promote wellness additional resources for mental health services and/or the role of occupational therapy in addressing mental health are listed below: world federation of occupational therapists position statement titled “occupational therapy and mental health”: https://wfot.org/resources/occupational-therapy-and-mental-health substance abuse and mental health services administration - interagency task force for trauma-informed care: https://www.samhsa.gov/trauma-informed-care american occupational therapy association federal recognition of ot as a provider of behavioral health: https://www.aota.org/~/media/corporate/files/advocacy/federal/federal-actions.pdf aota mental health fact sheets: https://www.aota.org/-/media/corporate/files/aboutot/professionals/whatisot/mh/facts/community-mental-health.pdf https://www.aota.org/-/media/corporate/files/aboutot/professionals/whatisot/mh/facts/mh%20in%20children%20and%20youth%20fact%20sheet.pdf with terminally ill patients occupational therapy (ot) practitioners help patients with terminal illnesses and conditions by assisting them with their needs related to end-of-life support. all of the areas of a patient's life including work, play and leisure are widely affected. an occupational therapist provides various treatment modalities to help such individuals to restore or maintain their deteriorating performance components by using their remaining capabilities to give them a sense of self-importance and a measure of self-confidence. the world federation of occupational therapy (wfot) recognizes the important role ot practitioners have in end-of-life care. in working with patients who have severe health conditions, disabilities and terminal illnesses, the ot clinician will help these individuals engage in meaningful, everyday occupations, as well as exercise the right to well-being and the best quality of life despite the unavoidable conclusion to their lifecycle. an ot practitioner understands the transactional relationship that exists between the individual, environment, and occupation; so that life enhancing, ongoing performance in quality of life activities are promoted. the wfot recognizes an optimistic presence for ot in end-of-life care with an ongoing need for advocacy and support. with people experiencing chronic pain occupational therapists often work within interdisciplinary or multidisciplinary teams (professionals such as physical therapists, nurses and physicians) to help individuals with chronic pain develop active self-management strategies. an area of specific concern to occupational therapists is the usage of a patient's time but it is also common for occupational therapists to help people return to work, and to return to leisure and family activities. occupational therapists may use a variety of interventions including biofeedback, relaxation, goal setting, problem solving, planning, and can use those tools within both group and individual settings. therapists may work within a clinic setting, or in the community including the workplace, school, home and health care centers. occupational therapists may assess occupational performance before and after intervention, as a measure of effectiveness and reduction in disability. assessment in order for an individual or group to receive occupational therapy services they must first be referred by themselves, another health care provider, or through their support system (family, friends) to receive an occupational therapy evaluation. as part of the service delivery process, the evaluation consists of the initial occupational profile followed by an analysis of occupational performance. occupational therapy evaluations and occupational therapy assessments are important in determining an individual's skill set or deficiency. through the occupational profile, which is a structured interview of the client, an occupational therapist can identify the client's self-perceived strengths and limitations in participating in daily occupations and help create an individualized treatment plan that addresses the occupations that are meaningful and necessary to the client. as part of the occupational profile, an occupational therapist also seeks to identify physical and social supports and barriers to participation. occupational therapists often gather additional information by communicating with the client's support system, which may include a child's parents/guardians, a student's teacher, an adult's spouse/siblings/friends, or a senior's caretaker. the analysis of occupational performance may be gathered through standardized assessments, clinical observations of the client performing a set of tasks and activities, and analysis of the physical or social environment and context in which the client performs the occupations. occupational therapist utilize skilled observation simultaneously with evaluation of motor and process skills and the effect on the ability of an individual to perform complex or instrumental and personal activities of daily living (adls). occupational therapists are trained in the administration of standardized assessments across the lifespan from infancy to old age, although some standardized assessments require an occupational therapist to gain additional certifications to administer. examples of the types of assessments or skill areas occupational therapy practitioners assess include: sensory processing skills visual perception and visual motor skills gross motor and fine motor skills handwriting hand dexterity cognition and intelligence school-based evaluations developmental milestones daily living tasks include dressing and feeding pain executive functioning through the initial evaluation process, occupational therapists work with the client to establish an individualized treatment plan. data is collected and recorded throughout the treatment process to be utilized to assess progress and guide ongoing client-centered intervention. this data is also frequently utilized for reimbursement of services. at the conclusion of therapy services, an occupational therapist will complete an outcome assessment which may include a re-evaluation. assessment may also be more broad such as assessing the accessibility of public spaces for all individuals. occupational therapists can provide recommendations for building design to allow for access for all. occupational therapists are also skilled at completing home safety assessments and altering the environment or providing accommodations for ways to complete occupations in the home for increased safety of clients. occupational therapists can also complete driving assessments to determine the required accommodations in the car or the ability of an individual to safely drive. furthermore, occupational therapists can work with whole organizations to assess their workspaces to ensure that the work demands and physical set up are conducive to safe working habits to prevent workplace injuries. hand therapy occupational therapy also plays a major role in the rehabilitation and recovery of patients who have hand as well and upper and lower extremity injuries. they play a significant role in liaising with the hand/orthopedic surgeon and a patient's employers or case managers in providing the best client centered rehabilitation program. occupational therapists treats conditions ranging from soft tissue injuries such as tennis elbow to neuropathies such as carpal tunnel syndrome. an array of upper limb assessment is utilized to provide a treatment care that is effective and appropriate. treatment modalities such as orthosis/splints, soft braces and education are some of the common treatment tools that an occupational therapist will use during treatment. hand therapy is a specialized field of occupational therapy and it requires the therapist to be highly skilled and knowledgeable in upper limb anatomy to be able to work in this area.