Latest in Lifestyle Redesign®
January 2026

LR IRL — Lifestyle Redesign in Real Life

Aging at a Walking Pace

Jerry was a self-proclaimed “workaholic”, who, at 73 years old, spent his retirement staying booked and busy with personal travels and continuing to work part-time as a lawyer. While his overall health had begun to fluctuate years earlier, it was only now that Jerry sought out support for the biggest factor impacting his wellbeing- his poor sleep habits. This is what led him to receive a referral to Lifestyle Redesign occupational therapy, and meet his new OT, a Fellow at the USC OT Faculty Practice, Susan Xing.

During his initial evaluation, while Jerry was primarily concerned with his sleep quality, Susan quickly noted that there were several behaviors that were not only fueling poor sleep, but also affecting Jerry’s overall wellbeing. For example, Jerry had a habit of snacking in bed as he was trying to fall asleep; this elicited a conditioned arousal response, actually making it harder to fall asleep. This, in conjunction with discomfort when wearing his CPAP and an inconsistent pain medication regimen, would result in anxious feelings about not being able to fall asleep, poor sleep quality, and waking up in the morning with fatigue and pain. Susan skillfully navigated this by prioritizing Jerry’s primary concerns, while gently educating him on the radiating effect that his daily activities were having on his overall health, and nurturing self-analysis to support Jerry in starting to make changes that felt realistic for him at this point in time.

Taking a client-centered approach, many of their initial treatment sessions together focused on problem-solving through Jerry’s sleep-related challenges. This involved Susan providing ongoing education about how his habits were contributing to poor sleep, followed by self-analysis and occupational orchestration to implement the solutions Jerry was willing to trial. After several sessions of trial-and-error, Jerry was finally ready to try tracking his sleep patterns, and very quickly saw the value in analyzing this data to help identify trends and support further solution-seeking. Once he was able to see the ripple effect of his nighttime habits, Jerry became open to seeing a nutritionist to help with his nightly snacking, exploring meditation practices to help with anxiety, and taking extra steps to make using his CPAP more comfortable.

Within the sleep-focused sessions, Susan subtly wove in interventions to support pain and fatigue management. While Jerry valued keeping his body in motion, walking for several miles per day in addition to physical therapy exercises, his frequent overexertion would only exacerbate his chronic back pain, gastrointestinal issues, and knee pain (he was pending a total knee arthroplasty). His inconsistent use of medications and pain management strategies only minimally helped to alleviate his symptoms. Susan collaborated with Jerry to break down his walking routine into more manageable segments, while embedding required rest breaks throughout the day; this supported Jerry in learning to balance his desire to be active with the need to rest. By learning to listen to his body’s signals before reaching the point of overexertion, Jerry was able to maintain his mobility without pushing his limits. The key shift came when Jerry accepted that he might need accommodations in certain environments to manage pain. For instance, when traveling, he began bringing a cushion for support and even started requesting wheelchair assistance at airports to alleviate the strain on his body. Initially resistant to these changes, Jerry eventually appreciated how these accommodations allowed him to participate more meaningfully in activities without exacerbating his pain.

By the end of his time with Susan, Jerry’s goals had evolved from simply managing his sleep to a broader sense of empowerment. Though his health challenges were ongoing, Jerry felt that he had a better grasp of his routines and a renewed sense of control, enabling him to optimize his quality of life as he aged. Through education, consistent trial and error, and ongoing support, he was able to make meaningful changes to his daily routines, significantly improving his sleep quality, energy management, and ability to manage pain. In reflecting on her time with Jerry, Susan shared,

“I realized that I can deliver education, but when it comes to the suggestions, it really needs to be client-driven for it to work. I think looking back…I probably could have done more motivational interviewing at the very get-go, but that was something that I was still developing along the way…Now I bring that skill into all of my sessions.”  — Susan Xing, MSOT, OTR/L, LRC

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Research Spotlight

Telehealth Lifestyle Pilot Study for Improving Occupational Performance in Older Adults

A large percentage of older adults often deal with chronic illnesses and face challenges in maintaining their health and balancing meaningful activities. Occupational therapy lifestyle interventions have been shown to improve health in older adults. This study introduced the Holistic Occupational Performance Empowerment (HOPE) program, which consisted of a six-week, telehealth-based, occupation-centered lifestyle intervention.

Results showed that almost 70% of participants’ personalized lifestyle goals were met or exceeded, and overall occupational performance improved after completing the HOPE program. Mental health scores showed a small increase, while other quality of life areas stayed relatively stable. Virtual delivery of the intervention allowed for consistent attendance, suggesting that brief, individualized telehealth lifestyle interventions can meaningfully support healthy aging. For occupational therapy practice, the study highlights the value of client centered, occupation based lifestyle programs delivered through telehealth to enhance older adults’ daily performance and engagement.

Impaired sleep, depressive symptoms, and pain as determinants of physical activity and exercise intervention adherence: an exploratory analysis of a randomized clinical trial

Sleep challenges, low mood, and pain are very common in older adults and can make it harder for them to keep up with regular physical activity. This study analyzes how lifestyle interventions helped older adults reduce their risk of dementia. The researchers examined whether sleep, mood, and pain at the start of the study affected how consistently participants took part in the exercise program and whether those same factors shaped their physical activity levels two years later.

Researchers found that participants with short (<6 hours) or long (9+ hours) sleep duration demonstrated lower adherence to the exercise intervention, whereas depressive symptoms and pain didn’t meaningfully reduce exercise participation. After two years, the intervention group was found to be more physically active than the control group, and this benefit held steady regardless of whether participants started with poor sleep, low mood, or pain. However, those who slept less than 6 hours were noticed to be less active overall two years later, emphasizing that sleep patterns have a significant impact long term on energy levels and health. For occupational therapy practice, these findings highlight the importance of addressing sleep as it is vital for supporting older adults in building and maintaining healthy physical activity routines.

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Upcoming Opportunities

Pediatric Endocrinology: Using the Resilient, Empowered, Active Living with Diabetes Framework in an Emerging Area of Occupational Therapy Practice
Free Webinar | Wednesday, February 18, 2026

Date: Wednesday, February 18, 2026

Time: 10–11am Pacific Time

Location: Zoom

Audience: This is an introductory level activity designed for OT practitioners, however, all levels of experience and disciplines are welcome.

Cost*: This webinar is free to attend; registration is required to join.

Type 1 diabetes (T1D) is one of the most prevalent childhood chronic conditions in the United States and requires consistent engagement in complex health management occupations to prevent serious health complications. The Resilient, Empowered, Active Living with Diabetes for Families (REAL-Fam) is an evidence-based intervention inspired by the Lifestyle Redesign® intervention framework that aims to improve the families’ quality of life, participation, and child’s health outcomes. The REAL-Fam includes seven modules that are flexible and tailored to the families’ specific needs over 12 weeks. This webinar will discuss the development of the REAL-Fam, describe the 7 telehealth modules, and examine real-world application of the intervention. The novel inclusion of occupational therapy as part of the endocrinology care team and telehealth delivery may provide a practical, immediate solution to expand beyond traditional medical consultative models and include individualized goals in domains such as health management, roles and routines, psychosocial health and well-being, and participation in everyday activities.

AOTA Mental Health Fellowship: Pathway for Lifestyle Redesign Certification

The USC Occupational Therapy Faculty Practice (OTFP) offers an AOTA-accredited fellowship program to provide Lifestyle Redesign training opportunities to licensed occupational therapy practitioners. The purpose of the USC OTFP Fellowship program is to foster the development of expertise in delivering the Lifestyle Redesign intervention to individuals living with chronic physical and mental health conditions.

The fellowship expedites the process of meeting requirements for certification in Lifestyle Redesign, as fellows will complete the didactic content and clinical hours needed to apply. For additional information, please contact the Fellowship Coordinator, Lindsey Shomer, at lindsey.shomer@med.usc.edu or visit the fellowship website.

Presenting at AOTA? Help us spread the word!

If you are presenting at AOTA (or any upcoming conference) on Lifestyle Redesign, lifestyle management, chronic condition management, or other related topic, we would like to highlight your presentation, so that other members of this community can learn from you!

Take 2 minutes to answer a few questions about your presentation and we will be sure to spread the word on your behalf:

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Course Series Corner

On-Demand Course Series Track

Check out our on-demand Lifestyle Redesign continuing education courses, and build confidence in implementing lifestyle interventions in your clinical practice!

The online, asynchronous (3) Core Courses and (5) Special Topics can now be completed at a pace that works for YOUR schedule.

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Certification Section

Congrats to the newest LRCs!

As of December 2025, 6 occupational therapists became Lifestyle Redesign Certified (LRC) practitioners! Congratulations to: Earlier this year, 2 occupational therapists became Lifestyle Redesign® Certified (LRC) practitioners! Congratulations to:

Find an LRC provider by visiting our Practitioner Database!