"What if OT?" Reflection (7/9/22)

After looking back at my video from the first day of class, I am genuinely surprised by the amount I got correct about the idea of occupation. Knowing what I know now, there are a few things I would do differently in terms of discussing occupation. First, I would focus less on the presence of a disability or impairment, as improving occupation does not always come as a result of a major obstacle. Also, while I may have had the idea down, I would make sure to use the words meaningful and purposeful, as those are really important when discussing occupation. Finally, I would attempt to connect occupation to my personal life as everyone, including the OT, experiences occupation, not just the client.

Goals for OT 510

1. Figure out my strengths as a therapist so that I can focus on those as I continue through the program.

2. Find the best strategies for me to learn, again, as graduate school will be different from undergraduate.

3. Figure out my weaknesses as a therapist so that I can compensate and adapt for the future.

Goals for Trait Development

My Long-Term Goal: to be more Direct and Firm

The situations in which I would most prefer to enact this trait:

Around people I trust and in therapeutic interactions when appropriate.

My short-term goal (tangible steps) is to:

Say what I mean in group projects and be firm in how I would like things to go.

When new roommates move in, set the rules on the outset for how the living situation should go.

Cultivating Therapeutic Use of Self: Reflection

1. What is a therapeutic relationship?

Relationship between the therapist & client with the ultimate goal of treatment or intervention.

2. What is involved in therapeutic relationship?

To me the biggest factors or trust and patience.

3. What are intrapersonal factors?

Important factors include flexibility, self-regulation, and confidence.

4. What are interpersonal factors?

Important factors include communication and social cues.

What are some anticipated challenges of the therapeutic relationship?

To name a few: lack of confidence, lack of motivation, and clients challenging your knowledge & expertise.

Interpersonal Reasoning (Taylor Ch. 3)

1. Have you ever experienced a client or other person in your life with one or more interpersonal characteristics that posed a challenge within the relationship? Please provide a detailed example, using IRM vocabulary to label the person’s interpersonal characteristics.

During my time working with people with disabilities, I worked with a younger client who had behavioral problems who I distinctly remember presented multiple interpersonal challenges.

In terms of the Interpersonal Relationship Model (IRM) a characteristic I often observed in this case was his response to change and challenge. Whenever I, and other coworkers, would attempt to modify our strategies for working with him, so that he would actually be making progress towards our planned goals, he would resist heavily. This resistance leads to another IRM characteristic, that being a need for control. This client would manipulate staff heavily so that he would have to do the least work possible and make our interventions work in his favor. There were many power struggles as a result of this, requiring many compromises between both parties, which often didn’t go in the way of the support staff.

2. In a past volunteer or professional capacity, have you ever prompted or witnessed an interpersonal event to have occurred? Describe what happened, including any attempts to resolve the situation.

Going back to the previously mentioned client, I often experienced boundary testing with him. Because of how often we spent time together the line between client and staff was often blurred. This would lead the client to attempt to make it seem as if I were his best friend or perhaps an older brother, and not his support staff, and would treat me as such. This perception often led to lack of respect or personal boundaries which were crossed. This line was hard to keep in place as I had good rapport with this client but also acknowledged that a staff/client relationship was needed in order for interventions to be successful. So when appropriate I would have to remind the client that I was staff, but still was there to support him as a friend would. These conversations were not always comfortable, and the relationship with this client was very emotionally draining for this and other reasons.

Knowing myself as a therapist: Natural Modes (Taylor Ch. 4 Exercises)

1. C A D B

2. C B A D

3. D C B A

4. D A C B

5. C A D B

6. B C A D

7. D B A C

8. A B C D

9. A C D B

Exercise 4.1

Modes Scoring Key

Advocating Total: 0/6 Percent: 0%

Collaborating Total: 1/6 Percent: 17%

Empathizing Total: 3/6 Percent: 50%

Encouraging Total: 1/6 Percent: 17%

Instructing Total: 2/6 Percent: 33%

Problem-Solving Total: 2/6 Percent: 33%

Exercise 4.2

My natural/preferred mode(s)

Empathizing

Mode(s) I can use when I need to

Instructing & Problem Solving

Mode(s) with which I am less comfortable/less able to use

Advocating, Collaborating, Encouraging

Key Strengths of the Empathizing Style:

1. Empathy is already vital to a functional and trusting therapeutic relationship.

2. This style also facilitates emotional healing.

3. Provides a model for clients to self-reflect and gain insight into their own emotions and behaviors.

4. Fundamental to resolving conflicts during therapy.

5. Therapists who commonly use this style are able to work better with interpersonally challenging clients.

Weaknesses of the Empathizing Style:

1. Overuse of empathizing can put emotions too much in the front of therapy.

a. Clients aren’t always ready to open up like this

2. Pacing of treatment can be slowed as fundamental tasks may be delayed.

3. Therapists may also project their own needs onto the client, and may misread the client’s needs.

4. Clients may also not be comfortable with the therapist expressing emotions in this way, seeing it as intrusive.

5. Over empathizing can also overprotect clients, not allowing any challenging of their abilities.

Exercise 4.3

Modes You Want to Incorporate Into Your Therapeutic Style

Using the Advocating mode in conjunction with empathizing can help address the pacing and overprotectiveness that can be an issue with empathizing. As the advocating mode is quick to identify barriers and allows clients greater autonomy in their own treatment.

Along with Advocating, the Collaborative mode may help with some of the uncomfortability that can come with empathizing. Collaborating with clients allows the client to tell you when they are ready and comfortable for certain stages of treatment and the therapist relationship. Thus this allows the client to express when they are ready, if at all, to share their emotions and beliefs with you, the therapist.

As both Collaborating and Advocating fall into the category of “mode(s) I am less comfortable using.” It would be wise for me to seek support or training, whether through classes, professors, or other professionals, in order to improve my use of these modes.

Taylor Chapter 6 Exercises

Matuska Life Balance Inventory

It was somewhat surprising to me how balanced my life is, at least according to this assessment. Since going off of my stress level some days, it definitely doesn't seem like my life is balanced. However, going through this inventory it was good to reflect on where I'm spending my time. Even though some categories like spending time with friends and family may seem lower than "normal" from the outside looking in, to me personally, I feel that I am doing these activities in the right amount. Of course there is always room for improvement as relaxing and doing leisure activities are something I'd like to do more, but activities like school, get in the way of that, and school is still important. Again there always needs to be a balance even if it isn't necessarily a "fun" balance.

Creating Occupational Balance

To help support my current and future occupational balance, I found a couple resources that will be useful as a student, now, and as a future occupational therapist.

Reflecting on Working on Others

Group Facilitation

What went well & why?

I think that our discussion of the topic went well. Anger can be a polarizing and heated topic so I think our more lighthearted approach worked well.

What didn’t go as well as you hoped or went differently than you planned and why did that happen?

The sharing portion of our facilitation went shorter than expected. Group members were just faster at sharing their stories with each other.

What feedback did you get that made you think? What was helpful/unhelpful?

The most helpful feedback I remember was the suggestion to engage with some of the groups during the sharing time when they had finished, before moving to the larger discussion. This is difficult for me at the moment so it is something I can work on.

What will you do next time?

Next time I will for sure try to engage in conjunction with my fellow facilitators. Although it is hard to have three people trying to lead a discussion. Some of the other groups "popcorned" a bit which I liked. I did feel like my group members encroached a little bit on my facilitation when I was trying to lead the main sharing time.

Promoting Diversity, Equity, Inclusion, Justice, Accessibility & Belonging

Community Learning Service Agreement (Class of '24)

Speaking:

• Respect others, do not talk over others so that everyone can feel heard.

• Intentionally listen to other group members when they are speaking and be respectful of their opinions

• Respect and acknowledge the context of a situation

• If you have already contributed, give space for others to speak

• Use inviting language (verbal and nonverbal) to include those who haven’t spoken

• Be willing to contribute, but also be willing to listen

• Give everyone an opportunity to speak and present their own ideas

• Respond thoughtfully

Refrain from value judgements:

• Try to avoid using words like good/bad, right & wrong

• Think before you speak, ask for clarification

Be an active listener:

• Show you are listening with nonverbal cues

• Verbal skills - reiterating/clarifying information

• Empathy

• Patience - respecting the pause

  • Have a verbal prompt or cue or question - think of two different ways to ask one question

  • Develop strategy to maintain the pause (preface, count in head, priming to scaffold - give options with the question, ‘by the end of this presentation we want you to be able to….”)

• Create a safe & brave environment where people feel comfortable being honest in a positive way

  • Feel okay setting boundaries for yourself - signal if you need a break (ask for time and space and return to close the loop)

  • We will all work on monitoring their responses (SNS - physiological signs of stress, thoughts, signs, emotion)

Give constructive feedback: (view additional info below)

• Be specific

• Use actionable phrases

• Be kind with feedback (growth and change)

• Openly communicate with group members. Handle conflict professionally and be open to change

• If you have a suggestion, provide resources or ask questions that make you think further or deeper

• Provide support for peers

• Practice kindness and compassion*

Stick to your commitments/follow through:

• Have group check ins to keep one another accountable

• Try to know your limits and stay balanced

• Stay within our scope unless asked for assistance

• Everyone should be aware of their role and be responsible for having work done by the specified time it should be completed by

• Keep a record of due dates so that you do not fall behind and respect your group mates

• Know that everyone has a different way of processing information; some process info outloud and some think to themselves to understand*

• Upholding self-accountability, while also encouraging others to be accountable

• Put your full effort into everything you do

• Self advocacy (ex. Asking for a break from working on a project) and practice self-care because you and your body are important*

• Communicate issues early and thoroughly

  • If issues arise, be open and communicate respectfully about the issue to form

Be humble and open minded:

• Have the attitude of “it is a privilege to be in the program”

• Assume best intent; understand that no one is speaking out of ignorance by choice; we all want to learn and better ourselves

• Approach situations with nuance

• Be respectful - even (and especially) in disagreements

• Balance between school and ‘fun’