Happy October! Fall is finally here, and I am super excited for sweaters, apple cider, and stepping on crunchy leaves.
(But seriously, I WILL STEP ON ALL THE LEAVES.)
I also excited because…drumroll please…as of last Tuesday, I am officially a Level II Fieldwork student! I am getting closer and closer to my dream of being an OT, and I can hardly believe that just three years ago I was taking undergraduate classes and volunteering to lay the foundation for this day. Sometimes I look around and just think about how crazy it is that I am here, now, doing exactly what I want to spend the rest of my life doing! It seems that on rare occasions, patience really does pay off.
My fieldwork placement is a lot like me in that it is fairly non-traditional. For the next three months, I will be working with a state-run vocational rehabilitation (VR) and independent living (IL) office to help clients with mental and physical disabilities return to work, find and maintain employment, successfully transition from to school to employment settings, and live safely and independently in their homes. In the office where I am working, there are VR and IL counselors working with military servicemembers with TBI, students undergoing the postsecondary transition process, people with mental health problems, people with physical disabilities, and others who are in need of vocational rehabilitation services. Although my supervisor is an OT (and a Certified Rehabilitation Counselor), there are no other OTs in the office except for me, the lone OT student/intern! Fortunately, I will be working with a rehabilitation counseling student who is also learning new things, so I don’t feel alone. Everyone here is also really nice, which makes it a nice working environment!
My First Day as an OT Fieldwork II Student
Although my FWII supervisor “Helen” told me that I would have my own office when I spoke to her before my arrival, I was completely shocked when I showed up and found that my big, bright office was right across the hall from hers and had a nice window and huge desk and EVERYTHING! (I’m sure things will probably go downhill from here for the rest of my working life, but for now I’m gonna enjoy it!)
My supervisor wasted NO time in getting me working with clients. She is the manager of the office where I’m working, and she stays super busy managing staff, working with clients, and dealing with a bunch of other people and organizations. So I was SUPER terrified when she had to take an important phone call in the middle of a client interview and I had no choice but to talk to him! It wasn’t that I was scared to speak with him, I just wasn’t expecting to have to DO anything on my first day! Even though I was taken by surprise, speaking with this client last week gave me a great opportunity to practice my interviewing and active listening (and memory!) skills.
One thing I learned from an OT I met recently is the value of open-ended questions. My new favorite go-to question to start an occupational interview is “How do you spend your time?” because typically people answer this question in a way that lets me gain an understanding of their daily occupations, routines, values, challenges, and interests, and it seems less like a formal interview. For example, the first client I met on Tuesday morning was a 30 year old man named “Tim.” Tim stated that he was diagnosed with adult ADHD, and that he had been diagnosed with ADHD as a child. Tim was struggling to find employment and had been fired or laid off from multiple jobs in the past several years. According to him, his ADHD prevented him from focusing on work tasks, and he got agitated quickly when dealing with “irritating people.” After asking Tim how he spent his time, I learned a great deal about his daily routine, leisure occupations, challenges, and strengths. Occupational interviewing skills are very important, as the information you collect can lay the foundation for the treatment plan you develop. Additionally, it can be a source of information about potential client triggers, motivators, and strengths that you can use to your advantage during therapy. Having such a great conversation with Time was definitely a boost in my OT student self-esteem, and while I have a pretty decent memory, I learned that I definitely want to keep a notebook handy to record client information if I’ll be spending a long time talking to a client.
Unfortunately, after my interview I was more than a little disappointed to see how Tim’s information was entered into the online records system. There was basically nothing entered into the computer but information about how the client’s disability inhibited his ability to work or function, and it was pretty depressing to see how negative the forms were. Although Tim informed me that he enjoyed writing and performing poetry, going to the local library, and had plans to pursue higher education in an online program, there were no spaces in the form for this kind of strengths-based information (although to be fair, it’s hard to make a justification for how these things are related to employment in order to bill for them, etc.). I did my best to include this information in the case note I wrote about Tim, but I wish that there was a way to have it be a bigger priority in the paperwork – I think it’s important to know how a client’s interests and strengths can support their future employment and help find a job that might match their interests. Alas, such is life when you’re living in a world (and a computer system) that wasn’t made by OTs! 🙂
Although much of what went into the forms was not particularly positive or even client-centered, I was glad to see that the “plan for employment” we developed for Tim was actually very individualized and took into consideration many things we discussed during the interview. For example, VR will work with Tim to not only help him find a job (his ultimate goal) but to obtain interview clothing, develop job readiness skills, and have successful interactions with others in the workplace. Although I’m not quite sure yet what my role will be with Tim’s treatment and plan, I’m interested to learn more about my role as an OT with this client.
So far I am really enjoying my fieldwork placement, and I am excited to see where OT fits into the field of vocational rehabilitation and independent living. In the future I’ll have my own mini-caseload of people to work with, and I’m really excited to start working independently with clients. Until then, keep following my Fieldwork Files posts to learn about my experiences as an OT Fieldwork II Student!