Latest in Lifestyle Redesign®
July 2025
LR IRL — Lifestyle Redesign in Real Life
Strength in Seeking Support
As her latest 12-week assignment as a travelling respiratory therapist came to an end, Angela felt a mixture of emotions in anticipation of a three-month break from work. While this break would offer time to recharge, Angela was also concerned about how she would manage her type 1 diabetes (T1D) without health insurance or access to specialist providers. As a travelling healthcare provider, she had become strategic in stockpiling medical supplies and prescriptions when on assignment, in order to maintain her health when she lost coverage in between work assignments. Despite this disruption to her healthcare access, Angela valued the flexibility of taking extended time away from work to spend time with her young daughter. When an online advertisement for a T1D research study caught her attention, Angela eagerly opted in for a chance to receive Lifestyle Redesign occupational therapy (OT).
Ultimately, Angela joined the REAL-T study and was randomly assigned to receive Lifestyle Redesign with Dr. Gabby Granados. It was clear that Angela had great insight into her diabetes care needs, however, was missing the social support to help her normalize her experiences. Diagnosed in her late teens, Angela was not exposed to the T1D social opportunities that are commonly promoted in pediatric care. Consequently, she did not know anyone else with T1D and felt isolated in her experience living with the chronic condition. Together, Angela and Gabby created a plan to address the gaps in social support, meanwhile build new routines that fostered a sense of balance between self-care, diabetes management, and quality time with her daughter.
The transition from full-time work (with 12-hour shifts) to having no set schedule was abrupt and dysregulating for Angela. She reported feeling anxious whenever she was “unproductive”, such as when she would catch up on her favorite shows or get her nails done, despite recognizing the benefits of engaging in restorative activities. With some cognitive reframing, Angela came to acknowledge that self-care, rest, and play were key to her quality of life and began to view these occupations as productive. To reinforce this mindset shift, Gabby encouraged Angela to schedule these activities into her already detailed calendar, which ultimately helped Angela honor the protected time. Within a few weeks, Angela had developed a routine with designated alone time for guilt-free rest, manicures, and reading, in addition to weekly park visits and movie nights with her daughter.
As she grew comfortable with slowing down, Angela felt ready to reengage in physical activity, which had recently been causing episodes of hypoglycemia (low blood sugar) and fear of “going low” in public spaces without a trusted person nearby to help. Gabby began with educating Angela on how different forms of exercise impact blood sugar and engaged Angela in analyzing how her experiences aligned or differed. In an effort to connect Angela to the T1D community, Gabby shared blogs, podcasts, and social media accounts where T1Ds were sharing about how they managed diabetes alongside a sport or activity they enjoyed; these provided invaluable lived-experience perspectives that Angela could relate to.
Once Angela was able to see the connection between her morning routine, which lacked nutritional intake, and her blood sugar levels in response to exercise, she was eager to trial out the various if-then scenarios she and Gabby collaboratively drafted into the notes section of her phone. Through trial and error, Angela was able to develop a pre-workout routine that complimented her ideal two-hour workout composed of weight lifting and cardio. The pre-workout routine consisted of a high-protein breakfast with complex carbohydrates and conservative insulin dosages to keep her blood sugar a bit more elevated than usual; this would ensure that Angela was in a safe range when her blood sugar inevitably dropped during the cardio portion of her workout. If her blood sugar ever dropped lower than preferred, Angela now had a reliable snack system in place to help raise her blood sugar enough to either continue her workout or safely drive home to eat. Angela began to see the value in having a diabetes community to learn from and was empowered to, safely, push herself out of her comfort zone and return to an occupation she had grown fearful of.
Halfway through their time together, Angela shared that she was preparing to return to work, which meant significant changes to her daily routines, leaving her daughter behind with her mother, and reactivation of her healthcare coverage. With Gabby’s guidance, Angela was able to locate a provider near her new workplace and scheduled an appointment. In preparation for said appointment, the duo identified priorities for the visit, including prescription refills, and practiced what Angela might say if her request for more than three months worth of refills was met with resistance. Ultimately, that appointment went smoothly and the provider was understanding of Angela’s situation, pacifying her worries about running out of supplies after this assignment ended.
The new assignment placed Angela on Covid ICU and NICU units, where exposure to high risk situations and frequent “code-blues” (or “code-pinks” for NICU) were unavoidable. This persistent heightened level of arousal made it challenging for Angela to compartmentalize her work from her daily life, especially since she was so isolated from loved ones. She began to experience trouble falling asleep, nightmares, and poor sleep quality. Consequently, her blood sugar levels were abnormally high, yet difficult to address while at work, due to the precautions in place on the units she worked. Gabby once again turned to online resources Angela could access to connect with others working on the front lines during the pandemic and normalize her experience. Angela was now empowered to join a support group for healthcare providers and felt like she was a part of a community that understood how chaotic her day to day felt.
Simultaneously, Gabby offered education about sleep hygiene and problem-solved with Angela potential strategies she could implement to help her get to sleep and stay asleep. The most effective strategies for Angela included sleeping with one of her daughter’s stuffed animals while a white noise machine played throughout the night- the background noise helped off-set the subconscious code-blues Angela would “hear” as she was drifting off to sleep. While work itself continued to be emotionally and physically taxing, Angela felt she now had the tools needed to successfully finish the assignment and, more importantly, once finished, switch back to a slower-paced routine that allowed her to recharge.
By the end of their six months together, Angela had gathered a multitude of tools and resources that she could turn to whenever she felt limited by her diabetes, overwhelmed by work, or struggling with transitions. She was extremely grateful for the support she was given as part of the REAL-T study, which modeled the importance of social support and motivated Angela to continue seeking community in virtual spaces. During their last visit together, Angela shared that she was proud of herself for the progress she had made because, “...I am showing my daughter that it’s just as important to work hard as it is to slow down and take care of all parts of herself.”
While the intricacies of T1D management were only lightly touched upon in this narrative, Gabby wants other OTs to know that T1D is a complex chronic condition to live with and treating T1D patients requires that a provider surrender the role of expert. While we as OTs can empathize with a patient, we cannot truly know that they live through; the best form of social support comes from connecting patients with others who share their experience.
“In chronic condition care, OT’s value is in promoting quality of life. We only get to be a part of our patients’ lives for a sliver of time in their lifespan, yet their chronic conditions stay with them. I encourage OTs to prioritize training their patients in the skills of problem solving, resource seeking, and self-advocacy so that they can build confidence in their own abilities to continue making the lifestyle changes they will inevitably need to make beyond their time in OT and throughout their lifetime.”
— Gabby Granados, OTD, OTR/L, LRC
Research Spotlight
Telehealth occupational therapy improves psychosocial well-being but not glycemia among young adults with type 1 diabetes: The Resilient, Empowered, Active Living-Telehealth (REAL-T) randomized controlled trial (2025)
Type 1 diabetes presents significant self-management and psychosocial challenges, especially for young adults navigating life transitions and changes in healthcare access. REAL-T, a randomized controlled trial, evaluated a Lifestyle Redesign intervention aiming to address the health management needs of young adults with type 1 diabetes, and evaluated the impact of the intervention on glycemia and psychosocial well-being.
Study participants aged 18–30 with HbA1c ≥ 7.5 % were randomly assigned to receive either telehealth occupational therapy (intervention) or usual care (control). The intervention utilized the Lifestyle Redesign intervention framework to address diabetes management, daily habits and routines, and emotional well-being. This article specifically speaks to the study’s 6-month outcomes (end of intervention period), which showed no significant differences in glycemic outcomes between the intervention and control groups. However, the participants who received the intervention did show improvements in diabetes-related quality of life and reduced diabetes distress. This study’s findings suggest that Lifestyle Redesign occupational therapy may improve well-being and quality of life among young adults with type 1 diabetes.
In reflecting on this article, primary investigator, Dr. Beth Pyatak, shared: “The diabetes community recognizes distress and quality of life as being equally important to well-being as maintaining glucose in a healthy range. Improving these outcomes for young adults, who often struggle with managing this complex disorder, is a win for the OT profession.”
*Full access may require additional subscriptions or institutional credentials.
Telehealth Lifestyle Redesign Occupational Therapy for Diabetes: Preliminary Effectiveness, Satisfaction, and Engagement (2023)
In response to the COVID-19 pandemic, occupational therapy (OT) was increasingly made available via telehealth, improving access to services and preventing delays in receiving care. The REAL-T study was designed to examine the intersection of diabetes management, OT, Lifestyle Redesign, and telehealth on the health outcomes of young adults with type 1 diabetes. This article used preliminary data from REAL-T to examine the effectiveness of the intervention in addressing occupational performance and satisfaction, assess client satisfaction with the telehealth format, and compare attendance and engagement in telehealth versus in-person OT.
Preliminary results indicate that study participants who received the intervention (young adults aged 18–30 with HbA1c ≥ 7.5 %) experienced increased occupational performance, occupational satisfaction, and health management following 6 months of Lifestyle Redesign OT intervention. Intervention participants reported high levels of satisfaction with receiving services via telehealth and showed similar levels of engagement and attendance in OT sessions as compared to in-person OT provided in a previous study. These findings support telehealth Lifestyle Redesign OT’s feasibility and accessibility, as well as its potential to positively impact occupation-based outcomes.
Dr. Beth Pyatak, the study’s primary investigator, reinforces: “Maintaining access to telehealth is an important area of advocacy for the OT profession, and this study provides evidence to support that effort.”
Upcoming Opportunities
New Job Opportunity at OTFP
The USC Chan Division of Occupational Science and Occupational Therapy is excited to announce an opening for an Assistant Professor of Clinical Occupational Therapy at the Occupational Therapy Faculty Practice.
This role involves delivering high-quality, evidence-based Lifestyle Redesign services for diverse physical and mental health conditions. Qualified candidates will possess an earned doctoral degree (OTD, Ph.D.), a current California OT license, and demonstrate excellent clinical ability, preferably with experience in Lifestyle Redesign, mental health, and health promotion. Interested applicants should visit the USC Careers website to learn more and apply.
Call for Presentations!
Are you a Lifestyle Redesign Certified (LRC) OTP or a Certification Candidate presenting presenting at an upcoming conference on Lifestyle Redesign, lifestyle management, chronic condition management, or other related topic? We would like to highlight upcoming presentations in future newsletters, so that other members of this community can learn from you!
These presentations would be considered approved activities for Lifestyle Redesign certification renewal. This means that presenters and attendees who are Lifestyle Redesign Certified can earn renewal credit for presenting/attending.
Help us spread the word about your presentation!
From Fieldwork to Fellowship: Integrating Learners to Expand Lifestyle Redesign®
Free Webinar | Wednesday, August 13, 2025
Date: Wednesday, August 13, 2025
Time: 1–2pm 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.
As Lifestyle Redesign certification expands globally, training the next generation of clinicians is crucial. This presentation explores how the USC Occupational Therapy Faculty Practice, the birthplace of Lifestyle Redesign, has adapted its fieldwork, residency, and fellowship models to empower learners in mastering and delivering this intervention. Discover practical strategies for integrating learners and expanding Lifestyle Redesign programs.
About the Speaker: Dr. Lindsey Shomer
Empowering Change: A Training for Occupational Therapy Practitioners in Motivational Interviewing
Interactive Course | December 5, 2025 through December 7, 2025
Strengthen your therapeutic communication with motivational interviewing (MI)! Join this interactive, online training to learn and practice MI principles. The training fosters a supportive learning environment where participants will be actively engaged in practicing MI skills through role-playing. While this course is designed to be applied to OT practice, the content covered can be applicable to any population- all disciplines are welcome.
This is a 12-hour course held across 3 days (4 hours per day). Participants are expected to fully participate for the entire course.
Dates/Times (Pacific Time):
- Friday, December 5, 2025, 1–5pm
- Saturday, December 6, 2025, 8am–12pm
- Sunday, December 7, 2025, 8am–12pm
Location: Zoom
Cost: US$250
AOTA Members and USC Chan Alumni: $225
CEUs: 12 contact hours (1.2 CEU)
Note: This course satisfies the 12-hour MI training requirement for obtaining Lifestyle Redesign Certification.
Course Series Corner
Redesign Your Clinical Practice
The Foundations of Lifestyle Redesign Course Series consists of online continuing education courses that provide a deep dive into the Lifestyle Redesign intervention framework and support its application to clinical practice. The Course Series prepares OT practitioners to enhance their clinical practice by:
- Applying clinical techniques to improve patient motivation, autonomy, and follow-through with lifestyle recommendations
- Expanding and refining OT treatment practices by integrating sleep, eating routines, healthy coping, physical activity, and other health management occupations
- Implementing lifestyle and health management assessments and outcomes throughout your OT plan of care
- Addressing performance patterns (orchestrating daily habits and routines), in addition to performance skills, to utilize the full scope of the OT practice framework
- Integrating Lifestyle Redesign into your current and future practice settings through program development, implementation, and monitoring processes
Registration is now available for the Scheduled Course Series Track, including a discounted “Bundled” option. On-Demand courses will available beginning October 2025.
Scholarship Opportunity - Mentored Practicum
In an effort to support the investment made by OTPs who complete the entire Course Series, we are expanding scholarship opportunities for the Mentored Practicum course!
OTPs who intend to take the Mentored Practicum course in Summer 2026 should consider applying for the scholarship opportunities this cycle- more details to come in September’s newsletter. The 4-week application window will open in September. In the meantime, click here to learn more about scholarship eligibility and application requirements.
Certification Section
Certification Info Sessions
Join us for an upcoming certification information session, learn about the Lifestyle Redesign certification process and get your questions answered! Info sessions are live, online events, hosted via Zoom — Meeting ID: 922 8683 2791 | Passcode: 588199
- Friday, July 18, 2025 @ 2pm Pacific Time
- Monday, August 4, 2025 @ 12pm Pacific Time
For full Zoom meeting details and future info session dates/times, check out our calendar by visiting the Upcoming Events page.