1. Advocates for clients who have been neglected or underrepresented in the system.
As an occupational therapist committed to advocating for clients neglected or underrepresented in the system, I found the continuing education unit (CEU) course presented by Brooke Genry, MS, OTR/L, and Laurie O'Brien, BS, COTA/L entitled "A Deeper Look into Occupational Deprivation and Destruction," particularly enlightening. The course discussed the essential concepts of occupational deprivation and occupational disruption, shedding light on their impacts on individuals, groups, and populations. Moreover, it addressed the pertinent role of occupational therapy practitioners in combating occupational deprivation. We also discussed how the pandemic exacerbated the effects of occupational deprivation.
One of the key takeaways from the course was the ability to differentiate between occupational deprivation and occupational disruption. While both concepts relate to the inability to engage in meaningful occupations, they differ in what causes them. Occupational deprivation refers to the inability to access occupations due to external factors such as social, economic, or political barriers. In contrast, occupational disruption is the temporary inability to engage in occupations due to unforeseen circumstances such as illness, injury, or natural disasters.
Understanding these distinctions is crucial for occupational therapists in effectively addressing the needs of neglected or underrepresented clients. The practical application of this knowledge is evident. By recognizing whether the issue stems from deprivation or disruption, therapists can tailor interventions accordingly, whether through advocating for systemic change to address barriers or providing support and rehabilitation during times of crisis.
The course also discussed various occupational therapy strategies for addressing occupational deprivation. As occupational therapists, we must empower clients and communities affected by occupational deprivation by facilitating access to resources and advocating for policy changes to promote self-advocacy and resilience-building. This begins by working to understand the origins and impacts of occupational deprivation, recognizing the role of therapists in times of crisis, and implementing effective strategies; occupational therapists can work towards promoting equity, inclusion, and well-being for all individuals, regardless of their circumstances. Below I have included a certificate of completion from the CEU course.
As an occupational therapist committed to advocating for clients neglected or underrepresented in the system, I found the continuing education unit (CEU) course presented by Brooke Genry, MS, OTR/L, and Laurie O'Brien, BS, COTA/L entitled "A Deeper Look into Occupational Deprivation and Destruction," particularly enlightening. The course discussed the essential concepts of occupational deprivation and occupational disruption, shedding light on their impacts on individuals, groups, and populations. Moreover, it addressed the pertinent role of occupational therapy practitioners in combating occupational deprivation. We also discussed how the pandemic exacerbated the effects of occupational deprivation.
One of the key takeaways from the course was the ability to differentiate between occupational deprivation and occupational disruption. While both concepts relate to the inability to engage in meaningful occupations, they differ in what causes them. Occupational deprivation refers to the inability to access occupations due to external factors such as social, economic, or political barriers. In contrast, occupational disruption is the temporary inability to engage in occupations due to unforeseen circumstances such as illness, injury, or natural disasters.
Understanding these distinctions is crucial for occupational therapists in effectively addressing the needs of neglected or underrepresented clients. The practical application of this knowledge is evident. By recognizing whether the issue stems from deprivation or disruption, therapists can tailor interventions accordingly, whether through advocating for systemic change to address barriers or providing support and rehabilitation during times of crisis.
The course also discussed various occupational therapy strategies for addressing occupational deprivation. As occupational therapists, we must empower clients and communities affected by occupational deprivation by facilitating access to resources and advocating for policy changes to promote self-advocacy and resilience-building. This begins by working to understand the origins and impacts of occupational deprivation, recognizing the role of therapists in times of crisis, and implementing effective strategies; occupational therapists can work towards promoting equity, inclusion, and well-being for all individuals, regardless of their circumstances. Below I have included a certificate of completion from the CEU course.
2. Fulfills commitments to the professional community.
While at Pi Beta Phi Rehabilitation Institute, I had the opportunity to present a journal club to the other occupational therapists on staff. Since this clinic specializes in the rehabilitation of people with neurological conditions, I have treated a lot of clients with spastic hemiplegia following a stroke. Throughout my time at the clinic, I was constantly looking for research on impactful interventions for clients with moderate to severe hemiplegia to offer more variation in my treatment sessions and keep my clients motivated. I eventually found several articles studying the effect of whole-body vibration on the reduction of spasticity. An article written in 2023, "Efficacy and safety of whole-body vibration therapy for post-stroke spasticity: A systematic review and meta-analysis," by Qi Zhang et al. serves to assess the efficacy and safety of whole-body vibration (WBV) for post-stroke spasticity to determine appropriate application for clinical use.
I created a PowerPoint (see image below) and discussion questions based on the information from the article to help facilitate conversations among the clinical team and determine if this could be utilized within our treatment sessions. All therapists tried out the vibration plate and discussed possible concerns about its use. These concerns included the fact that the article mainly outlined the clients standing on the plate for 10-15 minutes, which seemed complicated and time-consuming during the treatment session. They were interested in placing the affected upper extremity on the vibration plate while weight-bearing and completing a functional task with the non-affected upper extremity. Overall, all clinicians were open to trying something new and following the research recommendations if the clients were open to it.
Zhang, Q., Zheng, S., Li, S., Zeng, Y., Chen, L., Li, G., Li, S., He, L., Chen, S., Zheng, X., Zou, J., & Zeng, Q. (2023). Efficacy and safety of whole-body vibration therapy for post-stroke Spasticity: A systematic review and meta-analysis. Frontiers in Neurology, 14. https://doi.org/10.3389/fneur.2023.1074922
While at Pi Beta Phi Rehabilitation Institute, I had the opportunity to present a journal club to the other occupational therapists on staff. Since this clinic specializes in the rehabilitation of people with neurological conditions, I have treated a lot of clients with spastic hemiplegia following a stroke. Throughout my time at the clinic, I was constantly looking for research on impactful interventions for clients with moderate to severe hemiplegia to offer more variation in my treatment sessions and keep my clients motivated. I eventually found several articles studying the effect of whole-body vibration on the reduction of spasticity. An article written in 2023, "Efficacy and safety of whole-body vibration therapy for post-stroke spasticity: A systematic review and meta-analysis," by Qi Zhang et al. serves to assess the efficacy and safety of whole-body vibration (WBV) for post-stroke spasticity to determine appropriate application for clinical use.
I created a PowerPoint (see image below) and discussion questions based on the information from the article to help facilitate conversations among the clinical team and determine if this could be utilized within our treatment sessions. All therapists tried out the vibration plate and discussed possible concerns about its use. These concerns included the fact that the article mainly outlined the clients standing on the plate for 10-15 minutes, which seemed complicated and time-consuming during the treatment session. They were interested in placing the affected upper extremity on the vibration plate while weight-bearing and completing a functional task with the non-affected upper extremity. Overall, all clinicians were open to trying something new and following the research recommendations if the clients were open to it.
Zhang, Q., Zheng, S., Li, S., Zeng, Y., Chen, L., Li, G., Li, S., He, L., Chen, S., Zheng, X., Zou, J., & Zeng, Q. (2023). Efficacy and safety of whole-body vibration therapy for post-stroke Spasticity: A systematic review and meta-analysis. Frontiers in Neurology, 14. https://doi.org/10.3389/fneur.2023.1074922
3. Represents the unique perspective of occupational therapy when participating in inter-professional situations.
Both of my level II fieldwork experiences have allowed me to represent the perspective of occupational therapy in an inter-professional situation. At Ability Plus Therapy, we had an inter-professional team meeting about a client demonstrating a marked increase in adverse behaviors in class and at home. All members of his rehabilitation team, including his physical therapist, occupational therapist, speech therapist, nurses, parents, and teachers, met to discuss strategies to support the client. This client has successfully corrected behaviors in occupational therapy and speech therapy and has made improvements throughout our sessions, demonstrating appropriate behaviors. We provided the other members of the care team strategies that have been successful without sessions, including allowing time for self-correction by not reacting to undesirable behaviors, encouraging the use of self-soothing strategies, including lion breathing when the client becomes upset, and allowing the patient to communicate what they need to be successful and ensuring we work toward providing those things when the client verbalizes it. All care team members were open to ways they could use the same strategies, and we brainstormed adaptations based on their unique concerns. I have included a screenshot of a discussion post where I describe this meeting in further detail.
At Pi Beta Phi, we had weekly Patient Care Conferences (PCC) meetings where all rehabilitation team members come together to discuss client outcomes, care plans, and progress toward goals. It allowed us to promote crossover between therapy sessions and build a more unified team approach to client care. Below I have included a picture of a screenshot from a discussion post where I discuss these meetings.
Both of my level II fieldwork experiences have allowed me to represent the perspective of occupational therapy in an inter-professional situation. At Ability Plus Therapy, we had an inter-professional team meeting about a client demonstrating a marked increase in adverse behaviors in class and at home. All members of his rehabilitation team, including his physical therapist, occupational therapist, speech therapist, nurses, parents, and teachers, met to discuss strategies to support the client. This client has successfully corrected behaviors in occupational therapy and speech therapy and has made improvements throughout our sessions, demonstrating appropriate behaviors. We provided the other members of the care team strategies that have been successful without sessions, including allowing time for self-correction by not reacting to undesirable behaviors, encouraging the use of self-soothing strategies, including lion breathing when the client becomes upset, and allowing the patient to communicate what they need to be successful and ensuring we work toward providing those things when the client verbalizes it. All care team members were open to ways they could use the same strategies, and we brainstormed adaptations based on their unique concerns. I have included a screenshot of a discussion post where I describe this meeting in further detail.
At Pi Beta Phi, we had weekly Patient Care Conferences (PCC) meetings where all rehabilitation team members come together to discuss client outcomes, care plans, and progress toward goals. It allowed us to promote crossover between therapy sessions and build a more unified team approach to client care. Below I have included a picture of a screenshot from a discussion post where I discuss these meetings.
4. Assumes responsibility for professional behavior and growth, in accordance with AOTA standards.
My first level II fieldwork exposed me to clients grappling with socioeconomic challenges that hindered their access to necessary medical equipment covered by insurance. Collaborating with these clients to identify community resources, grants, and local community members who had formed a trade group with surplus equipment, I came to appreciate the importance of addressing systemic barriers to care within my practice. This experience underscored the significance of the Code of Ethics principle of justice, revealing that occupational therapy is not solely about treatment but also about advocating for fairness and equal opportunities for all to access the required assistance.
Emphasizing my commitment to professionalism, I actively sought feedback, a practice that has been instrumental in my personal growth. The insights I gained from others helped me identify my blind spots and areas for improvement. This humbling experience reinforced the importance of remaining open to growth and learning. Notably, I have made significant strides in reflex integration, manual techniques including mobilizations, evaluations including administrations of standardized assessments, and splint making. The image below showcases some of the splints I have assisted with in my Level II B fieldwork experience.
To supplement my understanding of the techniques I sought additional guidance on, I completed several CEU credits that I felt aligned with my goals. These included a CEU for the implementation of the neuro-developmental treatment frame of reference (NDT) for stroke recovery. My fieldwork educator in my first level II fieldwork also allowed me to borrow her book on reflex integration so I could study it while I was completing my rotation.
My first level II fieldwork exposed me to clients grappling with socioeconomic challenges that hindered their access to necessary medical equipment covered by insurance. Collaborating with these clients to identify community resources, grants, and local community members who had formed a trade group with surplus equipment, I came to appreciate the importance of addressing systemic barriers to care within my practice. This experience underscored the significance of the Code of Ethics principle of justice, revealing that occupational therapy is not solely about treatment but also about advocating for fairness and equal opportunities for all to access the required assistance.
Emphasizing my commitment to professionalism, I actively sought feedback, a practice that has been instrumental in my personal growth. The insights I gained from others helped me identify my blind spots and areas for improvement. This humbling experience reinforced the importance of remaining open to growth and learning. Notably, I have made significant strides in reflex integration, manual techniques including mobilizations, evaluations including administrations of standardized assessments, and splint making. The image below showcases some of the splints I have assisted with in my Level II B fieldwork experience.
To supplement my understanding of the techniques I sought additional guidance on, I completed several CEU credits that I felt aligned with my goals. These included a CEU for the implementation of the neuro-developmental treatment frame of reference (NDT) for stroke recovery. My fieldwork educator in my first level II fieldwork also allowed me to borrow her book on reflex integration so I could study it while I was completing my rotation.
6. Upholds the AOTA Code of Ethics in practice.
While shadowing a certified driving rehabilitation specialist in my second level II rotation at Vanderbilt Pi Beta Phi, I encountered a challenging situation where a client was in denial about losing their driver's license following the in-clinic driving assessments I administered with supervision. The client was agitated by the results of the cognitive assessments and did not believe the scores were accurate. Pulling upon the principles of beneficence and non-maleficence, I engaged in open dialogue with the client to address their concerns while ensuring their safety and the safety of others on the road. After walking through the reasoning behind the scores, the client agreed with the decision and understood the implications of driving on a medically suspended license for herself and the community.
Below is the score I recieved from my first level II fieldwork experience at the final.
While shadowing a certified driving rehabilitation specialist in my second level II rotation at Vanderbilt Pi Beta Phi, I encountered a challenging situation where a client was in denial about losing their driver's license following the in-clinic driving assessments I administered with supervision. The client was agitated by the results of the cognitive assessments and did not believe the scores were accurate. Pulling upon the principles of beneficence and non-maleficence, I engaged in open dialogue with the client to address their concerns while ensuring their safety and the safety of others on the road. After walking through the reasoning behind the scores, the client agreed with the decision and understood the implications of driving on a medically suspended license for herself and the community.
Below is the score I recieved from my first level II fieldwork experience at the final.
7. Serves as a role model for honesty, integrity, and morally grounded decision making.
During my clinical experience, I encountered a situation where a patient consistently missed appointments due to transportation issues that were communicated during his evaluation. Scheduling staff suggested discharging him without providing alternative time slots after the patient requested them. This presented an ethical dilemma, raising concerns about equality and justice in the clinic's healthcare delivery and potentially abandoning a vulnerable patient. To resolve this, I consulted with my supervisor and interdisciplinary team to collectively communicate the client's needs and reasoning for missing appointments to the scheduling time during a patient care conference. We also worked with the patient to provide alternative transportation options. Ultimately, by prioritizing patient advocacy and collaboration, we found a solution that upheld ethical principles and ensured continuity of care.
During my clinical experience, I encountered a situation where a patient consistently missed appointments due to transportation issues that were communicated during his evaluation. Scheduling staff suggested discharging him without providing alternative time slots after the patient requested them. This presented an ethical dilemma, raising concerns about equality and justice in the clinic's healthcare delivery and potentially abandoning a vulnerable patient. To resolve this, I consulted with my supervisor and interdisciplinary team to collectively communicate the client's needs and reasoning for missing appointments to the scheduling time during a patient care conference. We also worked with the patient to provide alternative transportation options. Ultimately, by prioritizing patient advocacy and collaboration, we found a solution that upheld ethical principles and ensured continuity of care.