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My Current Role As An Program

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I cannot validly answer this question without giving background information about my current role as an OT. I transitioned from physical disabilities (working in the Veterans Affairs Hospital System [VA]) to mental health. Currently I lead a “creative arts” clinic for mentally disabled, though high functioning Veterans. I have not found this to be the role I was looking for in terms of working with mentally ill. Because of this, I decided to transition to a different program, though still within the VA system. I will use my experience in physical disabilities to assess if my interventions were within the therapeutic or adaptive occupational level. While working in physical disabilities I employed both therapeutic as well as adaptive occupations. In my therapeutic occupations approach I designed the treatment using occupation, most often self-care tasks, to address the client’s limitations. I would grade the occupations as necessary. This was not always my first approach, as I just as often focus on performance skills to remediate physical limitations. However, I have found, specifically with a gross upper extremity functional level stroke patient, that using actual occupations promotes faster more reliable recovery of fine motor skills. For instance, I recall a patient that lacked the manipulation and coordination skills to effectively tie his shoelace. Instead of focusing on therapeutic activities to remediate, fine motor skills I had him tie his own shoelace repetitively.

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