Associate Professor Don Fogelberg has been an occupational therapist (OT) for more than 30 years. Despite his long and successful career, he first became interested in occupational therapy through chance. While earning his undergraduate degree in psychology, he spent a year in London. After graduating, he returned to visit friends and learned about an opening in an occupational therapy program. It caught his interest, and enrolling in the program allowed him to extend his stay in England. After completing his degree, he worked for a time in a psychiatric day hospital, and then with community mental health teams. Eventually, he took a position as a fieldwork coordinator for the OT program at the University of London. He enjoyed academia and decided to get his PhD.
Don came back to the U.S. to do his PhD in Los Angeles. While he enjoyed his time there, the constant sunshine was overwhelming to someone accustomed to London’s chilly drizzle. Famously grey Seattle, where the weather is closer to the UK’s, seemed like the perfect next step. Plus, Don had become fascinated with sleep disorders, particularly in people with spinal cord injuries or other neurological problems. The University of Washington (UW) had world-class researchers in those areas. Don was lucky enough to find a position at the UW just as his postdoc at the University of Southern California was ending, and he’s been here since.
"The OT superpower is seeing the complexity in everything."
For years, Don’s research has focused on sleep issues in people with spinal cord injuries or neurological conditions like multiple sclerosis and Parkinson’s disease. His interest in sleep began during his PhD work when he was a research assistant on a study about preventing pressure sores in people with spinal cord injuries. He noticed that 18 out of 20 participants mentioned sleep problems. No one else had seen the pattern in the same data, but Don did—perhaps because he was a sleep-deprived grad student at the time. Since sleep is crucial to health, improving sleep quality can have a significant impact on overall well-being, no matter what other health challenges someone may be facing.
While it may seem obvious that sleep issues affect health and well-being, Don points out that this is the essence of science. “It’s looking at something that is so common through a much more minute lens,” he says, “Rather than saying just, ‘I had a hard time sleeping last night,’ it’s looking at that from a really granular level.” Once the problem is clear, the next step is to figure out what might make it better.
Recently, Don has also revisited his roots in mental health. When he worked in England 30 years ago, it was common for OTs to play a role in mental health care, working in primary care, clinics, and community health settings. Only recently has the U.S. started exploring how OTs can contribute to mental health care. In 2023, Washington state passed SB 5228, which expanded Medicaid funding for OTs working in behavioral health. This opened new opportunities for OTs to work in this growing area.
Many people aren’t familiar with how occupational therapy can help with mental health, but Don explains, “we’re just working with people who have a different set of factors that limit their ability to do the things they need to do. And our job as OTs is to figure out how to bridge that gap. Whether it’s because they’re hearing voices or because they’ve got arthritis in their shoulder, we’re applying the same reasoning to it.” He also highlights the OT focus on subjective well-being and life satisfaction, which can be valuable in a wide range of situations. No matter the starting place, OTs help clients either adapt to challenges or build new skills to re-engage in meaningful activities.
As the Division of Occupational Therapy celebrates 65 years, Don is excited about the future of the profession. OTs traditionally help individuals, but they are also well-situated to see the challenges and possibilities for improvement within larger systems. Whether it’s tackling loneliness or making sidewalks better, the approach is the same. "The OT superpower,” Don says, “is seeing the complexity in everything. We can complicate anything—take tying your shoes. If you really think about everything that goes into it, it’s a complex process.” This ability to examine everyday tasks in detail allows OTs to figure out what’s going wrong and how to fix it. Whether for individuals or communities, that’s a skill that will always be in demand.