Victories and defeats

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even through challenging diagnoses such as expressive aphasia (inability to provide spoken or written language) or withdrawn client behaviour.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