Author: Sarah Anderson

Posted on

How to Stop Procrastinating: A Guide to Getting Things Done: Dr. Sarah Anderson

We’ve all experienced it—the clock ticking, the deadline looming, and instead of diving into the task at hand, we’re doing everything in our power to avoid it. It’s a struggle for many—procrastination. Whether it’s delaying a work project, avoiding studying for exams, or putting off a household chore, procrastination affects us all. But what exactly is procrastination? Why do we do it? And most importantly, how can we stop?

Procrastination is more than just a bad habit—it often stems from psychological and emotional factors that make it difficult to stop. However, there are effective strategies that can help you regain control. By adopting these techniques, you can improve focus, productivity, and time management, leading to reduced stress and more effective action. 

What Is Procrastination?

Procrastination is the deliberate avoidance of tasks. While everyone procrastinates from time to time, chronic procrastination can lead to stress, guilt, and anxiety. It’s important to note that procrastination isn’t a sign of laziness; rather, it’s a complex psychological phenomenon.

Procrastination is often seen as a failure in self-regulation (Steel, 2007). It involves engaging in activities that provide short-term satisfaction—like watching TV or scrolling through social media—rather than focusing on tasks with long-term benefits. This leads to a buildup of pressure as deadlines draw near, and over time, chronic procrastination can contribute to increased stress, poor performance, and decreased self-confidence. Ultimately, this cycle can negatively impact mental health.

Why Do We Procrastinate?

Procrastination often has deeper psychological roots than what appears on the surface, and understanding these underlying factors can help us break the cycle. Here are some of the most common reasons people procrastinate:

Fear of Failure or Perfectionism

One of the biggest reasons for procrastination is a fear of failure. When confronted with a challenging task, we may avoid starting it entirely because we’re so focused on not doing it perfectly. Perfectionists, in particular, tend to procrastinate because they are afraid of making mistakes, and this fear of imperfection often leads to complete avoidance of tasks (Flett et al., 1992).

Perfectionists tend to set unrealistically high standards for themselves, which can create a fear of inadequacy and result in avoidance. They often delay work because they worry they won’t meet their own expectations. Research has shown that perfectionism is strongly correlated with procrastination, especially when individuals feel the need to achieve flawless results (Flett et al., 1992). As a result, procrastination becomes a coping mechanism to avoid facing the potential for imperfection or failure.

Low Motivation or Lack of Interest

Sometimes, we procrastinate simply because we don’t want to do the task. If the task feels boring, overwhelming, or uninteresting, it can be difficult to find the motivation to start. Van Eerde (2003) found that individuals are more likely to procrastinate on tasks that are perceived as unpleasant, tedious, or lacking in immediate rewards. If a task doesn’t excite us, it’s easy to push it aside in favor of more stimulating activities. For example, instead of working on a long-term assignment, you may find yourself distracted by social media or texting. This is especially true for tasks that feel unrewarding, like studying for a far-off exam or working on a large project that won’t pay off immediately.

Poor Time Management

Procrastination is often linked to poor time management. Without a clear plan or sense of urgency, it’s easy to delay tasks until the last minute. Effective time management also involves prioritizing tasks. When someone struggles to determine what’s most important or urgent, they may have difficulty deciding what needs to be done immediately and what can wait. 

Additionally, if we don’t allocate enough time for each task or misjudge how long something will take, procrastination becomes even more tempting. Without a clear structure, it’s easy to push tasks aside until the pressure of a looming deadline creates unnecessary stress.

Avoidance of Discomfort

Procrastination often functions as an avoidance strategy. Tasks that feel mentally taxing or anxiety-inducing—like writing a report or filling out paperwork—tend to be delayed. This avoidance can provide temporary relief from uncomfortable emotions such as anxiety, frustration, or boredom (Sirois et al., 2013).

However, procrastination only worsens the situation. Although it may offer short-term relief, the underlying stress and anxiety will eventually accumulate, leading to an even more overwhelming experience in the long run.

The Consequences of Procrastination

While procrastination might feel like a temporary escape, it can lead to several negative long-term consequences:

Increased Stress

Procrastination typically results in higher levels of stress and anxiety as deadlines draw near. The longer we delay a task, the more pressure we feel to complete it last-minute. This creates a cycle of stress that worsens with every delay.

Lower Quality of Work

Procrastinators often rush to finish tasks at the last minute, which compromises the quality of their work. Steel (2007) found that procrastinators tend to perform poorly on tasks because they are rushed or distracted by the anxiety that comes with looming deadlines.

Negative Impact on Mental Health

Chronic procrastination can contribute to feelings of guilt, shame, and low self-esteem. The cycle of avoidance and stress gradually erodes self-confidence, resulting in a diminished sense of well-being (Sirois, 2014). These negative emotional experiences can ultimately impact mental health.

Relationship Strain

Procrastination can also strain relationships, especially in work or personal settings. If you’re constantly delaying tasks or missing deadlines, it can create tension with colleagues, family members, or friends who depend on you to fulfill commitments.

Methods to Stop Procrastinating

Stopping procrastination is not easy, but it is entirely possible with the right strategies. Below are several evidence-based techniques that can help you take control.

Break Tasks into Smaller Steps

One of the most effective ways to combat procrastination is by breaking large tasks into smaller, more manageable steps. Complex tasks can feel overwhelming, but when divided into bite-sized chunks, they become much more achievable. Instead of thinking, “I need to write a 10-page paper,” focus on one small part at a time—like writing a single paragraph or creating an outline. This makes the task feel less intimidating and helps you build momentum.

Use the Two-Minute Rule

The two-minute rule is a simple technique that helps you get started on tasks. The rule is straightforward: if something takes less than two minutes to complete, do it immediately. This principle helps prevent small tasks from accumulating and reduces the mental resistance to starting a task. David Allen, creator of the Getting Things Done productivity method, advocates for this approach as a way to prevent procrastination (Allen, 2001). Tackling quick tasks immediately builds momentum and makes larger tasks feel more manageable.

Time Blocking and the Pomodoro Technique

Time blocking involves setting aside specific periods of time to focus on tasks, creating a structured schedule that fosters a clear sense of priority and helps reduce procrastination. Similarly, the Pomodoro Technique—while a form of time blocking—offers a more structured approach by having individuals work in 25-minute intervals followed by a 5-minute break (Cirillo, 2018). 

Create a Reward System

Rewarding yourself after completing tasks can help keep motivation high. When tasks are boring or unpleasant, offering a reward afterward can make them feel more rewarding. For example, treat yourself to a break, a favorite snack, or a fun activity after completing a task. Self-reward can boost motivation and reduce procrastination by reinforcing productive behaviors, which increases the likelihood of forming better habits.

Practice Self-Compassion

Practicing self-compassion is a key strategy for overcoming procrastination. Instead of criticizing yourself for delaying tasks, practice kindness and understanding. Studies show that individuals who are self-compassionate tend to procrastinate less because they don’t experience the same level of guilt and shame that fuel procrastination (Sirois, 2014). Instead of berating yourself for procrastinating, recognize that it’s a normal part of life and focus on taking small steps to move forward. 

Why Common Strategies Might Not Work for Individuals with ADHD

While these strategies are effective for many, individuals with ADHD face unique challenges that make traditional procrastination techniques less effective. While pretty much everyone procrastinates from time to time, individuals with ADHD often experience chronic procrastination. Understanding the neurocognitive differences that contribute to procrastination in ADHD is crucial when it comes to finding effective solutions.

1. Impaired Executive Functioning

ADHD is associated with impairments in executive functions, such as planning, organizing, and task initiation (Gustavson & Miyake, 2017). These deficits make it challenging for individuals with ADHD to break tasks into smaller, manageable steps or develop detailed plans for completing them. As a result, strategies like task breakdowns may not be effective unless individuals are specifically taught how to make the process easier and more engaging. 

While procrastination is inherently tied to issues with executive functioning, it’s important to note that individuals with ADHD do not always respond well to typical strategies for overcoming procrastination. For example, standard techniques like setting deadlines or using time management tools may not provide the same level of effectiveness, as they do not account for the unique ways ADHD affects attention, motivation, and task initiation.

2. Skewed Time Perception

People with ADHD often struggle with “temporal discounting”—a tendency to underappreciate the amount of time a task will take and how imminent the deadline truly is (Thomas et al., 2007). This skewed sense of time makes it difficult to use time-based techniques like time blocking effectively. People with ADHD may feel that they have “plenty of time” until the deadline arrives, causing them to delay work unnecessarily.

3. Emotional Dysregulation

People with ADHD experience heightened emotional responses to tasks, especially those that feel overwhelming or uninteresting. This emotional sensitivity increases the likelihood of procrastination, as individuals with ADHD may avoid tasks to escape negative feelings such as anxiety or frustration (Van Eerde, 2003).

Tailored Approaches for ADHD

For individuals with ADHD, more tailored and personalized strategies are necessary. Here are some techniques that can be particularly effective:

1. Finding the “Why”

Connecting tasks to personal interests or long-term goals can increase motivation. Because individuals with ADHD often struggle to generate intrinsic motivation for boring tasks, linking them to a bigger “why”—such as future career benefits or personal goals—can help increase engagement (Gustavson & Miyake, 2017).

2. Gamifying Tasks

Making tasks more engaging by turning them into games or challenges can increase focus. For example, challenge yourself to complete a task in a set amount of time and track progress to add an element of competition. Gamification increases dopamine release, making tasks feel more rewarding.

3. Using Visual Cues

Visual reminders such as sticky notes, to-do lists, or color-coded calendars are especially effective for people with ADHD. These visual cues provide constant reminders, helping to trigger attention and prioritize tasks (Van Eerde, 2003).

4. Flexible Time Blocks

Rather than using rigid time blocks, allow for flexibility in work periods. People with ADHD often experience fluctuating energy and focus levels, so alternating between work and breaks can make time blocking more effective. When taking breaks, set a timer to help you get back on track. I recommend using a simple timer, separate from your phone, as this reduces the risk of distraction and prevents getting further off task.

5. Novel Rewards

Rewards are more motivating for people with ADHD when they are novel or aligned with personal interests. Instead of generic rewards like snacks, opt for activities that are personally engaging, such as watching a favorite TV show or dedicating time to a hobby. Additionally, changing up rewards regularly can help maintain their novelty and excitement.

6. Urgency

For individuals with ADHD, creating a strong sense of urgency can be crucial to overcoming procrastination (Barkley, 2015). Without a clear deadline or immediate pressure, tasks can feel endless, leading to avoidance. Setting internal deadlines that are earlier than the actual due date or breaking tasks into smaller, time-limited segments can help create that necessary sense of urgency. Additionally, having external pre-deadlines can be particularly helpful. 

For example, if you need to complete a paper for a class by a specific date, joining a writing group with an earlier deadline can create added urgency. This strategy helps ensure you finish your paper on time by giving you a deadline that’s sooner than the final due date. This approach prevents the tendency to delay work until the last minute and can increase focus by encouraging quicker decision-making and action. Creating time constraints also taps into the heightened focus people with ADHD may experience under pressure, motivating them to complete tasks efficiently.

7. Body Doubling

Body doubling is a strategy that can be particularly effective in reducing procrastination, especially for individuals with ADHD or those who struggle with focus. The concept involves having another person present while you work—whether in person or virtually. This “body double” doesn’t need to actively participate in the task, but simply their presence can create a sense of accountability and reduce the temptation to get distracted. The idea is that the act of having someone else in the room can provide the necessary external structure to stay on task and help combat feelings of overwhelm or isolation (Dittner, 2004).

8. Self-Compassion

As with anyone struggling with procrastination, practicing self-compassion is key for people with ADHD. Acknowledging the unique challenges posed by ADHD helps to reduce self-criticism and guilt. Self-compassion creates a more supportive mental environment for tackling procrastination (Sirois et al., 2013).

Final Notes

Procrastination is a challenging habit, but it’s one that can be broken. Understanding the psychological and emotional factors at play, and implementing targeted strategies, can help you regain control over your tasks and improve productivity. For individuals with ADHD, additional modifications and a more individual approach may be necessary to address unique neurocognitive differences. 

Whether it’s breaking tasks down, using time blocks, or practicing self-compassion, these strategies can help you reduce procrastination and unlock your potential.

Posted on

Designing a Sensory Room in a Mental Health and Substance Use Recovery Center: Dr. Sarah Anderson

Creating a sensory room within a mental health or substance use recovery center offers an innovative and holistic approach to healing. These dedicated spaces are designed to promote relaxation, reduce anxiety, improve focus, and provide therapeutic support. For individuals struggling with mental health conditions or addiction, sensory rooms are invaluable in meeting a wide variety of sensory needs, facilitating self-regulation, and enhancing overall recovery outcomes. This article delves into the essential components of designing a sensory room, the role of mental health occupational therapists, and how to create a sensory environment that fosters balance, safety, and emotional well-being. 

Understanding Sensory Rooms

A sensory room is a carefully constructed space that integrates a variety of sensory experiences, intended to help individuals manage stress, anxiety, and emotions. It encourages engagement with different sensory modalities—sight, sound, touch, smell, and movement—promoting regulation and offering relief from overwhelming stimuli (Champagne & Stromberg, 2004; Haig & Hallett, 2023). 

For individuals facing mental health challenges or recovering from substance use disorders, sensory rooms can provide tools for developing coping and self-regulation skills, increasing self-awareness, and fostering overall recovery. A sensory room provides a structured environment for processing emotional triggers, learning self-regulation techniques, and reducing physical symptoms of anxiety or distress (Champagne & Stromberg, 2004). Sensory processing challenges, commonly associated with ADHD, autism, or substance use disorders, can be effectively managed by thoughtfully selecting and organizing sensory modalities to support nervous system regulation and function.

Key Elements of a Sensory Room

When designing a sensory room, it’s important to have a balance between different sensory modalities. Each individual’s needs will differ, so the space should allow for flexibility and personalization while also providing common features that can be broadly helpful. Here are several key components of an effective sensory room:

  1. Visual Stimulation: Soft lighting (or the ability to dim the lights), calming colors, and soothing visual displays play a critical role in promoting relaxation. For example, adjustable light displays such as bubble tubes or fiber-optic lights can create a calming effect. Visuals that change slowly or projections of peaceful scenes help to engage the visual senses without overwhelming the user. Colors like pastel blues, greens, and purples are commonly used for their ability to promote calmness. 
  1. Auditory Experiences: Sound has a powerful impact on emotional states. Gentle sounds such as nature sounds or soft music can create an environment of tranquility. Instrumental or ambient music, in particular, is known to help clients focus and reduce stress. Personalized playlists or soundscapes can be tailored to individual preferences, making the auditory experience more effective for each user. While white noise is common in mental health settings, it is important to note that it has the potential to be overstimulating to some due to its constant and unchanging rhythm (Champagne & Stromberg, 2004; Haig & Hallett, 2023).
  1. Tactile Tools: Tactile experiences are essential for individuals who benefit from touch-based regulation. Sensory rooms should include a variety of textures for exploration and self-soothing, such as soft cushions, blankets, fidget tools, textured panels, and tactile mats. These materials allow clients to engage their sense of touch, providing opportunities to relax or self-regulate.
  1. Olfactory Elements: Calming scents, such as lavender, eucalyptus, and citrus, can significantly enhance the calming atmosphere of a sensory room. Essential oil diffusers or scent pads are common ways to introduce these scents. When introducing new fragrances, it’s important to consider allergies and sensitivities, as certain scents may trigger negative emotional responses. For example, some clients may have trauma-related sensitivities to specific scents. If a scent is used in the room, it needs to be easily removable. 
  1. Kinesthetic Activities: Sensory rooms should incorporate opportunities for physical movement. Swings, rocking chairs, exercise balls, and climbing walls are just a few examples of kinesthetic tools that allow clients to release energy, regulate their bodies, and express themselves physically. Gentle stretches, yoga mats, exercise bands, ankle/wrist weights, or spaces designed for relaxation also provide much-needed physical relief. 
  1. Safe Space for Retreat: Some individuals may need a quiet, secluded area within the sensory room where they can retreat when feeling overwhelmed. This space should include soft, comfortable seating and soundproofing to offer both physical and emotional safety. These private spaces allow for reflection and provide a place where clients can regain control over their emotional state during moments of distress.
  1. Interactive Technology: Digital tools like interactive touchscreens, virtual reality, and therapeutic apps can enhance sensory experiences by providing unique, engaging options. For instance, some programs combine visual stimulation with auditory feedback, helping clients participate in activities that promote relaxation or mindfulness. While not everyone finds interactive technology calming, some individuals do benefit from it. The key is to use technology thoughtfully and purposefully, tailoring it to each person’s needs and preferences.
  1. Weighted Products: Weighted blankets, vests, animals, pillows, and lap pads are often included in sensory rooms. These items offer deep pressure stimulation, which can help clients feel grounded and calm. Research shows that deep touch pressure can activate the parasympathetic nervous system, helping to reduce stress and anxiety. This makes weighted products beneficial for many individuals with sensory processing challenges (Champagne & Stromberg, 2004).

The Role of Occupational Therapists in Sensory Room Design

Mental health occupational therapy practitioners (MHOTPs) play a crucial role in designing and implementing sensory rooms. Their expertise lies in understanding how sensory input influences an individual’s emotional, cognitive, and physical states. A sensory room should never be designed without first understanding the sensory profiles of its potential users. Here’s how MHOTPs contribute to creating effective sensory rooms:

Client Assessments 

MHOTPs begin by conducting comprehensive sensory assessments of potential users. My preferred assessment is the Adolescent/Adult Sensory Profile, as it provides valuable insights into an individual’s sensory processing patterns. 

This assessment should always be administered by a highly trained mental health occupational therapy practitioner. It is important to know that both occupational therapists and occupational therapy assistants can administer The Adolescent/Adult Sensory Profile, however, only an occupational therapist can interpret the results. Additionally, a detailed occupational profile and supplemental interview questions are conducted to ensure accurate interpretation of the results. This thorough approach supports a well-rounded clinical assessment tailored to each individual’s unique needs and goals. 

Once enough assessments are completed, the therapist can analyze the data to identify common sensory patterns among potential users and design the space accordingly. Sensory rooms must be flexible and adaptable to meet the diverse needs of all users. (Brown et al., 2019).

Individualized Planning

Sensory needs differ greatly among individuals. Based on assessment results, MHOTPs can create a tailored plan for the sensory room that addresses the diverse needs of its users. For example, some individuals may require reduced auditory input due to sound sensitivity, while others may benefit from more auditory stimulation. This tailored planning ensures that the sensory room is equipped with tools and features that effectively support each person’s recovery (Brown et al., 2019).

Training and Support

MHOTPs also provide guidance on how to use sensory tools effectively. They educate clients on the purpose of each tool and offer strategies for engaging with the sensory room in ways that promote regulation as well as function. 

Through these efforts, MHOTPs ensure that sensory rooms are designed not only to meet the needs of potential users, but also to support their long-term well-being and recovery.

Designing Your Own Sensory Space at Home

Designing a sensory space at home can offer many of the same benefits as a sensory room in a recovery center, promoting relaxation and emotional regulation in a familiar environment. Start by choosing a quiet, comfortable area free from distractions, where you can control sensory input like lighting, sound, and visual stimuli. Tailor the space to your sensory preferences, such as dim lighting, calming music, or tactile textures like soft fabrics or weighted blankets, to create an atmosphere that supports relaxation. Incorporate a variety of sensory tools that engage different senses, such as textured pillows, fidgets, calming scents, ambient sound machines, or visual projections, experimenting to find what works best for you. Most importantly, ensure the space feels safe and supportive, offering a peaceful environment where you can process emotions and feel grounded.

Conclusion

Designing a sensory room in a mental health or substance use recovery setting is a powerful tool for promoting emotional regulation, enhancing self-awareness, and supporting overall healing. By integrating a range of sensory experiences and involving mental health occupational therapist practitioners in the process, these rooms offer a personalized and therapeutic space to help individuals in their recovery journey. Whether within a treatment center or at home, sensory spaces play a critical role in creating a holistic, supportive environment that nurtures emotional, cognitive, and physical well-being.

****The term “MHOTP” is used to refer to both Mental Health Occupational Therapy Practitioners (MHOTPs) and Mental Health Certified Occupational Therapy Assistants (MH-COTAs), providing inclusive language that encompasses both roles within mental health occupational therapy. Mental Health Occupational Therapy Practitioners (MHOTPs) are licensed occupational therapists who hold advanced knowledge and training in mental health interventions and assessments. They are responsible for designing and implementing treatment plans, conducting assessments, and providing direct therapeutic services. On the other hand, Mental Health Certified Occupational Therapy Assistants (MH-COTAs) work under the supervision of MHOTPs, assisting with the implementation of treatment plans, supporting clients with therapeutic activities, and ensuring that interventions are carried out effectively. Using “MHOTP” ensures that both practitioners and assistants are acknowledged for their valuable contributions to mental health care.

Posted on

Managing Panic Attacks: How to Pack Your Panic Pack: Dr. Sarah Anderson

Panic attacks can feel terrifying, overwhelming, and all-consuming. They arrive suddenly, often without warning, and can make it difficult to feel like you’re in control of your body and mind. If you’ve ever experienced one, you know how distressing they can be. A racing heartbeat, rapid breathing, dizziness, chest tightness, and an overwhelming sense of impending doom—these are just some of the common symptoms of a panic attack.

But here’s the good news: Panic attacks, while unpleasant, are not life-threatening. Once you understand what’s happening in your body during a panic attack, you can start to reduce their frequency and intensity. The key to managing panic attacks lies in having a toolbox of strategies that can interrupt the overwhelming cycle of panic and help you regain a sense of control. One such tool is a “Panic Pack”—a collection of sensory-based grounding items that can help soothe your body and mind when panic strikes.

Understanding Panic Attacks: What Are They?

Panic attacks are sudden, intense episodes of fear or anxiety that often come without warning (American Psychiatric Association, 2013). These episodes can happen at any time, even when you’re feeling calm and relaxed. Panic attacks typically involve a combination of physical symptoms (like a rapid heartbeat, dizziness, chest tightness, or sweating) and emotional symptoms (such as feeling disconnected from reality, or a sense of impending doom). Although panic attacks can feel life-threatening, they are generally harmless and do not cause lasting damage.

Research suggests that panic attacks are caused by the body’s overreaction to stress or perceived danger, triggering the “fight or flight” response (Vickers & McNally, 2006). During this response, the body releases stress hormones like adrenaline and cortisol, which elevate heart rate, blood pressure, and breathing rate, preparing you to flee from danger. In the case of panic attacks, there is no real threat, but the body reacts as though there is.

Sensory-Based Grounding: Why It Works

When you experience a panic attack, your body is overwhelmed by heightened sensory input, and your mind can feel flooded with anxiety. Sensory grounding techniques work by redirecting your attention away from the panic and engaging your senses in a way that helps calm your nervous system. By using tools that appeal to the senses—sight, sound, touch, taste, smell, and movement (remember proprioception can be a helpful sense to engage to reduce anxiety)—you can help interrupt the cycle of panic and return to a state of calm.

Research shows that sensory-based grounding strategies can be highly effective for managing panic attacks. For example, tactile stimulation (such as squeezing a stress ball) has been found to activate the parasympathetic nervous system, which helps the body shift from the “fight or flight” response to a “rest and digest” state (Haynes et al., 2022). Similarly, scents like lavender and peppermint have been shown to reduce anxiety by stimulating the limbic system, the brain region responsible for processing emotions (Barati,, 2016).

Packing Your Panic Pack: Essential Items for Grounding

A Panic Pack is a personalized collection of sensory tools designed to help ground you and alleviate anxiety. Below are several items you can include in your kit, each chosen for its ability to engage different senses and promote relaxation.

1. Weighted Lap Pad

Weighted lap pads are tools used by occupational therapists, typically as a sensory integration modality, to help with emotional and physical regulation. A weighted lap pad provides gentle pressure, which can have a calming effect. Weighted products stimulate the parasympathetic nervous system, promoting a sense of grounding and relaxation (Eron et al., 2020).

2. Fidget Items

Fidget toys such as orbeez squish balls, stress balls, or fidget spinners are simple, portable tools that can help distract the mind during a panic attack. These tactile items allow you to focus on a repetitive motion or texture, which can help redirect your attention away from overwhelming anxiety. (Kriescher,et al., 2023).

3. Earbuds or Headphones and a Calming Playlist

Music and sound have powerful effects on our emotions. Create a calming playlist with soothing music that helps you feel grounded and less anxious. Alternatively, consider having a calming podcast on hand, whether it’s guided meditation, breathing exercises, or a favorite calming show. Studies have shown that listening to calming music can reduce heart rate and lower levels of cortisol (Thoma et al., 2013).

4. Grounding Smells

Scent is one of the most powerful senses for evoking emotional responses. A portable essential oil diffuser, essential oil rollerball, or lotion with calming scents like lavender, chamomile, or peppermint can help reduce anxiety during a panic attack (Barati,, 2016).

5. Sour Candy (e.g., Warheads or Sour Patch Kids)

Engaging your sense of taste with something intensely sour can be a surprisingly effective grounding tool. Sour candies like Warheads or Sour Patch Kids can interrupt the cycle of panic by providing strong sensory input that shifts attention away from overwhelming thoughts and bodily sensations. This grounding effect helps bring focus back to the present moment. The sour taste acts as a sensory distraction, redirecting attention from anxiety to the immediate sensory experience (Rainville, 2013).

6. Breathing Exercise Guide

Consider packing a small device (like a Breathing Buddha Meditation Tool) or having an app with visual cues, such as color-changing lights or animations, to guide deep breathing. These devices often display colors that correspond to the in-breath, hold, and out-breath phases (e.g., blue for inhale, yellow for hold, green for exhale). Visual tools help regulate breathing patterns while using the sense of sight to anchor attention to the present, reducing physiological arousal during panic attacks (Bentley et al., 2023).

7. Personal Comfort Items

Personal items that evoke comfort and safety can be incredibly soothing during a panic attack. A small memento such as a piece of jewelry, a comforting photo, or a soft fabric (like a scarf or blanket) can help you feel more grounded and safe. These items provide a tangible reminder of calm and support, which can be particularly helpful during moments of overwhelming anxiety.

8. Water

Staying hydrated is crucial for both physical and emotional well-being. Including a water bottle in your Panic Pack ensures you’re prepared to stay hydrated during an anxiety attack. Taking slow, deliberate sips of water can be a soothing ritual that helps you re-focus and regain control. This simple act not only hydrates you but also activates the vagus nerve, which plays a key role in calming the body’s stress response. Drinking water offers a grounding task that interrupts the cycle of panic, providing a moment of clarity and connection to the present (Masento et al., 2014).

9. Phone Numbers of Trusted Contacts

Sometimes, the best way to reduce the intensity of a panic attack is by reaching out for support. Include a list of trusted friends, family members, or a therapist that you can contact when you feel overwhelmed. Research has shown that talking to a supportive person can help reduce feelings of isolation and anxiety, providing emotional relief and a sense of connection during a panic attack (Maulik et al., 2010).

Final Thoughts

Having a Panic Pack ready and accessible can be an empowering way to manage panic attacks. By using sensory grounding techniques, you can interrupt the cycle of anxiety and regain control over your body and mind. The key is to personalize your Panic Pack with items that work best for you, helping you feel safe, calm, and supported when panic strikes.

With practice, these tools can become second nature, providing you with a reliable strategy for reducing the intensity of panic attacks and navigating them with confidence. If you are needing more individualized support regarding your sensory processing and how it impacts your mental health, please reach out to a mental health occupational therapist.

Posted on

Sensory Processing and Mental Health: An Introduction: Dr. Sarah Anderson

Our senses shape how we experience the world—the sights we see, the sounds we hear, the textures we touch, the flavors we taste, and the scents we smell. While many people find everyday sensory experiences manageable or even enjoyable, others may find certain stimuli overwhelming or insufficient, creating challenges in their daily lives. By deepening our understanding of sensory processing and its link to mental health, we can foster greater well-being and support more effective paths to recovery.

What Is Sensory Processing?
Sensory processing refers to how your body and brain receive, recognize, and interpret sensory information (Brown et al., 2019). This process begins when your nervous system detects sensory stimuli through various receptors, leading to a behavioral response. For example, imagine hearing a loud alarm while working at your desk. You recognize the sound as a fire alarm, observe others moving toward safety, and are prompted to follow them. This highlights how sensory processing helps you respond adaptively to your environment.

There is variability in sensitivity to sensory stimuli based on individual thresholds (Brown et al., 2019). A high threshold indicates that a person needs a stronger stimulus to notice it, whereas a low threshold means even minimal stimuli can become overwhelming. For instance, while most people would quickly respond to a loud fire alarm, individuals who are hyper-responsive to auditory stimuli may find such sounds painful, causing long-lasting dysregulation. On the other hand, those who are hyposensitive may require a stronger stimulus for recognition.

While many people are familiar with the five traditional senses—sight, sound, touch, taste, and smell—three lesser-known senses are also critical for understanding sensory processing: proprioception (awareness of body position), vestibular (balance and movement), and interoception (awareness of internal body states) (Brown et al., 2019). In individuals with typical sensory processing, the brain effectively organizes and integrates sensory information, allowing appropriate responses to stimuli. For example, a person might walk along a crowded street, effectively filtering out distractions like billboards and other pedestrians, or engage in a conversation in a busy café without becoming overwhelmed by the surrounding noise and activity. Those with atypical sensory processing may struggle to take in stimuli and modulate their responses, leading to feelings of overwhelm or anxiety. 

A Model for Understanding Sensory Processing 

As a mental health occupational therapist, I use a specific framework to understand my clients’ sensory processing patterns—Dunn’s Sensory Processing Model. This model categorizes sensory processing into four quadrants (or patterns), each representing different ways individuals respond to sensory input (Brown et al., 2019):

Sensation Seeking

These individuals actively pursue intense sensory experiences and are often drawn to environments that provide heightened stimulation. They tend to crave loud environments, bright colors, and high levels of movement. Sensation seekers often thrive in situations that involve excitement and novelty. 

For example, they may enjoy engaging in contact sports such as football or rugby, where the physicality and intensity provide both sensory input and an adrenaline rush. Similarly, thrilling amusement park rides, like roller coasters, offer the fast movement and sensory overload they enjoy. Additionally, these individuals may find pleasure in activities such as dancing at loud clubs, racing motorcycles, or participating in extreme sports like skydiving or rock climbing, where the combination of physical exertion and sensory excitement is high. Sensation seekers are often drawn to high-energy, sensory-rich environments because they help satisfy their need for stimulation.

Sensation Avoiding

People with sensation avoiding patterns feel uncomfortable with strong sensory stimuli and actively limit their exposure to prevent stress or overwhelm. These individuals are particularly sensitive to intense or overstimulating environments, and they often seek out quiet, calm spaces to feel more in control and at ease. The key characteristic of sensation avoiders is that they make a conscious effort to avoid situations that may lead to sensory overload. 

For instance, they may prefer online shopping over visiting crowded stores because the noise, bright lights, and large crowds can cause distress. Similarly, they may choose to eat and converse at home rather than going to noisy restaurants, where the sounds, smells, and social interactions can be overwhelming. In other contexts, sensation avoiders might prefer a peaceful walk in nature over attending a crowded event or concert. They may also avoid certain types of music or films that feature loud noises or flashing lights due to their heightened sensitivity. By actively limiting sensory exposure, sensation avoiders can maintain a sense of comfort and reduce anxiety caused by overstimulation.

Sensory Sensitivity

Sensory-sensitive individuals, like sensation avoiders, are highly attuned to sensory stimuli and can become overwhelmed or anxious when exposed to certain sounds, sights, or other sensations. They are particularly responsive to environmental inputs, such as bright lights, strong odors, or loud noises. However, the key distinction between sensory sensitivity and sensation avoidance lies in their reaction to these stimuli. While sensation avoiders actively work to limit their exposure to sensory triggers, sensory-sensitive individuals do not necessarily avoid them. Instead, they confront and endure these sensory experiences, often feeling the full intensity of the distressing sensations. 

For example, a sensory-sensitive individual might attend a concert despite being sensitive to loud music, or they might work in a busy office environment even though the noise and activity create discomfort. The difference here is that, rather than avoiding these situations, they are exposed to them and may struggle to manage their heightened sensitivity, leading to feelings of overwhelm, irritability, or anxiety.

Low Registration

Individuals in this category may not notice sensory input readily, requiring stronger or more intense stimuli to respond. This can make them appear inattentive or uninterested in their surroundings, as they may not pick up on subtle sensory cues that others might notice immediately. For example, they may not be aware of a ringing phone, a colleague speaking to them, or even a change in the temperature of the room until the sensory input becomes more intense or disruptive. Because of this, people with low registration might be perceived as daydreaming, disengaged, or disinterested, but in reality, they are simply less responsive to sensory input.

These individuals often need support systems built into their environment to help them stay on track and become more aware of important stimuli. For example, they might benefit from the use of alarms to signal tasks or appointments, sticky notes as reminders for daily responsibilities, or bright, noticeable signs to highlight important information. These external cues help trigger their attention and provide necessary prompts to remain engaged with their environment.

In some cases, individuals with low registration may not respond to social cues or environmental changes unless they are more extreme. For example, they may not notice a subtle shift in tone when someone is upset with them, but if the person becomes visibly angry or vocal, they are more likely to react. Similarly, they might not notice a decrease in room temperature until it becomes very cold or uncomfortable. The challenge lies in their ability to process and respond to sensory stimuli only when the input reaches a certain threshold of intensity. While this pattern of sensory processing may not necessarily cause distress or anxiety for these individuals, it can lead to difficulties in social or work environments, where a heightened awareness of sensory details and a more timely response are often necessary.

It is important to know sensory processing is not always uniform across all sensory modalities, and people may display different patterns depending on the type of sensory input they encounter. For example, while someone might avoid certain auditory stimuli, they may actively seek out specific tactile or oral sensory experiences. This complexity emphasizes the importance of tailoring sensory interventions to the unique needs of each individual, ensuring that therapeutic approaches are both comprehensive and personalized. 

The Relevance of Sensory Processing in Mental Health
Many individuals with mental health conditions, including anxiety disorders, depression, ADHD, OCD, and post-traumatic stress disorder (PTSD), exhibit sensory processing differences (Brown et al., 2019). For those with anxiety, sensory overload can exacerbate symptoms, leading to panic and avoidance behaviors. An individual with sensory avoidance patterns may steer clear of crowded social events, often resulting in isolation and increased feelings of loneliness.

Additionally, a study by Jerome and Liss (2005) explored the relationship between sensory processing patterns and attachment types. The authors found that sensory sensitivity correlates with relationship anxiety, while sensory avoidance relates to relationship avoidance; low registration is associated with both forms of relationship discomfort, and sensory seeking is linked to secure attachment.

Sensory processing can also play a key role in building resilience and supporting recovery. Engaging in positive sensory experiences promotes overall well-being and helps individuals feel grounded during times of distress. Interventions that include sensory-based strategies, such as mindfulness practices and grounding exercises, have been shown to support nervous system regulation (Miller et al., 2007). For example, practicing deep breathing while focusing on tactile sensations like a soft blanket or stress ball can induce relaxation in overwhelming situations. Weighted blankets, in particular, offer deep pressure stimulation that activates calming sensory pathways, reduces anxiety, and boosts melatonin production, fostering a sense of safety and relaxation (Yu et al., 2024). Additionally, introducing a noxious stimulus, such as a sour taste, during a panic attack can help redirect attention. This interrupts the cycle of distress and engages neural pathways that regulate emotional responses (Rainville, 2013).

Practical Strategies for Engaging with Sensory Processing Differences
Understanding one’s sensory processing patterns can lead to effective coping strategies that enhance engagement in daily life. Here are specific strategies tailored to each processing category:

  • For Sensation Seekers: Structured physical activities such as rock climbing or martial arts provide the significant sensory input that sensory seekers benefit from, promoting physical and emotional regulation through intense engagement. Similarly, practices like yoga or tai chi enhance grounding and body awareness through controlled movement. For those craving excitement, adventure activities such as zip-lining offer stimulating sensory experiences while fostering a sense of community and connection with others.
  • For Sensation Avoiders: Gradual exposure to challenging environments, like shopping during off-peak hours, allows sensory avoiders to build tolerance without overwhelming their senses. Comfort tools such as noise-canceling headphones or sunglasses provide instant relief in overstimulating situations. Additionally, calmer venues with softer lighting create a sensory-friendly atmosphere for social interactions, contributing to more positive experiences.
  • For Sensory Sensitivity: Designating a safe space at home equipped with weighted blankets and sensory-friendly items can provide a calming refuge for sensory-sensitive individuals. Mindfulness techniques such as deep breathing and gentle stretching focus on regulation, reducing the effects of sensory overload. Engaging with nature through activities like gardening or hiking can also help mitigate sensory overwhelm by offering grounding sensory input in a peaceful environment.
  • For Low Registration: Individuals with low registration often miss sensory cues, making tools like alarms, sticky notes, or digital reminders valuable in fostering engagement and awareness. For example, placing a sticky note on a desk as a visual cue and pairing it with a timed phone alarm can help reinforce tasks that might otherwise go unnoticed. Incorporating tactile or flavorful experiences into routines, such as savoring meals or exploring varied textures, can further enhance sensory awareness and promote meaningful interaction with one’s environment.

Additional Considerations in Recovery
It’s crucial for centers and programs to have formal sensory assessments such as the Adolescent/adult Sensory Profile, as this helps to understand the unique sensory profiles of the individuals in their care. A formal assessment provides valuable insight into how sensory processing may be affecting their clients’ daily functioning, helping programs identify when sensory processing is a barrier. This enables them to implement targeted interventions and accommodations, ensuring that sensory needs are met. Furthermore, understanding the sensory profiles of individuals allows providers to offer personalized support strategies and create environments that foster greater comfort and engagement. Sensory processing is a foundational aspect of how we navigate the world, and understanding its complexities enables us to support individuals in overcoming challenges so that they can thrive in their daily lives. 

Posted on

Unlocking Mental Wellness: The Power of Routines: Dr. Sarah Anderson

In our fast-paced world, routines can play a crucial role in improving mental health. Daily routines act as a safety net, providing stability and security amongst chaos. Establishing regular daily habits allows us to bring structure to our surroundings while fostering resilience, resulting in a healthier mindset and a more balanced nervous system.

Studies indicate that children excel in settings with well-defined routines, and their ability to learn may be impacted negatively when these structures are lacking (Montroy et al., 2016). Structured schedules are beneficial for both children and adults, helping to reduce anxiety and stress through predictability. Additionally, routines help us manage our time better and prioritize tasks, leading to greater organization and less overwhelm. Regular routines also promote healthy habits, such as consistent sleep patterns and exercise—key elements for maintaining good mental health. Overall, establishing and maintaining routines can make it easier to navigate challenges and improve emotional well-being.

The Role of Routines in Mental Health

One of the main benefits of routines is their ability to significantly reduce decision fatigue, which arises from facing an overwhelming number of choices each day (Ilies et al., 2010). With research indicating that we make around 35,000 decisions daily, this cognitive overload can lead to stress and anxiety (Sahakian & Labuzetta, 2013). 

By establishing structured routines, we transform decisions into automatic actions, conserving mental energy and enhancing focus on more important tasks. Once routines become instinctive, they not only alleviate cognitive load but also allow us to direct our cognitive resources toward creativity, productivity, or simply enjoying the present moment. In contrast, a lack of routines can result in mental exhaustion and procrastination due to constant decision-making.

Routines and Mental Health Challenges

Routines can be particularly beneficial for people facing mental health challenges. Research has shown that sticking to regular routines can reduce symptoms of depression and anxiety, especially in adolescents and young adults (Muñoz-Fernández & Rodríguez-Meirinhos, 2021). Predictable daily tasks provide comfort and stability. For someone with anxiety, a structured morning routine that includes mindfulness can be grounding. Similarly, for someone dealing with depression, a simple routine like “get up, shower, and have breakfast” can reignite motivation. Creating an effective morning and evening routine can significantly enhance your mental health. 

Routines & Substance Use Recovery 

Routines play a vital role in substance use recovery by providing structure, stability, and a sense of purpose in an individual’s daily life. Engaging in consistent routines allows recovering individuals to establish healthy habits, reduce anxiety, and minimize triggers associated with substance use (Smith et al., 2020). Research indicates that routines can enhance coping strategies and reinforce positive behaviors, facilitating the development of new lifestyles free from substance reliance (Dunn & Tompkins, 2018). 

Many individuals facing substance use challenges also grapple with executive functioning deficits, which can involve difficulties in planning, organization, and self-regulation. Approximately 50% of individuals with substance use disorders exhibit some level of executive dysfunction (Davis et al., 2015). This impairment can complicate recovery efforts by making it harder for individuals to adhere to treatment plans or make healthy choices. Routines help alleviate these challenges by creating a framework that simplifies decision-making and fosters a sense of discipline. Maintaining a predictable daily schedule fosters a sense of control and accomplishment, which is crucial for building self-efficacy and preventing relapse (Witkiewitz & Marlatt, 2004). By effectively addressing issues related to executive functioning, routine management can significantly enhance the recovery process and support long-term sobriety. 

General Tips for Designing Routines

  1. Set Clear Intentions:

Before you start your day, take a moment to write down three things you want to accomplish. This could be as simple as “exercise for 20 minutes,” “complete that work project,” and “call my friend.” Writing them down can solidify your commitment and give you something to refer back to throughout the day.

  1. Start Small:

If a full morning routine feels overwhelming, begin by waking up just ten minutes earlier to dedicate those minutes to something positive, like taking a quick walk outside or sipping a glass of water. Gradually, as you become comfortable, you can extend this time and incorporate additional elements.

  1. Be Consistent, yet Flexible:

While it’s essential to keep a routine, allow room for inevitable life events. If you have to skip a morning workout, don’t stress; perhaps consider adding in a bike ride during lunch or a brief walk after dinner instead.

  1. Incorporate Mindfulness:

Incorporate mindfulness into your daily routines by allowing yourself moments of presence throughout the day. For instance, during your morning routine, take a few moments to engage fully with each activity, whether it’s brushing your teeth, showering, or preparing breakfast. Focus on the sensations, sounds, and smells, and try to immerse yourself in the experience rather than rushing through it. This practice of mindfulness not only helps you appreciate the small moments but also cultivates a sense of calm and awareness that can enhance your overall well-being as you go about your day.

  1. Track Your Progress:

Use a simple bullet journal or an app to keep track of daily achievements as well as challenges you are experiencing. Write down what went well each day, and reflect on any barriers you identify. This habit can help identify patterns that help or hinder progress.

Actions to Incorporate in a Morning Routine

  1. Wake Up at a Consistent Time:

To help regulate your circadian rhythm, choose a wake-up time and stick to it, even on weekends. For example, if you aim to wake up at 7 AM, set your alarm for the same time daily to help reinforce your body’s internal clock (Hirshkowitz et al., 2015). If you find yourself hitting the snooze button, try moving your alarm clock across the room. This will force you to get up and out of bed, making it less likely that you’ll go back to sleep. 

  1. Personal Care:

Enjoy a refreshing shower, and then take some time to groom yourself. Set aside at least 20-30 minutes to wash your hair, brush your teeth, and style yourself in a way that boosts your confidence and sets you up for the day ahead. You might also consider using your favorite scents or skincare products to make the experience more enjoyable.

  1. Remember to Take Your Medications:

Incorporate your medication into your routine by placing it next to your morning beverage or in a visible spot as a consistent reminder. For example, if you take your medication with breakfast, keep it in the kitchen next to the bowls. It’s essential to find a way to habit stack this practice, as taking your medications as prescribed is important for your health.

  1. Engage in a Mindfulness Practice:

Spend five to ten minutes meditating using a guided session. In addition to meditation, you can incorporate practices like a body scan, progressive muscle relaxation, or mindful eating. Research shows that regular mindfulness practice can lead to significant decreases in anxiety levels. These activities not only enhance your mental well-being but also help you cultivate greater awareness and presence in your daily life. (Kabat-Zinn, 2003)

  1. Physical Activity:

Incorporate exercise into your morning routine to jumpstart your day. Whether it’s a 15-minute yoga session to promote flexibility and mindfulness, a brisk walk to enjoy the fresh air and energize your body, or a quick HIIT workout to get your heart pumping, find an activity that resonates with you. Regular physical activity has been consistently linked to improved mood and reduced levels of anxiety. Engaging in exercise not only releases endorphins, which are the body’s natural mood lifters, but it also helps to foster a sense of accomplishment and sets a positive tone for the rest of the day (Craft & Perna, 2004).

Actions to Incorporate in an Evening Routine

  1. Create a Tech-Free Zone:

Commit to powering down screens at least one hour before bed. Instead of scrolling through social media, opt for reading a physical book, journaling, or engaging in puzzles. Establish a cozy nook in your living room or bedroom specifically for these activities. 

  1. Establish a Set Evening Ritual:

Prepare for sleep by making a cup of decaf herbal tea (like chamomile or peppermint). The act of preparing tea can be a calming ritual that signals your brain to wind down. Engaging in this mindful activity has been shown to ease the transition to sleep and reduce nighttime anxiety (McKay & Blumberg (2002).

  1. Incorporate Relaxation Techniques:

After your tea, consider a short yoga session or progressive muscle relaxation meditation for 10-15 minutes. Online resources, like yoga or relaxation apps, can guide you through these exercises. Research suggests that such practices can significantly lower cortisol levels, promoting relaxation and better sleep quality (Hirshkowitz et al., 2015).

  1. Reflect on Your Day:

Spend five minutes journaling about the positive aspects of your day. You might write three things you are grateful for or highlight a meaningful interaction you had. This reflective practice helps to create emotional closure for the day and can provide a buffer against daily stressors (Emmons & McCullough, 2003).

  1. Set a Consistent Sleep Schedule:

Aim to go to bed and wake up at the same time each day. Create a pre-sleep routine such as dimming the lights in your home, playing soft music, or using essential oils (like lavender) to signal that it is time for sleep. Over time, your body will start associating these cues with bedtime, promoting quicker sleep onset (Hirshkowitz et al., 2015).

Overcoming Challenges in Establishing Routines

Establishing a routine can come with its own set of challenges, but with a few tips and tricks, you can overcome obstacles and foster a sustainable practice. One common hurdle is a lack of motivation. If you find it difficult to get going, consider pairing your new routine with activities you already enjoy. For example, you might listen to your favorite music while exercising to make the experience more enjoyable or sip on a beloved beverage while journaling, transforming these tasks into more pleasurable moments. 

Another challenge many face is the fear of failure. It’s essential to understand that setbacks are a natural part of the habit-building process. Instead of perceiving a missed routine as a failure, view it as a valuable learning opportunity. Take time to reflect on what led to the disruption; whether it was time constraints, unexpected events, or lack of energy, identifying the cause will empower you to strategize and plan for similar situations in the future. This proactive approach will help you build resilience and adapt your routine as needed. 

External distractions can also pose significant barriers to maintaining your routine. To counteract these interruptions, create designated spaces for work and relaxation. Minimizing noise and visual distractions is crucial; for instance, consider using noise-canceling headphones or arranging your environment to reduce clutter. If you work from home, it’s helpful to set clear boundaries with housemates or family members during your designated routine times. Communication is key so that everyone understands the importance of these times for your focus and reflection. By cultivating an environment conducive to stability and mindfulness, you’ll be better equipped to establish and maintain a routine that enhances your mental well-being.

Embracing the Routine Revolution

In a chaotic and hectic world, routines provide stability and order. Developing personalized routines can enhance mental health, reduce stress, and create a sense of control. By embracing routines and tailoring them to fit your preferences, you can navigate life with greater ease. Remember, routines are about creating a flexible framework that supports healthier choices and emotional resilience. As you work on establishing your routines, be kind to yourself, acknowledge your successes, and keep building a daily rhythm that nurtures your well-being. Over time, you’ll discover that routines can transform your life for the better.

Posted on

The Importance of Neuroaffirming Care in Mental Health and Substance Use Treatment: Dr. Sarah Anderson

In recent discussions surrounding mental health and substance use treatment, the concept of neuroaffirming care has emerged as an essential paradigm shift. A neuroaffirming approach not only emphasizes each person’s individuality but also recognizes and respects the diverse range of neurocognitive profiles within our world. In this article, I will look into why neuroaffirming care matters, share its key ideas, explore its background, and highlight how it’s vital in mental health and substance use treatment.

Understanding Neuroaffirming Care

Neuroaffirming care is a progressive model grounded in an understanding of the diverse ways individuals think, process information, and interact with the world. It recognizes that neurocognitive differences—such as those found in individuals with autism (ASD), ADHD, dyslexia, and other learning disabilities—are not deficits or disorders to be fixed, but rather distinct variations that enrich how individuals perceive and interact with the world around them.

This perspective sees neurodiversity as an integral part of humanity, encouraging a more inclusive approach in therapeutic settings. Unlike traditional care models, which often apply a one-size-fits-all framework, neuroaffirming care tailors interventions to meet the unique needs and preferences of each individual. Traditional approaches may standardize assessments and treatments, potentially overlooking the nuances of a person’s lived experience. In contrast, neuroaffirming care acknowledges that neurodivergent individuals may process sensory information, social cues, and cognitive tasks differently, requiring interventions that are flexible and adaptive. (Chapman & Botha, 2023)

Examples of Neuroaffirming Care:

1. Inclusive Practices: Tailoring treatment plans to align with the client’s cognitive style, preferences, and personal history.

Example: A therapist working with a neurodivergent client adapts a mindfulness exercise by allowing them to focus on a sensory object, such as holding a stress ball or rubbing a textured fabric, instead of expecting them to sit still with their eyes closed, which might feel overwhelming or inaccessible.

2. Respecting Autonomy: Allowing clients to make informed choices about their treatment and respecting those decisions, even when they differ from standardized protocols.

Example: A client with ADHD requests shorter therapy sessions to maintain focus. Rather than insisting on traditional 50-minute sessions, the therapist offers 25-minute sessions and gradually builds toward longer durations as the client feels ready.

Examples of Non-Neuroaffirming Care:

1. Rigid Protocols: Applying standardized treatment methods that do not consider a client’s neurodivergent traits, potentially leading to frustration and disengagement.

Example: Forcing a neurodivergent client to participate in a large group therapy session despite their expressed discomfort in group settings, leading them to withdraw or avoid further sessions.

2. Invalidating Experiences: Dismissing or questioning the lived experiences of neurodivergent individuals, failing to recognize and honor their reality.

Example: A therapist tells a client with sensory sensitivities that their discomfort with bright lights in the therapy room is “just in their head” instead of addressing the environmental trigger.

Statistics on Neurodivergence in Mental Health Treatment

Neurodivergent individuals often encounter significant barriers in accessing effective mental health and substance use treatment. Research indicates that approximately 73% to 81% of adults with autism have at least one co-occurring psychiatric disorder (Buck et al., 2014; Madhavan, & Sambamoorthi, 2016). Additionally, substance use disorder rates are disproportionately higher among neurodivergent individuals. Research indicates that about 50% of individuals with substance use disorders also have ADHD, and people diagnosed with ADHD are six times more likely to face challenges related to substance use (Davis et al., 2015). This statistic emphasizes the need for tailored interventions that specifically address these challenges and underscore the importance of implementing neuroaffirming care. 

While neuroaffirming care is gaining recognition, its adoption in mental health settings varies widely. Some progressive clinics and therapists are beginning to embrace neuroaffirming approaches, especially in environments that prioritize inclusivity and holistic care. However, many traditional mental health settings still rely on standard practices that may not adequately account for neurodiversity and its implications in treatment. Neuroaffirming care is more likely to be found in specialized settings, such as those focusing on developmental disorders, community mental health programs that emphasize inclusivity, and practices run by clinicians who are informed about neurodiversity principles. In contrast, more traditional settings may struggle to integrate these principles into their practices, resulting in ongoing gaps in care for neurodivergent individuals. This inconsistency in the availability of neuroaffirming care further emphasizes the need for systemic changes in mental health and substance use treatment approaches.

Historical Context of Neuroaffirming Care

The emergence of neuroaffirming care can be traced back to the neurodiversity movement, which gained momentum in the late 1990s and early 2000s (Chapman & Botha, 2023). Advocates began challenging the traditional medical model that treated neurological differences solely as deficits or disorders. Instead, they promoted the idea that neurodiversity is a natural variation of human cognition, deserving of respect and understanding. For instance, the neurodiversity movement challenged stereotypes surrounding autism, emphasizing the strengths and unique perspectives that autistic individuals bring to the table, such as innovative problem-solving and attention to detail. This paradigm shift inspired mental health professionals to rethink their approaches, focusing on affirming and accommodating differences rather than attempting to “fix” them.

Neuroaffirming Interventions in Mental Health

Neuroaffirming interventions in mental health can vary widely but generally aim to create a supportive environment that is responsive to the specific cognitive and emotional needs of neurodivergent individuals.

1. Cognitive Behavioral Therapy (CBT) Adaptations

Traditional CBT can be adjusted to incorporate the client’s unique thought processes and emotional responses, making it relevant to their experiences.

Example: A neurodivergent client with autism might struggle with abstract concepts like “challenging negative thoughts.” The therapist adapts CBT by using concrete, visual tools, such as a thought diary with emojis or a color-coded chart, to help the client identify and manage their emotions in a structured way.

In contrast, a non-neuroaffirming approach might involve using overly abstract CBT techniques that leave the client feeling confused and unsupported, causing disengagement.

2. Mindfulness Practices

Mindfulness can be tailored to fit different sensory preferences, allowing clients to engage in exercises in ways that feel comfortable.

Example: A client with sensory sensitivities may find traditional deep-breathing exercises difficult due to the focus on internal bodily sensations. Instead, the therapist encourages them to practice mindfulness by listening to calming music or focusing on a weighted blanket’s pressure.

Non-neuroaffirming practices might force clients to adhere to rigid mindfulness techniques that increase their anxiety, such as insisting on silent meditation in a setting that feels overstimulating.

3. Strength-Based Approaches

Focusing on the individual’s strengths rather than their challenges fosters a sense of empowerment and self-efficacy.

Example: A therapist working with a neurodivergent teenager emphasizes their talent for drawing as a tool for emotional expression and problem-solving, integrating art therapy into their sessions.

Conversely, non-neuroaffirming practices might focus solely on deficits, such as repeatedly pointing out the client’s difficulties with time management, without offering constructive solutions.

Neuroaffirming Care in Substance Use Treatment

Substance use treatment, much like mental health treatment, benefits immensely from a neuroaffirming approach. Individuals with neurodivergent traits may face unique challenges in recovery, including heightened sensitivity to triggers, social cues, and emotional stimuli.

1. Individualized Treatment Plans

Tailoring recovery programs to the cognitive and emotional profile of clients enhances engagement and success rates.

Example: A client with ADHD might struggle with rigid schedules in traditional 12-step programs. A neuroaffirming approach would offer flexible scheduling options or introduce apps for task management to support the client’s executive functioning challenges.

2. Peer Support Alternatives

Creating support networks that resonate with neurodivergent individuals allows them to share their experiences in a safe space.

Example: A recovery program sets up a small, sensory-friendly peer support group for neurodivergent clients, ensuring the environment is free of harsh lighting and loud noises to accommodate sensory sensitivities.

Non-neuroaffirming practices might involve placing neurodivergent clients in large, overstimulating group settings without addressing their needs, potentially driving them away from recovery efforts.

Providing Neuroaffirming Care as a Mental Health Occupational Therapist

As a mental health occupational therapist, I prioritize neuroaffirming care in my practice by actively incorporating the principles of this approach into my therapeutic relationships. This commitment not only fosters a sense of safety and respect but also empowers clients to take an active role in their healing journey.

1. Personalized Assessments:

   In my practice, I conduct thorough and personalized assessments that go beyond standardized tools. For example, I might observe a client’s sensory responses in various environments, such as noting whether fluorescent lighting in the office causes discomfort. These observations inform the design of therapy sessions and treatment goals. Additionally, I encourage clients to share their preferences and experiences, allowing for a more nuanced understanding of their unique needs and challenges.

2. Flexible Therapy Sessions:

   Recognizing that each client has different sensory sensitivities and processing styles, I ensure that my therapy sessions are flexible. For a client with sensory sensitivities, I might introduce noise-canceling headphones or provide breaks during sessions to prevent overstimulation. This adaptability allows clients to engage more comfortably and effectively in their therapy, promoting a collaborative and supportive atmosphere.

3. Collaborative Goal Setting:

   Collaboration is at the heart of my practice. When a client expresses frustration with meeting deadlines, for instance, we work together to create achievable and meaningful goals. By implementing strategies like time-blocking, the client feels ownership and agency in their progress. I emphasize that all goals are client-driven; I will never set goals that clients do not choose for themselves. This process not only fosters a sense of empowerment but also enhances motivation and commitment to the therapeutic process.

4. Creating Safe Spaces:

   A significant aspect of neuroaffirming care involves creating safe and comfortable environments. I maintain a quiet, visually calming therapy room with sensory tools like weighted blankets, fidget toys, and dimmable lights. Clients are encouraged to customize their space and choose the tools that make them feel secure and comfortable. This environment reflects a respect for their individual needs and enhances their ability to focus and engage.

5. Ongoing Feedback:

   I prioritize ongoing feedback throughout our therapeutic relationship. Regularly asking clients how they feel about the therapy process and the strategies we employ allows me to adjust approaches as needed. For example, if a client feels overwhelmed by a particular technique, we can quickly shift to a different method that aligns better with their preferences. This responsiveness is a core component of neuroaffirming care, ensuring that each client feels heard and validated.

Conclusion

Neuroaffirming care represents a critical advancement in mental health and substance use treatment paradigms, offering a more personalized and respectful approach to care that takes into account the diverse neurocognitive profiles of individuals. Specific, practical interventions—such as adapting CBT, tailoring mindfulness, and creating sensory-friendly environments—illustrate how this approach can transform the therapeutic experience for neurodivergent individuals.

With increasing awareness and acknowledgment of neurodiversity, the mental health field must continue to evolve by embracing neuroaffirming principles. In doing so, we can enhance access to treatment and support for neurodivergent individuals, ultimately contributing to their overall wellbeing and quality of life.

Posted on

Navigating the Holidays: Essential Tips for Those in Early Substance Use Recovery: Dr. Sarah Anderson

The holidays are just around the corner, and while some people love this time of year, many feel anxious, overwhelmed, and even dread it. For those newly in substance use recovery or supporting a loved one in recovery, this season can bring added challenges. As a mental health occupational therapist, I work with many clients who feel stressed and overwhelmed this time of year. From increased family obligations to events with alcohol to overbooked schedules, it’s easy to feel overwhelmed. While setting boundaries with others and yourself can be difficult, maintaining balance is essential.

If you’re looking for practical strategies on maintaining your sobriety or supporting a loved one in their recovery, keep reading! I’ve compiled a few tips to help you find peace and maybe even enjoy the season.

Beware of Over Scheduling

Overcommitting is a top reason people feel overwhelmed during the holidays. If you have felt overstimulated and drained in past holiday seasons, try to prioritize which events you want to attend. Aim for no more than one gathering per weekend—many find even that can be too much. Everyone has a unique social and sensory stimulation threshold, so tune into what feels manageable for you. If you’re concerned about letting others down, here are some phrases that can help:

  • “Thank you so much for the invitation. I won’t be able to attend this year due to a scheduling conflict. Still, I’d love to stay connected and appreciate the invitation.”
  • “Thank you for thinking of me. Right now, I’m focusing on managing my schedule carefully, so I won’t be able to join this year. Still, I would love to do so during the next holiday season.”

Letting those close to you know that you’re intentionally avoiding overscheduling can also help set expectations.

Prioritize People Who Make You Feel Safe

If you’re facing challenges with your mental health or are new to recovery, focus on spending time with people who make you feel safe and supported. You don’t need the added stress of putting on a brave face for people who don’t honor where you’re at. Research has shown that negative social support can hinder sustained recovery (Kitzinger et al., 2023). So, while social connection is powerful for optimizing mental health, it’s crucial that this connection feels safe and genuine. I work with many clients who struggle with people-pleasing, and the thought of disappointing others can be distressing. Setting boundaries can be empowering and is one of the best skills you can develop to protect your recovery and mental health, especially during the holidays.

Stick to Your Routines

The holidays don’t mean abandoning your routines. Routines offer structure, keep you grounded, and help ensure you’re prioritizing yourself. You may need to leave a party early or decline an invitation if it conflicts with a self-care activity. Kitzinger et al. (2023) found that people in early recovery identified the consistency of structured routines to be a key factor in helping them maintain sobriety. If you’re in recovery, continue attending your meetings and staying connected with those who keep you accountable. Routines help reinforce your commitment to your health, especially during times that feel unpredictable.

Prioritize Sleep

Sleep is, in my opinion, the most important occupation within occupational therapies (OT’s) nine recognized areas. When you’re sleep-deprived, every other part of your life suffers. Lack of sleep can significantly impact mood, increase anxiety, and make managing stress harder. Additionally, poor sleep quality has been identified as a risk factor for relapse (Kitzinger et al., 2023). It is essential to prioritize rest, as it’s foundational for maintaining balance in this demanding season. Here are some strategies to ensure that you are getting adequate sleep this holiday season:

  1. Pick a bedtime and stick to it.
  2. Have some set phrases that you can use to get out of late-night events. 
  3. Stick to the sleep routine you’ve developed. I know it can be tempting to stay up late and get lost in a holiday movie, but I promise you will thank yourself tomorrow if you avoid screen time and get to bed on time. 
  4. If it feels hard to assert these boundaries with yourself and others, have some incentives and rewards handy. One of my personal favorites is investing in a new set of warm, cozy sheets or pajamas. Not only does this enhance your bedtime experience, but choosing fabrics that feel good on your skin also caters to your sensory needs, making it easier to prioritize rest.

Prioritize Healthy Leisure Activities & Limit Social Media

You read that right: put down the phone and stay present. It’s easy to get swept up in social media, but I want you to reflect on this– does it ever leave you feeling better? The holidays often bring a flood of curated, perfect-looking moments, making it hard not to compare. But remember—what you see is often far from the full picture. Instead, invest your time in activities that genuinely bring you joy and fulfillment. Baking cookies alone or with people you love who bring you joy is a great way to enjoy the holidays and fill time. Explore and rediscover games that you once loved. Games are a great way to spend time with others, and they help to fill time in a meaningful and healthy way. Curl up on the couch with a great book and a soft, cozy blanket. If you really want to get into the holiday mood, light a holiday-scented candle and play a little instrumental music in the background. Active living is central to recovery (Iwasaki, 2010). By structuring your time and prioritizing meaningful, screen-free activities, you can stay the course on your journey to wellness.

Identify High-Risk Situations in Advance & Create a Sober-Sensory Kit

It is important to understand your triggers that potentially can lead to relapse. Triggers can be anything from specific environments to specific people to various smells or memories. Having an awareness of what may be a trigger can help you either avoid them or have a plan in place as to what you need to do to maintain your sobriety. You have likely already done this with your therapist, sponsor, or someone else in your life. Your plan may include attending an AA meeting, calling your sponsors, or meeting with a trusted friend. Creating a sober-sensory kit can be another tool that you incorporate into your plan to help reduce relapse. Sensory kits, in general, are tools that help to promote grounding and regulation. Think about things you can eat, smell, touch, hear, and see that bring you peace. Here are some ideas of what you can pack in your sensory kit based on each of your senses:

  • Smell: Pack lotions with soothing fragrances or essential oils that are known for their calming properties. For example, lavender and chamomile are widely recognized for their ability to promote relaxation and reduce anxiety. A study by Seo (2009) found that pleasant scents, particularly essential oils, can enhance mood and reduce stress.
  • Touch: Choose lotions with textures that you enjoy—whether they are smooth or contain exfoliants. Pick one that feels nice on your skin. Always include a fidget, or focus tool, in your sensory pack. There are many different types, so I encourage you to explore various options to find the one that works best for you. Some people prefer soft, squishy fidgets, while others enjoy spiky fidget rings. There’s even the option to have fidgets that double as jewelry. Fidgets help relieve anxiety by providing a means of self-soothing while also releasing neurotransmitters that enhance focus and reduce cognitive load (Persia, 2023).
  • Hearing: Create a variety of playlists. Explore various genres of music to find the right fit. Remember, the goal with your music is to regulate your nervous system, not increase arousal. Many people enjoy instrumental jazz, low-fi, and classical music. Always make sure to pack some earbuds or headphones, that way, if you find yourself feeling overstimulated, you can easily put them on and find a sense of calm.
  • Taste: Make sure to include some candies in your kit! Both sweet and sour can help you feel grounded and ease anxiety. Sour candies, in particular, can act as little panic busters— the intense taste can redirect your focus and provide a grounding experience. Chewing gum is another great option to put in your kit. The repetitive motion of chewing not only gives you some sensory input but also has the potential to help regulate your nervous system and lower stress levels. Eating can also stimulate the vagus nerve, which plays a vital role in calming the body and promoting a sense of relaxation and well-being (Breit et al., 2018).
  • Sight: In my opinion, sight is the most challenging sense to pack because it’s harder to find items that are small enough to fit in a compact kit. One of my go-to strategies for reducing anxiety or stress is to take a quick break outside. Simply taking a look at nature can be immediately calming. Really observe what you see and take note of the unique visual qualities of the environment, such as the trees and their leaves, the sky, the grass, and more. What you see can greatly influence your emotional state, so it’s important to engage this sense if you start to feel overwhelmed. Items that you can pack to help stimulate your visual sense and provide a sense of grounding include adult coloring books, which feature intricate designs that require concentration. Liquid motion bubblers can be soothing to watch, as can fidget spinners or cubes.

Leaning into your senses and creating a sensory pack can quickly help you feel grounded if you’re feeling stressed, anxious, or triggered. By incorporating items that engage a variety of senses—such as soothing scents, fidgets, or calming music—you can help regulate your nervous system. With the hustle and bustle of the holidays, the best part is that these sensory packs are portable and easy to use. You can take them anywhere!

Putting it All Together 

This holiday season, make your recovery a priority by implementing practical strategies to help maintain balance amid the chaos. Avoid the trap of overscheduling by intentionally selecting events that bring you a sense of safety and support. Surround yourself with uplifting people who bolster your resilience. Sticking to routines—like getting enough sleep—is essential for your wellbeing. These habits empower you and lower the risk of relapse. Remember, prioritizing your recovery doesn’t mean you have to miss out on fun; it’s all about finding the right balance! Seize this wonderful opportunity to cultivate joy and connect with loved ones while also caring for your mental health.

Posted on

Attention Deficit Hyperactivity Disorder (ADHD) and Substance Use Disorders: Dr. Sarah Anderson

There is a strong relationship between Attention Deficit Hyperactivity Disorder (ADHD) and substance use disorders. Research indicates that up to 50% of individuals with a substance use disorder also have an ADHD diagnosis, and those with ADHD are estimated to be six times more likely to struggle with substance abuse compared to those without the diagnosis (Davis et al., 2015). So, what accounts for this connection? 

Some evidence points to personality traits associated with ADHD that may predispose individuals to substance use. Other research has examined differences in the dopamine reward pathway between those with and without ADHD. The impulsivity and self-regulation challenges linked to ADHD, along with difficulties in executive functioning, is another factor that potentially increases the risk of substance use. 

Although we may not be able to alter inherent personality traits or easily address the complexities of the dopamine system, therapy can play a vital role in supporting and enhancing executive functioning skills.

Executive Functioning and Its Role in Recovery 

Executive functioning encompasses the cognitive processes necessary for planning, organizing tasks, following through, and achieving long-term goals. Additionally, executive functioning skills are needed to maintain a job, live independently, and successfully engage in one’s daily life. Executive dysfunction can pose barriers to recovery. Individuals with executive dysfunction experience challenges in organizing their environment, accurately remembering facts/dates/appointments, and completing tasks (Barkley, 2015). 

Additionally, the inability to manage impulses, initiate tasks, and self-regulate can result in significant stress and hinder one’s ability to manage life independently, which may lead to relapse (Mannuzza et al., 2008).  Therefore, when it comes to designing a path for sustainable recovery, individuals struggling with both ADHD and substance use disorders must engage in therapy that focuses on building executive functioning skills.

Occupational Therapy, Executive Functioning & Substance Use Recovery 

As an occupational therapist specializing in mental health and substance use recovery, my role differs from that of other mental health therapists. My primary focus is on supporting the development of independent living skills, which includes a range of activities such as household management, job responsibilities, driving, grocery shopping, cooking, and budgeting. Executive functioning plays a crucial role in a person’s ability to live independently; I believe it is one of the most important skills necessary for successful independent living. Currently, I work at a mental health and substance use recovery center. Many of the clients I work with have difficulties maintaining employment, keeping their environment organized and clean, consistently taking their medications, engaging in basic self-care activities, managing their emotions, handling their finances, and structuring their time. I can confidently say, based on client reports, that the vast majority of clients I’ve worked with experienced challenges with executive functioning prior to their substance use. Furthermore, many clients who sought treatment before arriving at the center have mentioned that issues related to executive dysfunction, such as boredom—which is closely associated with difficulties in task initiation and time management—function as triggers for relapse.

Therefore, to ensure they can maintain their recovery, it is essential that we focus on fostering the development of their executive functioning skills.

Key Areas of Executive Functioning

Understanding the relationship between ADHD, substance use disorders, and long-term recovery requires an exploration of the key components of executive functioning that are often affected in individuals facing these co-occurring diagnoses. Below, I break down each of these areas, highlighting their impact on recovery and strategies that can help enhance these skills for improved outcomes.

Planning and Prioritizing

Individuals with ADHD often face challenges with planning and prioritizing, which can lead to difficulties in breaking tasks into manageable steps and organizing their responsibilities. Clients I have worked with who struggle with these skills often have trouble paying bills on time, cooking, grocery shopping, and arriving at work punctually. Additionally, they may find it difficult to balance their time between work, family, friends, and other responsibilities. 

Challenges with planning and prioritizing can pose significant issues in early recovery, as many individuals who are newly discharged are tasked with managing new responsibilities, including completing step work, regularly attending meetings, and independently handling everyday life activities. Effective strategies to assist clients in these areas include the use of planners or digital calendar tools, which help establish a structured framework for daily activities (Cole et al., 2024). Other strategies such as time-blocking and creating actionable task lists can further enhance the ability to stay organized. 

The Eisenhower Matrix is an incredibly useful tool for prioritizing tasks, as it allows individuals to categorize their responsibilities based on urgency and importance (Jyothi & Parkavi, 2016). The matrix divides tasks into four quadrants: 

  1. Urgent and Important: Tasks that require immediate attention and are critical to achieving goals. These should be done right away. 
  2. Important but Not Urgent: Tasks that are essential for long-term goals but do not require immediate action. These should be scheduled for later. 
  3. Urgent but Not Important: Tasks that require immediate attention but are not necessarily tied to your personal objectives. These can often be delegated to others. 
  4. Neither Urgent nor Important: Tasks that have little significance; these should be minimized or eliminated from your to-do list. 

Using the Eisenhower Matrix can help individuals visualize their tasks and prioritize effectively, ensuring they focus their time and energy on what truly matters. 

Organization:

Organization directly impacts a person’s ability to manage various aspects of daily life. Effective organization helps individuals create a structured environment, prioritize tasks, and manage important responsibilities, including appointments, medication schedules, and personal commitments. For those recovering from substance use, the ability to stay organized can significantly reduce feelings of overwhelm and stress, which are often triggers for relapse (Kitzinger et al., 2023). 

When I work with clients, I help them create systems to declutter their living spaces, use visual reminders, and implement paper or digital organizers to keep track of their tasks. I also support them in developing personalized routines that foster consistency and accountability, which ultimately empowers them to manage their recovery journey more successfully.

Task Initiation

A common hurdle for clients with ADHD is difficulty in starting tasks, which often leads to procrastination and avoidance, further exacerbating feelings of anxiety and overwhelm. Two of my favorite methods to use with clients are the “5-minute rule” and the “Pomodoro Technique,” as they encourage them to work on tasks in smaller, more manageable time intervals. 

The Pomodoro Technique, in particular, involves breaking work into 25-minute focused intervals, known as “Pomodoros,” followed by a 5-minute break (Biwer et al., 2023). After completing four Pomodoros, clients take a longer break of 15 to 30 minutes. This method not only makes tasks feel more manageable but also helps sustain attention and reduce distractions. By creating a structured approach to work, the Pomodoro Technique allows clients to cultivate a rhythm that can enhance productivity and concentration. 

Additionally, this technique promotes a sense of accomplishment as clients complete each interval, reinforcing positive behavior and making it easier to tackle larger tasks over time. The regular breaks also provide opportunities for clients to engage in self-care or relaxation, further reducing feelings of stress and anxiety that can often hinder their progress (Gnanavel et al., 2019). Implementing the Pomodoro Technique can be a powerful tool for fostering time management skills and improving overall task initiation. 

Impulsivity Control

Enhancing impulse control, particularly when it comes to making unhealthy choices during times of distress or dysregulation, is essential for recovery. Interventions aimed at improving impulse control involve teaching clients mindfulness techniques to help them pause and reflect before acting on their impulses (Zylowska et al., 2008). Incorporating games and activities that promote impulse control, such as Jenga and Simon, can also significantly aid in fostering self-regulation. Lastly, cognitive-behavioral strategies can be utilized to help clients identify and challenge the thought patterns that contribute to impulsive decisions. 

Emotional Regulation

Improving emotional regulation is crucial for reducing ADHD symptoms and minimizing substance use behaviors. Difficulty in managing emotions effectively can result in increased stress, strained relationships, and other life challenges, all of which can potentially contribute to relapse. Teaching clients techniques like sensory modulation strategies, deep breathing exercises, and coping skills can empower them to manage their emotions more effectively. Incorporating expressive arts, such as drawing or painting, or physical activities, such as exercise, can also serve as healthy outlets for emotions (Hasegawa et al., 2017).

Working Memory 

Deficits in working memory significantly affect a person’s ability to engage in daily life. Difficulties in short-term memory can lead to issues such as forgetting important appointments, mismanaging medication schedules, or failing to recall coping strategies during stressful situations, all of which can increase the risk of relapse. To address this area, therapists implement memory aids, such as written reminders or digital apps, that assist in retaining important information and instructions. Training in mnemonic devices and visualization techniques can also enhance memory recall (Martin & Marsh, 2009). 

Additionally, engaging in mindfulness practices has been shown to enhance short-term memory. Research indicates that mindfulness can improve cognitive functions, including memory retention and recall abilities, by promoting focused attention and reducing distractions (Zeidan et al., 2010; Killingsworth & Gilbert, 2010).

Self-Monitoring 

Self-monitoring skills are important because they help individuals notice how they are doing and make changes to their behavior when needed. Clients often benefit from learning how to evaluate their performance on tasks and reflect on their emotions and thoughts throughout the process. Journaling or using mobile apps can facilitate self-reflection by allowing individuals to document their thoughts, feelings, and experiences regularly. 

For example, someone might use a journal to reflect on their daily challenges and successes, helping them identify patterns in their behavior over time. Similarly, mood tracking apps can encourage clients to log their emotions throughout the day, providing insights into triggers for anxiety or stress. This process of self-reflection can lead to more effective self-regulation, as they become more aware of their emotional responses and can devise strategies to manage them (Barkley, 2015).

Comprehensive Assessment and Goal Setting

To help clients enhance their executive functioning skills, the process begins with a thorough assessment aimed at identifying both strengths and weaknesses. This assessment is crucial, as it not only reveals specific executive functioning deficits but also ensures that the interventions used are relevant and effective. Without a comprehensive evaluation, important areas of need may go unrecognized, resulting in interventions that do not adequately address the client’s deficits. Standardized tools, interviews, and observations provide valuable insight into how these limitations impact daily life engagement. Once the assessment is complete, establishing goals collaboratively is essential. This process empowers clients to choose goals that are meaningful to them, fostering a sense of ownership in their recovery journey. 

By creating a collaborative environment, clients are more likely to make significant progress. This tailored approach not only addresses specific challenges associated with ADHD and substance use disorders but also promotes a greater sense of agency and self-efficacy. When clients feel that their needs are understood and prioritized from the start, they are better equipped to engage in the therapeutic process and achieve lasting change.

Key Points

The significant connection between ADHD and substance use disorders presents unique challenges that require a comprehensive approach to support sustainable recovery. Addressing executive functioning skills — such as organization, time management, impulse control, and emotional regulation — is essential for individuals with these dual diagnoses. By focusing on enhancing these skills, individuals in recovery can learn how to manage their daily lives more effectively and navigate the complexities associated with both ADHD and substance use.

Recognizing the specific needs of individuals with this dual diagnosis is crucial for developing effective treatment strategies. Tailored interventions that target executive functioning can lead to improved recovery outcomes and a better overall quality of life. A holistic focus on these skills not only helps individuals address the symptoms of ADHD but also empowers them to take control of their lives, establish meaningful goals, and create a sustainable path toward lasting recovery.

Posted on

How Occupational Therapy Advances Mental Health and Substance Use Recovery: Dr. Sarah Anderson

Important Note: In this article, I will use the term “Occupational Therapy Practitioner” (OTP) to refer inclusively to both Occupational Therapists (OTs) and Occupational Therapy Assistants (OTAs). This distinction is important because “Occupational Therapist” refers specifically to professionals with advanced education, training, and responsibilities. OTs hold a master’s or doctoral degree, while OTAs are required to have an associate degree and work under the supervision of an OT. If the term “OT” is used in the article, it will be to highlight a role or responsibility specific to Occupational Therapists that differs from that of OTAs.

Disclaimer: The views and opinions expressed in these contributions are those of the individual authors and do not necessarily reflect the views of Recovery.com.

Occupational Therapy in Mental Health and Substance Use Recovery: An Introduction 

Mental illness and substance use disorders impact more than just a person’s thoughts and beliefs about themselves, others, the world, and their relationships—they also greatly affect an individual’s ability to participate in daily life. Many mental health conditions can make it challenging for a person to get out of bed, brush their teeth, shower, make breakfast, care for themselves and others, and engage at work or school. While most mental health and substance use recovery centers have therapists and other psychiatric practitioners who can support processing trauma, emotional regulation, medication management, and inner child healing, very few have specialized professionals who can support skill building to enhance engagement in everyday life. This is where Occupational Therapy (OT) comes in. 

Occupational therapy practitioners (OTPs) are experts in helping people build skills needed to manage day-to-day life. These skills include decision making, time management, goal setting, communication, cooking, organization, establishing daily routines, as well as many others. 

OTPs focus on practical, personalized solutions that empower clients to engage in meaningful daily tasks, referred to as “occupations.” Within the field of OT, these occupations are categorized into ten distinct areas:

  1. Activities of Daily Living (ADLs) 
  2. Instrumental Activities of Daily Living (IADLs)
  3. Work
  4. Education
  5. Play
  6. Leisure
  7. Sleep
  8. Rest
  9. Health management
  10. Social participation1

OT is a broad and versatile field. You can find OTPs working in settings such as pediatric clinics, schools, hospitals, hand therapy, dementia care, and neuro-rehabilitation centers. Although only a small percentage of OTPs specialize in mental health today, the roots of the profession are deeply grounded in psychiatric care, making OT an essential part of recovery for many individuals2.

A Brief History of Occupational Therapy in Mental Health 

While some aspects of the profession can be traced back to the 1800s, OT as we know it today didn’t emerge until the early 20th century3. The profession was founded on the belief that meaningful engagement in daily activities could promote recovery and well-being for individuals with mental illness. The idea that participation in purposeful activities could help improve mental health was groundbreaking and laid the foundation for the profession2 which remains, to this day, the heart of what we do as OTPs.

In the early years of the profession, OTPs worked primarily with individuals who were institutionalized3, using activities to help patients develop a sense of purpose and reduce boredom. However, as medical and behavioral health care evolved, the role of OT expanded beyond psychiatric practice. Due to this expansion and other challenges, OT’s presence in mental health settings has decreased over the years2. Only about 2% of OTPs work in mental health4, which makes it challenging for people to access OT.

Occupational Therapy’s Role in Mental Health 

OT in mental health focuses on helping individuals participate in activities that give their lives meaning and structure. For individuals experiencing mental illness and/or substance use disorders, it can be challenging to maintain daily routines or manage the demands of work, school, and relationships. OTPs help clients identify activities that are important to them and develop strategies to overcome barriers that prevent participation5. 

Before working with a client an occupational therapist will evaluate a client’s current abilities to perform a variety of daily activities and work with them to set realistic and achievable goals. These goals often focus on improving self-care, building coping strategies, addressing sensory processing challenges, developing executive function, enhancing social skills, and establishing routines. For example, a client struggling with depression may find it difficult to get out of bed in the morning or prepare meals. An OTP can help by working with the client2 to develop a morning routine, break tasks into smaller steps, and use strategies to overcome fatigue or lack of motivation.

OTPs also focus on helping clients develop coping mechanisms to manage symptoms related to mental illness. For individuals with anxiety, this may involve teaching relaxation techniques or helping them use sensory-based strategies to reduce stress and dysregulation. For people with ADHD, it may include creating structure and organizational strategies to help them stay on track with tasks. 

It’s important to know that OT doesn’t stop at skill building; one of the core focuses of the profession is ensuring integration of learned skills into daily life. It’s not just about teaching and having clients practice skills in therapy; it’s about helping them take the skills and apply them in real time. The ultimate goal of OT is to help clients build and implement the skills they need to lead fulfilling, balanced lives.

Working with Clients in Substance Use Settings

Substance use disorders often co-occur with other mental health conditions such as trauma, anxiety, depression, and ADHD. OT can play a vital role in helping individuals with substance use disorders rebuild their lives5 by focusing on establishing healthy routines, improving self-care, and finding new ways to experience joy and fulfillment without the use of substances.

One of the key ways in which OTPs help individuals in substance use treatment is through exploration and development of leisure skills5. Clients with substance use disorder often lose the ability to engage in healthy, fulfilling leisure activities. Additionally, boredom is frequently reported as a significant trigger for relapse6 as it can lead to feelings of restlessness, isolation, and frustration. These are feelings that many people seek to reduce through the use of substances. 

Additionally, OTPs help clients in substance use recovery develop practical skills5 for daily life in recovery. This includes managing finances, preparing meals, finding and maintaining employment, and self-care. For many people in recovery, these are areas that are often neglected during substance use, and relearning how to manage them can be overwhelming. OTPs work with clients to break these tasks into manageable steps, build confidence, and develop the skills needed to maintain independence.  

In substance use recovery, OT empowers clients to explore new hobbies, interests, and activities that bring joy and meaning to their lives. By nurturing independent living skills and establishing structured routines, OT not only promotes a journey of healing but also lays a foundation for long-term recovery.

A Brief Overview of Mental Health Occupational Therapy Interventions 

OT interventions vary depending on the specific mental health condition a person is experiencing. For individuals with anxiety disorders or those who have experienced trauma, interventions might include developing coping strategies to manage symptoms7, such as deep breathing, progressive muscle relaxation, or sensory modulation techniques. If a client were experiencing depression and struggled to engage in self-care tasks, an OT would likely focus on establishing a daily routine2, setting small, achievable goals, and finding ways to increase motivation and energy. Clients with ADHD require an approach that focuses on creating organizational systems, such as using a planner, breaking tasks down into manageable steps, and using visual supports, like a timer, to stay on track. 

Additionally, OTPs are specially trained to assess and address sensory processing challenges, which are common among people with mental health conditions like anxiety, ADHD, OCD, bipolar disorder, SUD, and trauma. This is one of the most unique aspects of the profession. Sensory processing refers to how the nervous system receives and organizes sensory information8 from the environment so that individuals can respond appropriately. 

Dunn’s Sensory Processing Model helps occupational therapists understand a person’s unique sensory preferences by categorizing these preferences into four patterns: Sensory Sensitivity, Sensation Avoiding, Sensation Seeking, and Low Registration. Someone with sensory sensitivity patterns will likely become more easily overwhelmed with stimuli9 such as bright lights or loud sounds, which can lead to feelings of anxiety or agitation. In contrast, someone who has sensation seeking patterns will crave more intense input, such as jumping, pushing, or spinning, to feel calm and focused. 

By identifying a client’s sensory profile, occupational therapists can tailor interventions to support their nervous system needs so that they are more regulated and able to engage in their daily life (Pfeiffer et al., 2018). 

Summary

OT plays an essential role in the recovery journey for those with mental health disorders and substance use issues. While the profession may not be as well-known in mental health settings as other types of therapy, its unique focus on helping people engage in daily life makes it an essential part of the recovery process. Whether working on establishing a morning routine, building coping strategies, or developing new leisure skills, OTPs help clients regain a sense of purpose, independence, and fulfillment in their daily lives.