During fieldwork as an Occupational Therapy Assistant student, I learned how the act of helping someone has a delicate nature. Even though the people you encounter may not ask for help or even say they don’t want help it may be best to still be a little persistent in showing them how you can help. That little persistence may in fact change their mind. Taking the word of what others say is not necessarily accurate or sufficient because they may have a distorted perception, they may be in denial, they may want to impress you, they may fear being judged, and many more reasons. I have come to this understanding with children since it is hard for them to see the big picture and what they truly want or to know what is best for their health and development. However, no matter what age or disability a person has, a person may tell you they don’t need help when they actually do. It is my job as a therapist to gently show them that they may actually need help and that it’s okay to need help because that’s what I’m there for. Sometimes even then they may not accept help so it may be best to let go of that problem and move on by asking them what would they like help with. It’s good though to not give up without trying and to realize there is a chance that they may be grateful that you did push them a little bit.
On a separate note, it is strange when someone says that you have a “problem” when that’s the way you have functioned for years or when someone claims to know you better than you do yourself. It may feel offensive if the “problem” is something that has been identified as a unique personality quirk. Even “problems” are relative. A “weakness” in one culture may be seen as a “strength” in another culture or even in the same culture but in a different context. For example giving someone eye contact in Western culture is encouraged while in Eastern cultures it is discouraged however, if you were giving a stranger eye contact for the duration of an elevator ride in the West it would be considered inappropriate. There are many other aspects that add subjective-ness to behavior, engagement, participation, and health. There are six domains that each have categories within categories underneath them. Studying these aspects is actually a big part of OT. In the end though it all comes down to how all these factors influence a person’s function and what aspects of functioning does this particular person value. If a person doesn’t value cooking but manages to survive with prepared food from the store or has someone at home that enjoys to cook, then cooking is not a priority in therapy. Not wanting to learn how to cook cannot be judged as a “problem” or a “deficit.” There are things that are simply not a priority and other things that are.
Becoming an OTA is definitely a change in my usual personal role. Typically in my personal life, I have felt like the one that receives advice and support from others. To make the support more mutual, it takes me a little more effort and conscious decision making. Who knows why that is but I do know there are people I perceive to be born helpers and nurturers because they seem to get involved almost on impulse. Sometimes I am embarrassed to be nice or helpful similar to how you can imagine a little boy feeling after being nice to the girl next door and seeing his parent giving him counter-productive praise and adoration. Other times I may feel that helping someone puts me in a position of authority that I am not used to. However, I have realized this uncomfortable feeling and position of authority is an important thing to be mindful of and not something to get in the way of me doing great things in life.
When one person is teaching, guiding, advising, mentoring, healing, counseling, empowering another person there is automatically an uneven distribution of power. The person being helped depends on the helper. It is important to not let this control and power be the motivating factor of choosing a health profession. Help someone because they need it, not in vain to appease the ego. Being aware of this power dynamic is a good way to consciously create a team situation where the person receiving care can make some decisions and have choices. They say the best leaders are the ones that make the ones they lead feel like leaders. I think think this concept can also be used in OTA. I have learned from working with children that it is important that there is mutual respect between each participant so that each person fully listens and has clear communication with the other. Sometimes having that little bit of authority can promote that respect and may make a positive impact on therapy by making it more effective for the recipient. Luckily having a title and getting paid makes the inevitable slight unevenness in power justifiable. Getting paid for doing “altruistic” careers can seem hypocritical and can make some practitioners feel guilty, but in some ways it creates a personal and clear boundary and an expectation of quality care to be thankful for along with financial support in exchange for doing something that supports the well-being of society. It is also good to keep this saying in mind:
“Give a man a fish, and you feed him for a day; show him how
to catch fish, and you feed him for a lifetime.”
In the long run, these people will leave you and be more empowered than they ever were. At first, there may be a lot of hand-holding but then you scaffold your support so you are giving less and expecting more. An OTA has the responsibility to offer support and patience while acknowledging where the person is and balance between offering too much help and too little help.
When being in this therapist role, I feel I have to be a role model but almost to the extent of being a super being that is perfect in every way possible from always making my bed in the morning and never procrastinating to having a regular sleep schedule and having a perfect exercise and diet regimen. Though this “perfection” may also actually be un-functional in its psychological implications like inflexibility and lack of spontaneity. I feel for me to be believable I have to show that it is easy and possible to grow, improve, and achieve goals. There are also little behavioral things I feel I have to exhibit like making sure I have a good posture, eat healthy, have clear communication, and have an organized planner. As a child, I saw teachers as gods. They know everything and are always morally good and have good habits. However, I now know that this mystique was part of their job and that they are paid to have it. Playing the “perfect person” has a role to an extent that you don’t look stiff or inauthentic. It’s good that the person you are working with believe you and treat you with respect but also have good rapport with you and are comfortable with you.
My two level I fieldwork opportunities this semester have given me a lot to think about along with some new insight into my personal ideas of therapeutic use of self. I am happy to have my values and perceptions impacted by this current transition in my life.