Anna Ketron Cusano (she/her)

When working with older adults, I address challenges related to cognitive changes, physical limitations, and social isolation by promoting independence, engagement, and safety in daily life. I assess and support activities of daily living (ADLs/IADLs), introduce adaptive strategies or tools, and incorporate movement, routine planning, and leisure engagement to maintain mental and physical wellness. I also offer caregiver coaching to ensure aging individuals remain connected and supported.

As an OT, I support individuals with depression by helping them re-engage in meaningful routines and occupations that promote purpose and self-worth. I focus on restoring or developing daily structure, exploring leisure activities that spark joy, and teaching stress management, emotional regulation, and self-care strategies. Using evidence-based techniques, I help clients set achievable goals, reduce overwhelm, and find fulfillment in everyday life—empowering them to reclaim control.

For individuals with learning disabilities, especially teens or young adults, I provide strengths-based support focused on executive functioning, life skills, and adaptive strategies. My approach helps clients develop time management, organization, and task completion routines tailored to their unique learning styles. I also integrate sensory regulation and confidence-building activities to improve social-emotional skills, independence, and resilience.

From an OT standpoint, the horse becomes a co-facilitator of therapeutic occupation—allowing clients to work on things like: Self-awareness and body regulation, Stress management through sensory and movement-based input, Communication and relationship-building, and Responsibility, routine, and follow-through (all tied to IADLs and executive function.

Occupational therapy is inherently holistic—we look at the whole person, not just symptoms. In holistic therapy, OTs: Integrate mind-body-spirit practices such as mindfulness, lifestyle redesign, values clarification, and meaningful occupation engagement Address not just what a person needs to do, but what they want to do, and the barriers to wellness (physical, emotional, social, or environmental).

OTs can be trained to use biofeedback tools (e.g., heart rate monitors, breathing devices, EMG) to help clients build self-regulation, awareness, and behavioral change through visual or auditory cues about their body's physiological state. OT uses biofeedback as a client education and self-management tool, often in: Stress management & anxiety treatment, Pain and fatigue management, ADHD or executive functioning work, and Performance enhancement for daily occupations.