It is a truth universally acknowledged that fledgling OTs find it difficult to see their successes when blinded by their struggles. I've reached a milestone: one month of treatment through fieldwork.The reality of the rehabilitation process has struck me with full force. I’ve had a month. A month to improve someone’s life. A month to show off my skills. A month to learn from the best. By this stage, some sort of success is inevitable, but as students, we are quick to focus only on our shortcomings. Though its essential to keep improving, we have done some good in the world, and it’s important to acknowledge this.
This week has been brutal; by far the busiest and most stressful
week of the semester. Why? It was submission week! My Midterm case study and
presentation were submitted and through the process of compiling them I was
able to do a great deal of reflection on my work. If I examine what I feel I
succeeded at in terms of therapy and building a therapeutic relationship, a few
things come to mind. Firstly, I’ve made a genuine effort to get to know my
clients, even through challenging diagnoses such as expressive aphasia
(inability to provide spoken or written language) or withdrawn client behaviour.
This allowed me to understand what is important to them, what their aims are,
and plan sessions that could be directly applied to their individual contexts. Sessions
like my recent face-washing activity illustrated this well, as my client with a
tetraplegia diagnosis- who is a working mom, was grateful to be given the
opportunity to perform her own grooming rather than depending on nurses. She
left the session motivated and with an elevated mood, and to me this marked
success. I feel that I have succeeded when an activity I have planned is received
well by the client and they leave the session happy and with more knowledge/skill
than they came in with.
I’ve also felt successful with the way I have approached
intervention with my client who has a TBI, Client A. Throughout all my
experience with clients, recently his plan for treatment has been the clearest
for me. I have a clear direction of where treatment is going and have been
using my sessions to slowly build on from each other and use knowledge/skill from
previous sessions and apply them to present sessions. An example of this, was a
money managing and budgeting exercise that I performed with Client A this week
that built on the arithmetic and decision-making exercise I performed last
week. He then incorporated the addition and subtraction techniques we had
practiced in the prior session and applied it to the budget. I feel that I have
also succeeded at forming a good therapeutic relationship with Client A, which
I did not think was possible at the beginning of fieldwork, as I struggled for
the first two sessions with handling his aphasia and learning how to adapt to
his silence. Despite this challenge, we have established an understanding between
each other and have our own method of communicating and can even share jokes at
this point. This was a major success for me and a huge learning opportunity.
My sessions were not without their difficulties. An integral part
of being a student is knowing that you will fail at some point, it can be a
minute failure or a huge failure, but either way it is the only way to learn
and improve. My first session with Client A was certainly a “flop”, mostly
because I had just taken an assessment finding (lack of sensation) and
cut-and-pasted my theory knowledge. My sensory re-education session that
resulted, though interesting and beneficial to my understanding of the client
factor, was not at all contextually relevant to the client and he could not
carry over the session once discharged. With this, came the difficult process
of identifying what had gone wrong and fixing it for future sessions. It was difficult to plan my initial
interventions, and I know that my end-result was due to a lack of identifying
the key problem areas with my client using my assessment findings. I’ve learnt
that I need to draw up my problem list and integrate it with my assessment
findings on day 1 with the client so that I immediately have a clear direction for
treatment and am not floundering and treating factors randomly without relevance
and application for the client.
I’ve also experienced difficulty with my handling of clients.
Though I am confident with my knowledge and have my aims in mind during
sessions, I tend to come across as anxious and hover over my clients during
sessions. It has been difficult for me to step back and let them make mistakes
or stumble; but just as I need to make mistakes in order to become a better
therapist, they need to make mistakes in order to have a better understanding
of their limitations. It is just my nature to want to help out and rescue
clients, and upon advice from my supervisor, I know that I need to make a conscious
effort to let my clients take the lead and wait for them to ask me for help. My
physical handling is something that I’ve also had some trouble with, not knowing
where to place my hands and when to decrease physical assistance makes me come
across as uncertain to the client, and is mostly due to a lack of research and
experience on my part. My supervisor often alerts me to the way I’m handling my
clients and how I can improve this, so during my session write-ups I spend more
time thinking about my handling principles for my future sessions.
So yes, it is a truth universally acknowledged that fledgling
OTs find it difficult to see their successes when blinded by their struggles;
but see success we must. Only then, can we build in our confidence as
therapists and use our successes as stepping stones to improve and expand upon
what we are doing correctly. Failure is just as inevitable as success. But both
are inevitable. Take the small victories with the large defeats and continue
flapping those fledgling wings, such is the life of a student.
Until next week,
Kaylee
*Redefining "failure" as "falling forward", interesting reads!
https://www.huffingtonpost.com/marilyn-tam/falling-forward-winning-s_b_12176578.html
https://www.huffingtonpost.com/nozomi-morgan/falling-forward-to-achiev_b_9994038.html
Pictures taken from:
https://etaustralia.com/wp-content/uploads/2017/06/Success-Meme-v2.jpg
https://cdn.dribbble.com/users/833040/screenshots/3215415/high_give.gif
https://motivationping.com/wp-content/uploads/2017/10/motivational-inspirational-quotes-24.jpg
It is a great responsibility on one's shoulders to provide treatment to an individual. An honour and a privilege which must be handled with care. A month is a long time and it is necessary to evaluate and make necessary adjustments.
ReplyDeleteRemember to have specific markers to measure therapeutic success in a session - if a client has fun, and that makes us happy, that feeling is satisfying the human in us. Therapy is hard work and not always enjoyable - that doesn't mean it doesn't benefit the client. Some sessions may be emotionally draining as we persevere to achieve therapeutic aims. The aim of OT is to facilitate independence so how can we teach a client how to problem solve their way through a difficult situation if we are rescuing them .Food for thought.