LR IRL — Lifestyle Redesign in Real Life
Metaphorical Momentum
For a lot of Gregory’s life, he had skilled challenges together with his psychological well being and, over time, was identified with generalized nervousness, main depressive dysfunction, consideration and focus deficit, and irregular weight reduction. By his mid-thirties, Gregory discovered himself feeling like he wasn’t the place he wished to be in life but uncertain of learn how to make a change. He acknowledged that he had turn into socially remoted over the previous couple of years following the tip of a long-term relationship; working as a supply truck driver grew to become his important motive for leaving house. More not too long ago, he had begun to scale back the variety of shifts he picked up every week and was not showering or brushing his enamel at a frequency that felt consultant of what self-care meant to him. After sharing these noticeable purposeful modifications together with his psychiatrist, Gregory was referred to Lifestyle Redesign providers the place he met his occupational therapist (OT), Dr. Emma Schiewe.
During their preliminary assembly, Gregory’s self-awareness was a priceless asset in serving to Emma higher perceive how OT might be of assist. While Gregory didn’t expertise challenges together with his work participation, he was requiring important psychological and emotional preparation to bodily get himself to work and address work-related frustrations. As a supply driver, Gregory had restricted management over his work routines, particularly when and the place he would have the ability to take a break to make use of the restroom or eat lunch. With a greater understanding of Gregory’s lived expertise, and his affinity for metaphors, Emma took the chance to introduce the Law of Inertia from an OT lens: an object at relaxation stays at relaxation, an object in movement stays in movement.
Following that very first assembly, Gregory started taking steps to beat inertia. His first set of short-term targets included brushing his enamel not less than as soon as a day, and showering not less than twice every week to assist him in gaining the momentum to go to work. Emma guided Gregory in constructing self-awareness round how day by day self-care might have a domino impact: sustaining his hygiene helped him be ok with himself, which made it simpler for him to interact in actions exterior of the house, equivalent to going to work or attending medical appointments. The alternative to explicitly join the dots between his habits and the influence they’ve on his self-efficacy and, consequently, his willingness to depart house, was sufficient for Gregory to take initiative and maintain the change he desired.
From there, classes centered on figuring out methods for growing Gregory’s work attendance. Initially, he described his expertise as tunnel imaginative and prescient: solely capable of concentrate on the stressors and obstacles instantly forward of him. Emma expanded on this metaphor, inviting Gregory to think about that if he left the tunnel there could be an unlimited panorama round him. The permission to zoom out and assess the larger image resonated with Gregory, who felt like he was able to push by the tunnel to see the panorama on the opposite finish. To put together him for this, the pair created an individualized resolution tree that supported Gregory in figuring out what his subsequent steps have been for the day, relying on how he felt upon waking up, if he had already missed a day of labor that week, and different related components. This software, which lived on his bed room wall, was key to decreasing the cognitive load that will sometimes exacerbate Gregory’s nervousness; he now had a map for exiting the tunnel. To start shifting by the tunnel, and growing the motivation to proceed shifting, Emma guided him in an train to discover why it was vital to go to work and make cash, ultimately touchdown on Gregory’s motivation to get pleasure from life by travelling and enjoying golf. These motivators have been strategically externalized onto sticky notes that will be part of the choice tree on Gregory’s wall and encourage him each morning to go to work in order that he can afford the hobbies he loved. Within just a few weeks, going to work constantly had turn into much less cognitively and emotionally taxing and was starting to really feel recurring once more.
Reengaging with work inevitably led to addressing the stressors Gregory skilled whereas at work. They found that he discovered it priceless to externalize his ideas by writing them down, so Gregory started carrying a journal in his backpack in order that he might entry it anytime he wanted. Given the character of his job, Gregory had turn into accustomed to consuming solely as soon as per day and consuming a number of soda since he had no constant house to take a break or eat lunch. After receiving schooling on how his eating regimen might be contributing to his low temper and lack of urge for food, particularly with consideration for the psychiatric medicines he was taking, Gregory was prepared to discover methods he might enhance his caloric consumption whereas decreasing his sugar consumption. Their classes grew to become areas for collaborative drawback fixing, exploring combos of fast snacks, meal prepped sandwiches, and more healthy drive-thru choices. Over time, Gregory was planning every week’s value of lunches round his anticipated supply routes, making certain that he was consuming one thing whereas “on the clock” and incorporating sufficient selection to make consuming pleasing once more.
By the tip of his 16-session plan of care, spanning over a yr’s time, Gregory had stayed in movement and exited the tunnel. He was grooming himself day by day, attending work recurrently, consuming three meals per day, and even gained a wholesome quantity of weight. Gregory acknowledged that the gradual shifts in his look and engagement nurtured his rising self-efficacy, motivating him to proceed the momentum he had constructed and reconnect with the hobbies that allowed him to pour into himself. Emma attributes Gregory’s success in OT to his readiness for change and openness to new concepts.
When requested what she hopes different OTs can study from Gregory’s story, Emma shared:
“We are the provider that fills the gaps and helps patients visualize their future and what they’re wanting for themselves. Lifestyle Redesign leans on the perspective that change is a domino effect: if we can help someone make one change, everything else falls in line just a little bit more than it did before. Allowing yourself to go into these [therapeutic relationships] with the confidence that you can help make a change, even if it seems overwhelming at first, is a wonderful opportunity to help someone.”
— Emma Schiewe, OTD, OTR/L, LRC
Research Spotlight
Lifestyle Redesign OT pays off: Primary Care Integration Cuts Emergency and Hospital Use
“Occupational therapy (OT) is not just an “add-on” service; it may essentially reshape how sufferers interact with healthcare. When OT is embedded inside major care, we see a shift away from reactive, crisis-driven utilization towards extra proactive, preventive, and routine care. That shift issues for each affected person consequence tendencies and system sustainability.
This work contributes to a rising physique of proof that positions OT as a significant major care service supplier with influence, offering systems-level options reasonably than simply individual-level interventions.
In the US fee-for-service healthcare panorama, pushed by cost-benefit evaluation, healthcare providers should, at a minimal, justify value containment reasonably than forestall detrimental well being outcomes for populations. OT has the potential to make a novel contribution by addressing the day by day habits, routines, and environmental components that drive persistent illness administration points and expensive healthcare utilization.
This is particularly important in safety-net major care settings, the place sufferers usually face complicated social and structural obstacles. If we need to cut back avoidable crisis-responsive utilization and enhance long-term outcomes, we want interventions that meet folks the place they’re of their on a regular basis lives, and that’s precisely the place OT operates.
If OT goes to be meaningfully included in Medicare and Medicaid reform, built-in care groups, or major care settings, we should proceed to supply and elevate outcomes information that speaks the language of the system: utilization, prices, and measurable medical influence.”
— Valerie Tapia, OSOT PhD Candidate (Primary Author)
Upcoming Opportunities
Perinatal Transitions: Conceptualizing an Application of the Lifestyle Redesign® Framework
Date: Wednesday, June 24, 2026
Time: 11am – 12pm Pacific Time
Location: Zoom
Audience: This is an introductory stage exercise designed for OT practitioners, nonetheless, all ranges of expertise and disciplines are welcome.
Cost*: This webinar is free to attend; registration is required to affix.
In this 1- hour webinar, contributors will discover the transition to parenthood from preconception by postpartum, with a specific emphasis on nesting, place-making, and useful resource searching for. The function of occupational remedy practitioners using the Lifestyle Redesign intervention framework might be thought of within the context of offering family-centered interventions for birthing and supporting dad and mom inside their wider social networks. Through an evidence-based lens, contributors will think about the implications of various environmental contexts and acquire a deeper understanding of the influence transitioning into parental roles has on occupational participation.
Course Series Corner
NEW Special Topics Course: Chronic Headache
Our course choices proceed to develop! The new Chronic Headache Special Topics course is designed for contributors to acquire understanding of Lifestyle Redesign intervention for persistent headache administration.
All Special Topics programs are on-line, asynchronous, and obtainable on-demand!
CEUs: 3 contact hours (0.3 CEU)
Cost: $100
AOTA Members & USC Chan Alumni: $90
Last Chance to Register for the Summer Mentored Practicum
The Mentored Practicum in Lifestyle Redesign is the gateway to start accruing observe hours for certification in Lifestyle Redesign. Earn persevering with schooling (CE) credit score when you apply the intervention framework to your medical observe, and obtain mentorship alongside the way in which from a Lifestyle Redesign Certified teacher. A cost plan choice is now obtainable!
Last Chance to Register: Compressed Timeline: May 18 – Aug. 14, 2026
Weekly synchronous class occasions (14 complete). Choose between:
- Mondays, 8-10am Pacific Time
- Wednesdays, 4-6pm Pacific Time
(New) Extended Timeline*: Sept. 14, 2026 – Mar. 8, 2027
Biweekly synchronous class occasions (14 complete), scheduled for Mondays, 5-7pm Pacific Time.
*This course providing is topic to minimal enrollment necessities.
Enhance Your Practice at Your Own Pace
Interested in evidence-based interventions? Check out our on-demand Lifestyle Redesign persevering with schooling (CE) programs, and construct confidence in implementing way of life interventions in your medical observe.
The on-line, asynchronous (3) Core Courses and (6) Special Topics could be accomplished on-demand, at a tempo that works for YOUR schedule!
Certification Section
Next Certification Info Session
Join us Friday, May fifteenth @ 10am PST to study in regards to the Lifestyle Redesign certification course of and get your questions answered! Info classes are on-line occasions, hosted by way of Zoom. For further particulars about this and future data classes, go to our calendar.
If you’re unable to attend, be happy to submit any questions you’ll have by way of the contact type.