Understanding Executive Dysfunction

Executive dysfunction therapy helps adults manage real-life challenges like focus, planning, and organization. At Holistic Community Therapy in Portland, we understand that these difficulties are not failures—they’re functional challenges that can be supported and improved. Executive dysfunction is a term used to describe difficulty with the brain’s self-management system. It often impacts a person’s ability to plan, organize, start, and complete tasks.

It can show up in many forms:

• Struggling to follow through on intentions—like finally starting that laundry pile that’s been staring at you for days
• Losing track of time or appointments—even with Google Calendar reminders buzzing
• Becoming overwhelmed by clutter or unfinished tasks—especially in small apartments or shared living spaces common here in Portland
• Feeling stuck or paralyzed by indecision—like whether to cook dinner or just order takeout again
• Frequently forgetting important steps in a routine—especially when juggling work-from-home demands and personal care

These challenges are common for individuals with ADHD, autism, brain injury, trauma, or mood disorders.

At Holistic Community Therapy in Portland, OR, we understand that these are not failures. They’re functional challenges that can be supported and improved.

Why It Matters

Executive dysfunction can erode self-esteem. Many clients say, “I should be able to do this,” or “I’m just lazy.” Especially in a city like Portland, where independence and creativity are so highly valued, it can feel isolating to struggle with daily routines. The truth? You’re not broken. Your brain just needs support. That’s where occupational therapy comes in.

Our goal isn’t to “fix” you—it’s to help you function with freedom in your daily life.

How Executive Dysfunction Therapy with an OT Can Help

Occupational therapists (OTs) are uniquely qualified to address the real-life effects of executive dysfunction. While other therapies may focus on insight or emotion, occupational therapy emphasizes doing—helping clients build skills and systems that promote everyday success.

Functional Support in Real Environments

At Holistic Community Therapy, therapy isn’t confined to a clinic. We offer:

• In-home sessions to assess how your space—whether it’s a cozy North Portland apartment or a shared Southeast co-op—supports or hinders function
• Community-based visits to practice skills in real-world contexts, like navigating grocery runs at New Seasons or managing time between stops on a Trimet route
• Virtual therapy for flexibility and comfort—especially helpful during rainy months or on busy workdays

We work with clients where their life actually happens, which is essential for effective executive dysfunction therapy that supports real habits, not just theory.

Key Areas OT Can Address in Executive Dysfunction Therapy

Time Management & Scheduling

Many adults with executive dysfunction struggle to estimate time or create sustainable schedules. We introduce tools like visual calendars, time-blocking, and alarms tailored to your routines.

Organization & Task Initiation

Feeling stuck starting tasks? We use evidence-based strategies like “chunking” and environmental cues to reduce friction and support motivation—like breaking up weekend chores into manageable time blocks so they don’t take over your whole Saturday. Our OTs also help declutter and organize spaces to reduce sensory overwhelm.

Planning & Prioritization

Clients learn how to break down complex tasks into manageable steps, prioritize effectively, and adapt when plans change. This is where OT for organization and planning shines.

Energy & Attention Regulation

We help clients track energy patterns, build rest into routines (especially important during Portland’s gray winter months), and create strategies to maintain focus—even when motivation is low or distractions are high.

Our Personalized Approach at Holistic Community Therapy

Led by Dr. Elizabeth Martin, Holistic Community Therapy takes a client-centered, affirming, and trauma-informed approach. We serve adults navigating:

• ADHD and Autism
• Brain injury or chronic illness
• Trauma, including systemic and generational
• Sensory processing differences
• Life transitions, grief, or burnout—especially common in Portland’s nonprofit, healthcare, and education workforce

We understand that traditional systems may not serve everyone. That’s why our work is rooted in equity, inclusion, and real-life application—always honoring the lived experiences of our BIPOC, LGBTQIA2S+, and neurodivergent communities.

Tools We Use in Executive Dysfunction Therapy

Here are some of the adaptive strategies we implement with our clients:

Client Story: From Chaos to Clarity

A recent client came to us feeling constantly overwhelmed. Tasks like paying bills, cooking dinner, and managing medications felt impossible. Through in-home OT visits—right in their NE Portland apartment—we reorganized their kitchen for clarity, introduced weekly planning tools, and created a visual medication tracker.

Within three months, the client reported fewer missed doses, smoother meals, and improved confidence. More importantly, they no longer felt ashamed—they felt capable.

How to Get Started

If you or a loved one struggles with organization, follow-through, or daily routines, executive dysfunction therapy may be the missing piece. Reach out to Holistic Community Therapy to book a free consultation.

Call or Text: (503) 882-0988
https://hctpdx.com