What do Occupational Therapists do in community private practice…

I’m Anna and I’m a community Occupational Therapist working in private practice in British Columbia, Canada.  

Where do I work: 

In the community. This means that I usually meet people in their homes, in parks, coffee shops, neighborhoods, at their workplaces, or in our clinic.  Since the pandemic began, I have also broadened my practice and now work with people via telehealth, using the phone or secure video chat, delivering a hybrid model of services tailored to each individual.

What does a typical day look like?

In my role, each day looks different. The one constant is that when I work with people, we discover and explore strategies and tools so that they can live their lives how they want and need to for their wellbeing. This includes working on:

  • Learning to meet their physical, emotional, cognitive, and social wellbeing needs through how they spend their time
  • Returning to work and connecting with coworkers in supportive ways
  • Returning to activities that make a person’s life their own
  • Taking care of their home and loved ones
  • Contributing to their community
  • Connecting with friends, family, and pets
  • Having fun. Adding in pockets of joy and restorative time for blooming and growing
  • Finding ways to occupy time to restore a sense of purpose, autonomy, belonging, competence, and confidence, and thrive in their lives

I work with people experiencing chronic pain, persistent concussion symptoms, traumatic orthopaedic injuries, moderate to severe brain injuries, musculoskeletal injuries, neurological conditions, and mental health conditions. This is a speckle of the ways we work together:

  • I could meet a client at their home so that we can figure out what home modifications need to happen so that they can access their bathroom, kitchen, and/or bedroom. (or their whole house). Sometimes it feels a bit like that TV show ‘Love it or List it’ except we have to make sure that people love it and can live well in their home – and the best way to do this is for the person to be actively involved and leading the team.
  • I could meet a client at a park and integrate some occupational activation with nature-based therapeutic activities. 
  • I could meet a client near or at their workplace and they do exposure therapy so that they build their confidence at work and do their jobs. 
  • I could meet a client and they could participate in acceptance and commitment therapy or motivational interviewing towards doing their meaningful activities. 
  • I could meet a client with a vendor and they could be trialing a wheelchair and learning wheelchair skills so that they can get where they need to go safely. 

Another part of my day is working with team members (clients, rehabilitation assistants, physiotherapists, psychologists, counsellors, vision therapists, kinesiologists, case managers, adjusters, field rehabilitation specialists, architects, construction project managers etc.). It’s having conversations and meetings so that we can all be on the same page about where a person is at, the progress they have made, and the support and services that they may still benefit from as they navigate their recovery. It’s conversations with employers to discuss what is possible for a return to work plan, and what accommodations a person may need, either temporarily or permanently, so that they can do their job. It’s writing reports celebrating the progress that people have made so far and describing the recommended next steps, whether they’re continued services or we’re saying farewell.

I love my job because….

I love my job because I get to meet and work with people as humans. I get to be present with people and see their beauty, their growth and all they bring to and hope for in the world. I have my knowledge and skills in occupational therapy, and people have their expert knowledge in their lives. When we work together, we get to figure out individualised long term strategies that they can use to live well and do what they need, want, and love to do.

I love the diversity of my work. I love that I get to specialize in being a generalist. I love that everyday looks different. I also love it because my practice is really occupation-focussed and I get to use all different kinds of occupations as parts of the intervention tools and work with clients towards participation in a variety of occupations. I love that I can bring all my tools to the table – so when a person needs a new wheelchair or home modifications and they experience mental health barriers to participation, I can work with them on both. Ultimately, in occupational therapy, what we do with people – whether it’s finding a just-right wheelchair or coaching in work-around strategies for doing what matters to people – we’re doing it so that people access wellbeing.  

My job is challenging when…

I have a hard time setting boundaries with work. Then it has this trickle down effect onto everything, with a growing pile of reports looming, feelings of guilt, and I get burnt out. I care so much about people that it is really important for me to practice my own self-care and set boundaries with work so that I can truly be present with people and support them in their recoveries and their lives. 

How could my role be accessible?

For my role to be accessible, if a person cannot drive, the person would need to have the accommodation of transport support. It can also be tricky when people’s homes are not accessible. This could be worked around by setting an alternate meeting location, meeting in the clinic, or meeting via telehealth. There may be certain aspects of my work that currently would be physically inaccessible to people who use mobility aids, like assessing currently inaccessible homes, however, as technology and tools develop and we work more with Rehabilitation Assistants, this could be more possible in the future. If people have decreased mobility, strength, and sensation in their hands or arms, they may have a hard time doing MAT assessments with clients or detecting pressure points by touch. For pressure points, a pressure map could help, but it’s really important to be able to feel how a person sits to do an accurate seating and mobility assessment. The most physically accessible parts of my job are when I work with people experiencing chronic pain, persistent concussion symptoms, or mental health conditions. 

This blog is part of our ‘What do Occupational Therapists do…’ series to celebrate OT month.

Author: Anna Braunizer

Twitter: @ABraunizer

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