeper we realized he was sitting and staring at his screen because he didn’t know what to do and needed to ask for help. 

He reflected that he didn’t ask questions for a multitude of reasons:

1. He didn’t specifically know what he was stuck on
2. His perceived expectation was that he “should” know the answers given his role/ title 
3. Team meetings were 1x a week- which meant they were packed with other agenda items and were fast paced

In conclusion, when it came to questions, he didn’t know what to ask or when to ask them. However, the answers to these questions would give him clarity on his next steps which would allow him to get started quicker and use his time more efficiently.  

Ultimately his challenges with work were executive functioning challenges interacting with communication and his work environment

This is why using the occupational therapy lens is so powerful. If we had focused only on executive functioning skills, I might have missed an important part of what was getting in his way.

By looking at the whole person, we could develop a deeper understanding of all the factors that were impacting task completion. 

In turn, that understanding changed the strategies we choose..

That’s the value of an occupational therapy lens: understanding how the person, their environment, and the task demands interact so we can build strategies that truly fit.

If you are interested in understanding more about my approach please click “book a consult” on my website to schedule a free 30 minute informational call.