If you have met an occupational therapist, chances are you experienced a small part of our scope of practice in the one context you met them in. Perhaps your elderly parent or grandparent was in the hospital after a surgery and their occupational therapist helped recommend some grab bars for their shower or a walker to get around during recovery. Perhaps your child was assessed by an occupational therapist at their school for handwriting skills or attention challenges. Perhaps someone you know had an occupational therapist help them get insurance to pay for a wheelchair after an accident and help them return to their job with modifications to the work place.
Whatever your experience is, often you have just peaked into the tiny corner of the occupational therapy scope and you may not know all the other ways an occupational therapist can help you and your family!
The Canadian Model of Client Centred Enablement is a model that shows the therapist-client relationship and the client centred enablement that we aim to create in our practice as Occupational Therapists. According to the model, the main goal of occupational therapy is enablement, which helps us guide our reasoning and choices within each therapy session with a client.
What does Enablement look like in Occupational therapy?
Think of the saying “give a man a fish and you feed him for a day, teach a man to fish and you feed him for a lifetime”. If you provide someone with the skills to do what they need to do or want to do throughout the day, and work with them on designing ways for them to complete these activities, you are enabling them to be as independent as possible in their lives. I think it is important for me to stress here that we want them to be as independent AS POSSIBLE. This means that deciding you need support in certain parts of your life does not detract from your independance… it is their choice! For example, let’s say a mom has experienced an injury after giving birth to her child. It might take her twice as long to do certain things during the day because of her injury, and so she may choose to ask for help doing her laundry and opting to order meal services, so that she can take care of her baby on her own. Sure she isn’t independent in all of her daily activities, but she’s saving her energy for the things that are most important to her; taking care of her baby.
Occupational therapists have 10 enablement skills that they can bring to their practice; adapting, advocating, coaching, collaborating, consulting, coordinating, designing/building, educating, engaging and specializing. Let’s jump into a bit of detail about each of these…
Occupational therapists work with their clients to adapt their occupations to their specific situation. This could look like changing the tools that they are using to complete a task (ex: using a long handled reacher to help put on your pants if you cant bend at your hips) or adapting the way you do a task (ex: using two hands to carry a mug to protect your wrist)
Occupational therapists can advocate for their clients by speaking up to their health care professionals, decisions makers, employers etc about certain issues. We can also help teach our clients the skills and the confidence to advocate for themselves! An example of this might be speaking with an employer about getting a client a padded mat for under their feet if they have a back injury/bad back and are standing constantly at their job.
“Coaching is an ongoing partnership designed to help clients produce fulfilling results in their personal and/or professional lives, improve their performance and enhance their quality of life” (International Coach Federation, 2006). You may have heard about coaching or “life coaching” from social media, but coaching is also a skill that can be used in counselling when the professional has the proper training (with Occupational therapists being trained to work with mental health, they are able to go deeper in a safe way with coaching skills than a life coach without mental health training.) Often coaching skills in this setting will look like the OT actively listening to your story and challenges and using coaching techniques to help you discover what goals you would like to work on and help you create a plan on how to achieve them!
Occupational therapists often engage in power sharing with their clients, which means that instead of doing things to them or for them, they work with their clients to create change. This allows the client to be acknowledged for their talents, trusted in their expertise in their situation, and to shown the ultimate respect. By collaborating together to explore goal setting and problem solving to create interventions, the client will be more likely to work towards these goals and achieve success because they were involved in the process. This is an important part of client centred practice.
Occupational therapists might work in a role where they aren’t necessarily working one on one with an individual, but are providing a consultant role. They may go into different settings and share their knowledge, education and research with different health care practitioners, school groups, government officials, consumer groups etc. For example, an occupational therapist may consult with a team on how to make their building more accessible to wheelchair users, individuals with visual impairments etc. They might go into schools and provide recommendations for teachers on how to engage a child with additional needs in circle time or how to adapt an activity.
Care management or coordination can be a huge part of the occupational therapy role depending on where you are accessing their care. Occupational therapists might manage teams of health care providers, support personnel and students and organize different individuals involved in the client’s life to achieve a certain goal. The occupational therapist might help coordinate services for the client including government funding, linking them with resources or helping them apply for services.
Occupational therapists can work with their clients and engineers to design or build products to help them participate in their meaningful occupations. Some examples of this could be designing and recommending ramps to enter buildings, creating recommendations to modify a kitchen or bathroom for accessibility and safety, or creating splints or orthotics. Another example of design can be in the form of assistive technology for individuals with visual impairments or who are unable to communicate verbally.
Education can look like a bunch of different things in the occupational therapy scope – I know I find myself educating my clients all the time, whether it is on new strategies or tools that they can use to cope, different skills, or expectations they can have from therapy. You can experience education in individual sessions such as learning breathing techniques to cope with anxiety, learning how to support your child with autism in their sensory sensitivities so they can succeed in the classroom, or in a group setting such as being part of a budgeting group or cooking skills group.
Occupational therapists work to involve their clients in doing and participating in activities or occupations, potentially engaging them with others in their circles or in the community.
Occupational therapists are often generalists, which means that in school we learn a broad array of skills so that we can help people with a wide variety of lived experiences. However, some occupational therapists choose to specialize in different techniques and skills through continuing education. Some examples of this might be specific psychosocial rehabilitation techniques, being able to prescribe specialized wheelchairs, or working in a hand therapy clinic.
I am sharing this as a quick and simple look at the different ways you may see an occupational therapist show up in services – often times you might see your occupational therapist using many of these skills throughout your experience with them.
If you think you might benefit from an occupational therapist, or think you might be interested in becoming an occupational therapist and you have questions, feel free to reach out to me or leave a comment below!
Happy OT month! xo
Townsend, E. A., & Polatajko, H. J. (2007). Enabling occupation II: Advancing an occupational therapy vision for health, well-being, & justice through occupation. Ottawa, Ontario: CAOT Publications ACE.