1. Appreciates the influence of socio-cultural, socioeconomic, political, diversity factors, and lifestyle choices on engagement in occupation throughout the lifespan. Throughout the past 9 months, one of my main focuses when intervention planning was developing good rapport with my clients to be able to incorporate meaningful, occupation-based treatment plans. This was particularly important during my pediatric rotation because children on my caseload were from all different socioeconomic backgrounds, which was very important information to know before suggesting carry-over activities for home to their parents. I was working with a client in particular who had decreased hand strength, and was struggling with handwriting secondarily. As a reward at the end of his session, he always chose to color pictures despite his mom reporting that he never wants to color at home. Through further discussion with the patient, he informed me that he loves coloring at therapy because we had the Crayola Pip-Squeaks markers and "these don't make my hands hurt." I was quick to reply, "tell your mom that they sell these at Walmart!" My patient replied, "my mom says all our money has to go to bills and she can't buy me things like this." My heart broke, and I was immediately disappointed in myself that I believed it would not be a big deal for his mother to go buy him these specific type of markers for him. Over the next week, I wanted to ensure that he would be able to color at home because it is an activity that he enjoys and would further help build up the strength in his hands. I talked to my supervisor, and we created a check out system where he could check out five markers a session and would return them the following session. He was so excited to be able to color with Pip-Squeaks markers at home, and his mom was grateful that we did not put financial pressure on her by suggesting she go and buy them. Through this experience, I learned to appreciate the different backgrounds of all my patients and made a conscious effort to make suggestions based off of their values to better support occupations through the lifespan.
2. Communicates effectively with a wide range of clients, peers, and professionals both verbally and non-verbally. Understanding how to communicate effectively, verbally and non-verbally, with clients, peers, and professionals is essential to providing quality client care. Effective communication ensures that all team members and clients are on the same page and working towards the same outcomes. Throughout the past 9 months, I have been able to communicate effectively with team members and clients. The following comments provided by my level II supervisors demonstrates my ability to effectively communicate. Megan Brack, OTR/L stated at midterm that I "collaborates well with the team to provide the most effective treatment for each client." During my final evaluation she stated, "Great communicator, changing language to be appropriate for audience, whether staff or patients." Carrie Hoing, OTR/L, stated, "Maggie has shown an ability to communicate the purpose of OT to caregivers. She has communicated with parents regarding activities to carryover at home with their children to promote developmental skill progression."
3. Collaborates with clients and caregivers in establishing and maintain a balance of pleasurable, productive, and restful occupations to promote health and prevent disease and disability. Collaborating with clients and caregivers in order to promote health and prevent disease through meaningful occupations is an essential aspect of occupational therapy. Without being able to gain an understanding of factors that motivate your clients, it would be difficult to encourage occupations that would promote health and prevent disease and disability. During my mental health rotation at East Louisiana Mental Health System (ELMHS), I had one client in particular that was frequently disengaged during my initial group sessions. She was depressed, and did not interact with other group members except when she would make rude comments towards them. One of her goals was to become more aware of her impulses so she could better practice impulse control. I quickly realized that when I planned talking groups, she would become disengaged and would not get much out of the group session. Through further collaboration with the client and staff, I learned that she was highly motivated to participate in activities that engaged the sensory system and she enjoyed being able to have a physical item to take with her at the end of the session. I began incorporating crafts that addressed her impulsivity. She became an active group member, and started to better practice impulse control secondarily to becoming more aware of her impulses. The nursing staff even reported to me how much more pleasant she had been on the ward and how much better she was interacting better with other clients. I have attached an example of a craft that I planned for a group session to address impulsivity. My supervisor loved the craft so much that she had me write an article for the monthly newsletter so other staff members could use these THINK flowers with their clients who needed to better practice impulse control. Collaborating with clients and other staff helped me address client's goals to help them become more independent. Stacey Dupre, OTR/L stated, "LOVE your group activities!!!! Addressing goals EVERYDAY with fun, sensory aspects that engage :)"
4. Inspires confidence in clients and team members. Throughout my experiences, I have learned the importance of working together as a team to achieve a desired goal. If team members are not motivated and do not have a clear outcome goal, it is difficult for team to stay focused and confident that the team will succeed. Throughout my time at ELMHS, I frequently found myself motivating and encouraging my clients throughout group sessions. On Thursdays, the groups had a free choice day where they could choose a craft that they wanted to complete that day, but they had to complete a "bell ringer" worksheet before they could begin their free choice day. Bell ringer worksheets consisted of two to three questions directed specifically towards the client's goals. I had one client that loved the bell ringer worksheets because she was able to prove to herself all the life skills knowledge she had gained during group sessions. However, because of her diagnosis, she was very impulsive and her handwriting was very difficult to read because she could not slow herself down to write legibly. She would often become discouraged when I would have her read to me what she wrote because she could not read her own handwriting. I collaborated with my supervisor, and thought back to my previous handwriting interventions used during my pediatric rotations. The next week when I typed her bell ringer worksheet, I created the answer lines to simulate primary paper lines. The client was so excited that she was able to read her handwriting, and never became discouraged again during bell ringer worksheets! I feel like this experience is a good example of how I inspired confidence in a client because I was able to grade down an activity so she could better succeed. I have attached a photo of all bell ringer worksheet comparing her handwriting before and introducing primary lines. Stacey Dupre, OTR/L stated, "your strategy with helping M. with her handwriting was a success!"
5. Considers client motivation when using occupation based intervention to maximize functional independence. Occupation based intervention is when you incorporate an actual occupation or ADL into your intervention. You are using occupation as a means. If clients are not motivated to participate in the occupation, you will not maximize functional independence. On my pediatric rotation, I quickly realized the importance of being creative and planning motivating treatment activities. I had one client who is 5 and has down syndrome that needed to strengthen his hands in order to improve his endurance for handwriting. However, he was not interested in many common pediatric hand strengthening treatment activities such as crab walking or finding objects in Theraputty. He challenged me to think outside the box because he was never interested in what I had planned. One day, I remembered that he loved to play with the toy insects we had at the clinic. I found a pediatric reacher and scattered the plastic insects down the hallway. My client acted as an exterminator by using the reacher to smash and pick up the bugs. This activity quickly became the client’s favorite activity. I often used the activity as a reward after he completed his handwriting tasks. Overall, the client became more of an active participant in the tasks he considered mundane, because he was motivated to "play the bug exterminator game." As time progressed, I graded the activity to ensure continued increased hand strength. I have learned that client motivation is vital in achieving functional progress. If a client is not motivated, they are very slow to make progress. Finding activities that motivates client makes the client's experience of attending therapy fun and rewarding for both the therapist and the client. I think that this client is the perfect example of how motivation and occupation-based practice are keys to success when choosing intervention. 6. Applies theory regarding the therapeutic use of occupation and adaptation to screen and evaluate, plan, and implement intervention, while establishing and maintaining a therapeutic relationship with the client. During all of my level II fieldwork experiences, I utilized theories and frame of references everyday throughout the screening, evaluation, and intervention processes. Reflecting back over the past 9 months, the most common theory that I used was the Model of Human Occupation theory. This theory believes that humans interact with their environment mostly through occupation, and you must consider client's motivating factors during the therapeutic process to help the client become more independent. Before I would evaluate a client, I would always screen their charts for necessary information and to try to gain insight into their lifestyle so I could begin to build a therapeutic relationship during the evaluation process. I believe establishing good rapport with clients goes hand in hand with creating motivating, client-centered treatment plans. The following comments provide evidence supporting my ability to establish and maintain a therapeutic relationship with my clients. Stacey Dupre, OTR/L stated, "you asked non-intimidating probing questions, initiated informal conversations to help your clients feel more comfortable, and were able to successfully and respectfully redirect clients when needed." Megan Brack, OTR/L stated, "She is energetic and has established a great rapport with all clients." rapport.pdf