Latest in Lifestyle Redesign®
March 2025

LR IRL — Lifestyle Redesign in Real Life

Practicing What She Preaches

As a medical professional, Maya had spent years advising her patients on the importance of rest and listening to their bodies.  When she sustained a concussion while snowboarding, Maya found herself in an all-too-common dilemma: knowing what she should (and shouldn’t) do, yet not giving herself permission to follow a concussion protocol. At first, Maya experienced a bit of brain fog and mild headaches, but soon, her symptoms worsened—light and sound became overwhelming, fatigue crept into every part of her day, and simple tasks felt exhausting. Still, Maya pushed on and continued to work full-time as a nurse practitioner in a primary care setting, care for her two young children, and maintained her daily responsibilities- rest didn’t feel like an option.

Four months after her injury, symptoms only began to worsen; Maya had begun missing work and too much activity led to severe headaches and dizziness, but doing nothing made her feel unproductive and helpless. After confiding in her neurologist about these daily challenges, she was referred to Lifestyle Redesign occupational therapy (OT). In her initial session with Dr. Lindsey Shomer, Maya shared that she was aware of her triggers—bright lights, loud noises, overexertion—but admitted she had not made adjustments to mitigate them. Instead, she had been forcing herself to tolerate them, hoping her mind and body would eventually sync back up.

In the initial treatment sessions that followed, Lindsey educated Maya on the importance of consistent symptom tracking. While Maya knew what triggered her symptoms, it was crucial that she gather objective data about these triggers (e.g. severity, time of day, location, stimuli) in order to support her ability to identify activity modifications and pacing strategies. Together, they strategized Maya’s symptom tracking method and, eventually, analyzed the data Maya had collected, noting patterns in light and sound sensitivity, physical exertion, and cognitive fatigue. With an awareness of Maya’s baseline activity tolerance, the pair created an activity pacing plan that gradually reintroduced triggers in a controlled way, allowing her body to adapt without worsening symptoms. At first, the idea of pacing frustrated Maya; she was accustomed to functioning at a high level and struggled with the concept of slowing down, but with Lindsey’s guidance, she started to notice that intentional breaks helped her sustain energy throughout the day.

Through guided problem-solving, Maya identified the most meaningful activities she wanted to preserve and collaborated with Lindsey to explore ways she could modify her participation as well as delegate less critical tasks. Maya was challenged to resist the urge to “push through” and instead recognize early signs of fatigue and adjust her activity participation accordingly. One of the most significant shifts came in her return to exercise. Before her injury, Maya exercised daily, often going on long walks as a form of stress relief, though, post-concussion, she had stopped entirely, unsure of how to safely resume movement. Using a structured pacing approach, she started with just a few minutes of walking, slowly increasing her tolerance each week. Over time, she built back up to her full 60-minute walks, regaining a sense of normalcy in a way that felt achievable rather than overwhelming.

Work was another major hurdle– the demands of patient care, constant screen exposure, and the overstimulating clinical environment exacerbated Maya’s symptoms. Lindsey supported Maya in identifying workplace accommodations that would allow her to continue working without further postponing her recovery. Together, they created a phased reintegration plan, reducing her workload and making environmental modifications such as adjusting lighting, closing her office door to minimize noise, and structuring scheduled breaks throughout the day. It was during this time that Maya finally decided to take a temporary leave of absence—a difficult but necessary step that allowed her to fully focus on healing. When she returned, she revisited the reintegration plan she created with Lindsey and began working part-time, with limited patient interactions, and progressively increased her hours and responsibilities over a three-month period.

Beyond work and exercise, Maya had to confront another challenge: asking for help. As a healthcare provider, she was used to being the one offering support, not the one receiving it. Delegating tasks at home and communicating her needs to her partner felt foreign and she struggled with guilt—she questioned: if she wasn’t handling everything herself, was she failing? Lindsey supported Maya in challenging these thoughts and nurtured Maya’s realization that adjusting expectations did not mean she had to give up control, rather, it meant prioritizing what truly mattered. Maya learned to distinguish between activities that were deeply meaningful to her and those she could delegate, allowing her to be more present for the moments that mattered most, especially when it came to caring for her children.

Fourteen sessions and seven months later, Maya had not only regained function but also developed a newfound appreciation for pacing and self-care. She had improved her tolerance for light and sound, returned to full-time work, resumed her exercise routine, and felt more confident in her parenting role. Most importantly, she had learned to extend the same care and patience to herself that she so readily gave to her patients. Maya’s experience highlights a challenge many healthcare professionals face—practicing what they preach. She had spent years telling her patients to prioritize their recovery, yet when it came time to apply those same principles to herself, she resisted. Her time in OT taught her that healing isn’t about pushing against her body’s limits, rather, it’s about working with her body. Consequently, Maya became an even stronger advocate—not just for her patients, but for herself.

When reflecting on what might be valuable for other OT practitioners to know about working with post-concussion syndrome, Lindsey shared:

“I want to encourage other OTs to think about building [the patient’s] awareness [about their symptom triggers] initially, to give the patient the intrinsic motivation to want to set those limits and make those changes…The other thing that’s interesting about this particular diagnosis of post-concussion syndrome is that there’s so many symptoms that people can experience and so it is such an individualized experience that, as the OT, you really do need to understand what are the symptoms that the individual is experiencing, because one patient may have brain fog, another patient may have headaches, another patient may have sensory sensitivity, and so the treatment plan for someone with post concussion syndrome could look very different, depending on what the patient is presenting with.”

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Research Spotlight

Interventions to Improve the Occupational Performance of Youth With Persistent Postconcussion Symptoms: A Systematic Review (2024)

Due to ongoing brain development, youth are especially vulnerable to persistent post-concussive symptoms (PPCS), which can impact cognitive, emotional, physical, and social functions. Despite the growing awareness of PPCS, research that explores the role of occupational therapy in managing PPCS remains limited.

This systematic review analyzed 20 studies investigating occupational therapy interventions for youth with PPCS, focusing on functional outcomes in areas such as activities of daily living (ADLs). Findings indicate strong evidence in the use of cognitive-behavioral therapy (CBT) for improving occupational performance with supporting success in psychoeducation and active rehabilitation (such as aerobic exercise and targeted activity) demonstrating effectiveness in school engagement and quality of sleep. Although current research focuses mainly on sports related concussions with little inclusion of PPCS for the pediatric population. The authors assert that occupational therapists have critical skills suited for concussion rehabilitation, particularly given their holistic perspective that prioritizes meaningful engagement over symptom management alone. Increasing involvement in interdisciplinary concussion care could substantially enhance outcomes and support a full meaningful recovery for youths with PPCS.

*Accessing full article requires AOTA membership.

Surveying the Landscape of Persistent Concussive Symptoms in Adults Through an Occupational Lens (2024)

Persistent concussive symptoms (PCS) can affect a person’s ability to participate in meaningful daily activities, such as disturbances in physical, cognitive, and emotional states that can be experienced for over a year. Despite the known impacts of PCS, existing research has rarely examined how these symptoms limit occupational engagement, instead primarily addressing symptom management rather than returning to roles and routines. Occupational therapists have a potential to fill this gap, given holistic perspectives and the support given for clients to re-engage in activities.

This cross-sectional study aimed to evaluate occupational performance limitations in adults with PCS using the Canadian Occupational Performance Measure (COPM). Participants identified significant challenges in education, social participation, and instrumental activities of daily living (IADLs), such as job performance and maintaining daily routines. Overall, participants rated their occupational performance and satisfaction as low. Research suggests that prolonged rest post-concussion may contribute to worsening symptoms, while a graded return to activity is more beneficial. The use of semi structured interviews, such as the COPM, provides a more comprehensive evaluation than fixed-item questionnaires, capturing the individualized impact of PCS on daily life. The increased research attention to occupational therapy’s impact, highlighting the profession’s ability to directly improve quality of life and occupational satisfaction for adults living with PCS.

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Upcoming Opportunities

OcupApp: How a Mobile Application Encourages Self-Analysis and Changes in Engagement in Meaningful Activities
Free Webinar | Monday, April 28, 2025

Date: Monday, April 28, 2025
Time: 9–10am 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.

Join this webinar to learn about OcupApp, a mobile application designed by occupational therapy researchers to increase awareness of participation in meaningful activities. Based on Eakman’s model of universal emotions, this application prompts users to record their daily activities and aims to increase their awareness of the meaning they attribute to each, respectively. This increased awareness supports users in reaffirming their activity participation as well as making changes to their lifestyles to include activities that bring greater personal meaning. Speakers will highlight their proposed methodology to test the effectiveness of OcupApp in improving perceived quality of life in people over 60 years of age living with anxiety and subclinical depression.

About the Speakers: Drs. María Rodríguez, José Antonio Merchán, Judit Fernandez, Laura Vidaña

*Webinars are free for live attendees. This webinar will be recorded and made available for on-demand viewing, for a fee, within 10 days of the event. If you are unable to attend the live event, consider visiting the On-Demand Learning page to register for on-demand webinar access once the recording is made available.

 

OT Faculty Practice Mental Health Fellowship: Pathway for Lifestyle Redesign Certification

The USC Occupational Therapy Faculty Practice (OTFP) offers a 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 administering the Lifestyle Redesign intervention to individuals living with chronic physical and mental health conditions.

The fellowship curriculum will include more than 1,400 hours of didactic and clinical education, mentored service delivery and non-mentored service delivery and will cover topics including pathophysiology of chronic conditions, occupation-based and evidence-based practice guidelines, safety regulation and ethical practice guidelines, interpersonal skills, and professional engagement. Fellows will be paired with a faculty clinician and will engage in training, structured mentoring sessions and scholarly activities to enhance their clinical practice and leadership skills. Throughout the experience, fellows will work on interprofessional teams, engage in public speaking, and participate in community engagement activities.

The fellowship will expedite the process of meeting requirements for the Lifestyle Redesign certification, as fellows will complete the didactic content and clinical hours needed to apply. This opportunity has a start date of Summer 2025- applications will be closing soon!

For additional information, please contact the Fellowship Coordinator, Lindsey Shomer, at lindsey.shomer@med.usc.edu.

The fellowship program is currently in candidacy status with the American Occupational Therapy Association. See additional information about the OT Faculty Practice and current programs.

 

Empowering Change: A Training for Occupational Therapy Practitioners in Motivational Interviewing
Interactive Course | May 9, 2025 through May 11, 2025

Back by popular demand: Dr. Jesús Díaz will be offering this motivational interviewing (MI) training again, this Spring!

This is a live, interactive course in which participants will apply MI principles through role-playing. This is designed to be a supportive learning environment where participants will be actively engaged in practicing MI skills. While this course is designed to be applied to OT practice, the content covered can be applicable to any population; therefore, 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, May 9, 2025, 1–5pm
• Saturday, May 10, 2025, 8am–12pm
• Sunday,  May 11, 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.

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Certification Section

Upcoming LRC Exam Window

If you have completed your education and experience requirements for Lifestyle Redesign Certification (LRC), take the final step towards certification and apply for exam eligibility! The next LRC exam will be offered April 1, 2025 through May 15, 2025. If you intend to take the exam this cycle, start the process today!

The LRC exam is offered in an online proctored format on a biannual basis. The following exam cycle will be October 1 through November 15, 2025. For more information about exam eligibility, visit Section 3.2 of the Certification Handbook.

LRC Info Sessions

Join us for an upcoming Lifestyle Redesign Certification information session, learn about the certification process and get your questions answered! Info sessions are live, online events, hosted via Zoom: usc.zoom.us/j/94343068918 | Meeting ID: 943 4306 8918

• Monday, April 7, 2025 @ 12pm Pacific Time
• Monday, May 12, 2025 @ 1pm Pacific Time

For full Zoom meeting details and future info session dates/times, check out our calendar by visiting the Upcoming Events page. In the meantime, consider checking out the resources on the Certification page.

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Course Series Corner

Register for Upcoming Courses

Core Course 3: Lifestyle Redesign Program Development
Course Dates: April 14 - May 9, 2025
CEUs: 0.6

Special Topics Courses
Chronic Pain, Mental Health, Multiple Sclerosis, Sleep Disorders, Weight Management
Courses Dates: May 19 - June 27, 2025
CEUs: 0.3 each

 

Thinking About Enrolling?

Beginning Fall 2025, there will be two Course Series “Tracks” available to CE learners:

Scheduled Course Series Track

• Courses have set start and end date, once per year
• Access to 1:1 meeting opportunities with course instructor for individualized problem-solving and support
• Opportunities to attend multiple optional synchronous discussion sessions to connect with the course instructor and other course participants
• Learning activity feedback that is individualized to each learner

On-Demand Course Series Track

• Courses available on-demand within 5 business days of registration and should be completed in window of time allotted (varies per course)
• Access to drop-in meeting opportunities with course instructor through Lifestyle Redesign clinical office hours (occur every other month)
• Learning activity feedback that represents general themes observed across learners

All other aspects of the courses remain the same for both tracks:

• Courses utilize an online, paced, asynchronous format
• Anticipate an average of 2-4 hours per week interacting with course components, including reviewing course lectures and completing learning activities
• Synchronous (“live”) participation is not required, but optional opportunities are available
• Access to course instructor and technical support through email for questions and troubleshooting

The next offerings of Core Course 1 will start in September 2025. Sign up to be notified when Core Course 1 registration pages become available!