From Basket Weaving to Behavioral Health: OT’s Return to Mental Health

For many people, the first time they hear about occupational therapy, they picture a quiet, cozy room filled with art supplies and basket-weaving. It’s a gentle, almost nostalgic image - but it doesn’t tell the whole story.

The truth is, occupational therapy has been part of mental health care since the very beginning of the profession. In the early 1900s, OT was built alongside the mental health movement, using meaningful activity as a way to support recovery, hope, and social connection. Early therapists saw that engaging in purposeful, enjoyable tasks helped people regulate emotions, build routines, and reconnect with themselves and others.[pubmed.ncbi.nlm.nih]

That’s a message that still resonates today: recovery isn’t just about stabilizing symptoms. It’s about rebuilding a life worth living.

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So why did OT drift away?

Over the decades, the healthcare system changed around occupational therapy. Deinstitutionalization, shifting funding models, and a growing emphasis on short-term, medically focused care meant that mental health became less central to OT practice - even though the need never went away.

Only about 2% to 3% of occupational therapists now work exclusively in mental health, showing just how much OT became underrepresented in this area. But that wasn’t because OT had less to offer. It was because the system made it harder to stay visible and sustainable in behavioral health settings.

What the research says

The evidence base is clear: OT supports real-life recovery. A scoping review found that recovery is an ongoing occupational process and that engaging in meaningful and valued occupations supports connectedness, hope, identity, meaning, and empowerment. Another systematic review and meta-analysis found that occupational e-mental health interventions were associated with significant health improvements, with 50 studies included in the systematic review.[pubmed.ncbi.nlm.nih]

A separate scoping review of occupational therapy interventions for adults with severe mental illness found 35 studies and identified psychosocial, psychoeducational, cognitive, and exercise interventions as the main categories. A meta-analysis of theory-based occupational therapy interventions also found positive effects on occupational performance and well-being in people with mental health diagnoses.[pubmed.ncbi.nlm.nih]

That’s the heart of OT: helping people rebuild the routines, roles, and activities that support daily life.
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Why OT is coming back into focus

Now, more than ever, mental health systems need what OT offers. The global mental health crisis, workforce shortages, and a shift toward recovery-oriented care are all creating space for OT to be more visible again.

Therapists, organizations, and health systems are rediscovering the power of supporting:

• Daily routines and self-care.

• Sleep and wellness.

• Social participation.

• Return to work or school.

• Community involvement.

• Emotional regulation and coping skills.

These are exactly the areas where occupational therapists excel.
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Digital tools are helping OT thrive

Technology is also opening new doors. With the rise of teletherapy, remote care, and digital health, digital intervention platforms are helping clinicians deliver more engaging, personalized, and efficient therapy.[pubmed.ncbi.nlm.nih]

One example is Cognishine, a digital intervention platform built for occupational therapists, speech-language pathologists, educators, and other allied health professionals. Cognishine is designed as a clinician support platform and therapy content platform that offers ready-to-use, customizable resources for cognitive, language, speech, and social-emotional therapy.

With Cognishine, therapists can draw from an online therapy library of evidence-based therapy activities and multidisciplinary therapy resources that can be used in-clinic, for teletherapy, or for home-based practice. That flexibility supports remote rehabilitation solutions, accessible therapy software, and patient-centered therapy technology - all of which are becoming essential in modern mental health care.

This is digital therapy innovation at its most practical: tools that help clinicians do what they do best, without replacing the human connection at the heart of therapy.

AI in therapy: a supportive partner, not a replacement

As AI in therapy grows, many clinicians are asking the same question: How can AI support therapists without replacing them?

The answer is simple: by handling the routine parts of preparation, documentation, and content delivery, while leaving the relationship-centered work to humans. AI can support clinical decision support, therapy session preparation, intervention planning, and goal setting, making it easier for therapists to focus on connection, creativity, and client outcomes.

Cognishine’s approach reflects this balance: it’s a technology that empowers therapists, not one that replaces them. It supports functional outcomes in therapy by making it simpler to deliver evidence-based therapy activities, track progress, and tailor sessions to the person in front of you.
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What this means for you

If you’re a clinician, this is a moment to feel excited about OT’s role in mental health. Your skills are more valuable than ever, and digital tools like Cognishine are there to support you, not compete with you.

If you’re a leader or organization, this is a moment to invest in occupational therapy resources, online therapy tools, and patient-centered therapy technology that help you deliver better outcomes at scale.

And if you’re someone seeking therapy, this is a moment to know that recovery is not just about managing symptoms. It’s about rebuilding daily life, finding your rhythm again, and doing the things that give your life meaning.
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The future of OT in mental health

OT didn’t disappear from mental health - it was quietly waiting for the right moment to return. Today, that moment is here.

With research backing its value, healthcare systems recognizing the need, and technology making care more accessible, occupational therapy is re-emerging at the center of behavioral health.

And with platforms like Cognishine supporting clinicians with digital therapy exercises, multidisciplinary therapy resources, and accessible therapy software, the future of OT in mental health looks brighter than ever.

About the Author:

Meital Karni Buchman, OTR/L, is Chief Clinical Officer and co-founder of Cognishine, a digital platform supporting cognitive, language, and emotional well-being across the lifespan. An occupational therapist with deep expertise in clinical innovation and digital health, she leads the development of evidence-based tools used by healthcare professionals, educators, and care organizations in Israel and beyond. Meital is driven by a commitment to translating clinical needs into accessible, technology-driven solutions that promote participation, engagement, and quality of life.
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References

• Exploring the mental health roots of occupational therapy in Canada: a historical review of primary texts from 1925-1950. Can J Occup Ther. 2007 Dec;74(5). PMID: 18183776.[pubmed.ncbi.nlm.nih]

• Recovery as an occupational journey: A scoping review exploring the links between occupational engagement and recovery for people with enduring mental health issues. Aust Occup Ther J. 2015 Dec;62(6):378-392. doi: 10.1111/1440-1630.12238. PMID: 26555561.[pubmed.ncbi.nlm.nih]

• Effectiveness of occupational e-mental health interventions: a systematic review and meta-analysis of randomized controlled trials. Scand J Work Environ Health. 2019 Nov 1;45(6):560-576. doi: 10.5271/sjweh.3839. PMID: 31184758.[pubmed.ncbi.nlm.nih]

• Occupational therapy interventions for adults with severe mental illness: a scoping review. PMID: 34716157.[pubmed.ncbi.nlm.nih]

• Clinical Effectiveness of Occupational Therapy in Mental Health: A Meta-Analysis. Am J Occup Ther. 2017 Sep/Oct;71(5):7105100020p1-7105100020p10. PMID: 28809647.[pubmed.ncbi.nlm.nih]

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