Latest in Lifestyle Redesign®
May 2025

LR IRL — Lifestyle Redesign in Real Life

Referral to Resilience

“What do you want to get out of your time in OT?”, Dr. Marissa Marchioni asked her new client, Jennifer. It was a simple yet powerful question that gave Jennifer the space to set the tone for her own plan of care. While she had been referred to Lifestyle Redesign® occupational therapy for support with weight management, Jennifer quickly clarified that anxiety—not weight—was the biggest factor impacting her quality of life. At the time of evaluation, she was experiencing daily episodes of tearfulness, often breaking down during her lunch break or at the end of the workday. These emotional episodes were more than a symptom; they were disrupting her occupational roles, exhausting her energy, and distancing Jennifer from the sense of identity she once felt grounded in.

By the time she met Marissa, Jennifer had already made progress in her physical health journey; she was exercising, eating well, and committed to healthy routines, but her mental health was an ongoing challenge. Her anxiety was intensified by workplace stress, familial tensions, and physical limitations related to an ongoing medical condition. Jennifer didn’t need more discipline or motivation, rather, she needed a safe space, support, and tools to manage an internal landscape that had become overwhelming. Marissa helped Jennifer map the complexities of her life by creating mental “baskets”: work, family, social life, health. At the time, each of Jennifer’s baskets was facing disruption; her demanding job lacked boundaries, family relationships were strained, medical issues interfered with physical activity- her preferred outlet for stress relief-, and her social life suffered as a result. It was no wonder that anxiety had intensified, despite her many efforts to cope.

The work began with identifying core therapeutic targets: reducing the frequency of emotional episodes, improving sleep, restoring daily rhythms, and implementing self-regulation strategies. Jennifer also completed the Adult/Adolescent Sensory Profile, which validated her heightened sensitivity to sensory input—something that helped explain why daily life often felt so overstimulating. With this insight, Marissa and Jennifer tailored her environment and routines in ways that honored her sensory needs. Interventions included diaphragmatic breathing, progressive muscle relaxation, and gentle pacing. Jennifer responded especially well to techniques that aligned with her physical identity—she had always felt connected to movement and sport, and reimagining what physicality could look like while managing medical constraints was key. One of the turning points in her care came when Marissa helped her explore light stretching and relaxation practices that provided nervous system regulation while offering a sense of control and embodiment.

As the work evolved, Jennifer also began practicing assertive communication. She had long struggled with discomfort in social and professional exchanges—not due to lack of insight or skill, but because of the internal distress those moments triggered. With support, she advocated for a redistribution of responsibilities at work, clearly expressing the overwhelming nature of her current role. The results were immediate; tasks were reassigned, expectations clarified, and her workdays became more manageable.

There were aspects of Jennifer’s life that couldn’t be changed in the short term, however; particularly a challenging parental relationship. In those moments, Marissa introduced the therapeutic practice of acceptance and delayed engagement—a strategy that honored Jennifer’s intuition and timing, while reducing the stress of unresolved interpersonal tension. Rather than forcing a resolution, they agreed on the importance of trusting that future readiness and opportunity would allow for healthier dialogue when the time was right.

Over the course of nine sessions spanning four months, Jennifer met all of her therapeutic goals. Her sleep improved, emotional regulation stabilized, and her daily routines became more sustainable and fulfilling. Tearful episodes during work had become a thing of the past, and even when a flare in her medical condition caused a temporary setback, Jennifer was able to apply the tools she had gained to re-stabilize and reconnect with herself. What stood out most throughout her care was Jennifer’s insightfulness and persistence; she was direct, candid, and deeply self-aware. Despite the discomfort that came with change, she remained open–  willing to try, reflect, and grow. Jennifer’s story is a powerful reminder that OT is not about fixing people—it’s about creating space for them to reclaim their lives, their routines, and their sense of self.

“It is a gift to be even a small piece of someone’s life, and to be a care provider. I genuinely feel love for every single person I get to work with…There is no client interaction where you won’t learn something, if you let yourself.”  — Marissa Marchioni, OTD, OTR/L, LRC

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Research Spotlight

Occupational Therapy Psychosocial Interventions for Middle-Childhood Aged Refugee Children in High Income Countries: Focus Group Perspectives (2023)

Over the last decade, millions of refugees around the world, a significant percentage of which being children, have been displaced as a result of conflict or disaster. Refugee children are subject to stressors such as food insecurity, limited or lack of access to healthcare, exposure to violence, and resettlement after displacement. This abnormal childhood experience increases the likelihood of refugee children experiencing psychosocial challenges, and occupational therapy (OT) has the potential to expand into the realm of psychosocial interventions being used to address the needs of this population because of the profession’s attention to context and occupational engagement and adaptation.

A group of researchers from Curtin University utilized a thematic network analysis methodology to better understand the perspectives of OT practitioners, researchers, and students with at least 1 month of experience with refugee children in the last 10 years. Focus groups were held to identify interventions that promote refugee children’s psychosocial well-being in middle childhood in high income countries and yielded four main themes: (1) making the more of what you have, (2) the child in their various environments; (3) OT lens helping to build a bridge between old and new lives, (4) sensitivity matters/considerations. Ultimately, OT’s unique approach to addressing psychosocial well-being situates the profession to “(re-)emerge” into this area of practice. The authors encourage further research to develop an evidence-base of OT interventions that address the needs of refugee children.

Exploring performance patterns of family members caring for a loved one with mental illness in rural and remote Capricorn District of South Africa: A secondary analysis (2024)

Caregiving for loved ones living with mental illness is a co-occupation that is often overlooked, despite the undeniable impact it has on the caregiver’s* performance patterns. For caregivers in rural settings, access to respite and other essential resources can be sparse, yet these individuals are crucial collaborators for OTs and other healthcare providers who are caring for the loved one living with mental illness.

Researchers from the University of Limpopo in South Africa conducted a secondary analysis to explore how caregiving in rural African communities, specifically within the context of mental illness, influences the performance patterns of caregivers. Findings from re-analyzed qualitative semi-structured interviews with 15 caregivers revealed four main themes (and 10 subthemes): (1) Family members develop both negative and positive family coping strategies to care for a mental health care user, (2) an increased level of burden on the family members caring for a mental health care user, (3) victims of mental health care users’ symptomatic and violent behavior, (4) influences related to preferred treatment for mental illness. Understanding the caregiver experience and the changes in performance patterns that inevitably co-occur equips OTs to develop strategies to support caregivers in their role while optimizing well-being for both the caregiver and their loved one they care for.

*Although “care partner” is the preferred term for health professionals to use to describe this role, we use the term “caregiver” as this was the term used by this publication’s authors.

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Upcoming Opportunities

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

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.

Last call to register for this live, interactive motivational interviewing (MI) training course! 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.

OcupApp: How a Mobile Application Encourages Self-Analysis and Changes in Engagement in Meaningful Activities
Free Webinar | Rescheduled to Monday, May 26, 2025

NEW Date: Monday, May 26, 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.

Lifestyle Redesign®’s Role in Gender-Affirming Care
Free Webinar | Tuesday, June 17, 2025

Date: Tuesday, June 17, 2025
Time: 12–1pm 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 application of the Lifestyle Redesign® intervention framework to serve trans and gender diverse (TGD) clients and understand the critical role that occupational therapy can play in gender affirming care. Attendees will gain a greater understanding of the impact of lifestyle considerations for this population and learn evidence-based intervention approaches that support mitigating gender dysphoria and optimizing gender euphoria.

About the Speaker: Dr. Nora Dixon

Continuing Education Information

*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.

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Certification Section

Spring LRC Exam Window Closing Soon!

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 current LRC exam cycle will be open until May 15, 2025.

If you intend to take the exam in the next cycle*, start the process today! For more information about exam eligibility, visit Section 3.2 of the Certification Handbook.

*The next exam cycle will be October 1 through November 15, 2025.

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 — Meeting ID: 922 8683 2791 | Passcode: 588199

• Monday, May 12, 2025 @ 1pm Pacific Time
• Monday, June 2, 2025 @ 9am Pacific Time

For full Zoom meeting details and future info session dates/times, check out our calendar by visiting the Upcoming Events page.

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Course Series Corner

Register for Upcoming Special Topics Courses

Course Options: Chronic Pain, Mental Health, Multiple Sclerosis, Sleep Disorders, Weight Management
Courses Dates: May 19 - June 27, 2025
CEUs: 0.3 each
Prerequisites: Successful completion of Core Course 1, Core Course 2, and Core Course 3
Note: (4) Special Topics courses are required to meet Lifestyle Redesign Certification requirements

 

Fall 2025 Course Registration Opening Soon!

Registration for the Scheduled Course Series Track opens Monday, May 15, 2025. The courses in this track have set start and end dates:

• Core Course 1: September 8 - October 24, 2025
• Core Course 2:  November 10, 2025 - March 20, 2026
• Core Course 3: April 6 - May 1, 2026

Course registration will be available for individual courses, as well as a Bundled Course Registration option for participants who intend to take Core Courses 1, 2, and 3 in the same cycle (i.e. Fall 2025 through Spring 2026). The bundled discount only applies to the 3 Core Courses on the Scheduled Track and cannot be applied to courses in the On-Demand Track (available beginning October 2025).

Visit the Course Series page for more information about the course tracks, descriptions, and costs.