You get to play with LEGO all day!?

In 2010, I was in my second year at Acadia University and the previous 1.5 years of partying late on weekends and studying last minute for tests were done. I took a look at what I wanted to do post undergrad and ideas of nursing, physiotherapy, law enforcement, and teaching entered the realm of possibilities. Nursing was out because a 6”4 fainting goat is not pretty when you have to empty your first bedpan. Being a physiotherapist sounded great, law enforcement petered out and teaching was still a possibility of applying. It wasn’t until later in the year that my friends and I attended a speaker series presentation from Acadia alum and OT, Cale Wadden, that occupational therapy came to the forefront. It took approximately 45 minutes for me to be like, “Yep. I wanna do that.”

Over the next 2 years, getting into OT school was the main goal I wanted to work towards and chipped away at it. My parents’ friend knew a wonderful human and occupational therapist, Chris McWilliam and arranged for us to meet up and chat about OT prior to applying to schools. I got some answers to my outstanding questions and went ahead and applied. I luckily got in. I had the best 2 years in graduate school making new friends and connections, being involved in the school, learning, and working hard to pass and move onto the next semester. I dove into mental health via student placements at an overnight winter shelter, and men’s shelter, and then sought out more opportunities in neuroscience and hospitals. All of the stars aligned, and I graduated in 2015 and it has propelled me to be in my dream job today.

What is OT?

Early on in our career, every OT starts to form and cement an informative explanation of what occupational therapy to prepare for the inevitable question of “what does an OT do?” To comments of “oh so you’re like a physiotherapist?” To my late grandfather’s explanation in his most beautiful South Shore Nova Scotian accent: “Yeah Matthew is going to some sort a school to fix dem wheelchairs.”

Here is my explanation: As OT’s our we focus on people’s occupations, which are essentially the meaningful activities, tasks and events that people do and participate in to occupy their time throughout their day. Occupations land within three core areas of a person’s life including self care, productivity, and leisure. Self Care is how we take care of ourselves. Focusing on brushing your teeth, washing your hair, eating, showering, dressing, taking care of your mental wellbeing, medications, etc. Productivity refers what you do to be productive throughout the day. Early on in our lives, productivity might look like play and going to school, and as we grow up, we might venture into volunteering, and then part time and/or full time work. And finally, there’s leisure which is the area focused on what people enjoy doing for fun in their spare time. So if we take that into consideration and also think about any mental, physical, neurological conditions or illnesses that might get in the way of allowing a person to participate in what they want and need to do - we have assessments, interventions, and skills to help a person get back to doing what is most meaningful to them.

Given that this month is OT month, I wanted to talk a bit about what I’m doing now as an OT and provide some insight as to why I love my job so much. Working in paediatrics has been one of the biggest blessings for me as an occupational therapist. Most of my caseload now focuses on working with children living with diagnoses such as autism, ADHD, cerebral palsy, Down Syndrome, ODD, mental health concerns, and other neurological conditions. I see some adults as well with unique neurological cases, but primarily it’s children. I moved to BC with my fiancée Erin in 2018 and hit the ground running with a wonderful mentor and friend to guide me in my first job in paediatrics. I had worked closely with children with special needs in university, but now I was stepping into a larger role, and one that I was really excited for. When clients come to see me in this setting, you can think of it like a doctor’s office in that clients come in for individual sessions on a weekly, biweekly, or monthly basis. We run one on one sessions and create collaborative goals to work towards with clients and their families. Children come to see us for OT services to help with emotional regulation, sensory concerns, fine and gross motor skills, attention and focus in school, coordination, handwriting, keyboarding, following directions, and executive functioning skills. I also help where I can with navigating bullying, mental health concerns at school and at home, support parents and families with equipment needs and adapting the home environment when necessary. We look at activities and instrumental activities of daily living to assess and help with development of skills in these areas. Some client goals might look at preparing for work with resume and cover letter building, social skills, and interview practice, and preparing for the workforce. Some may be looking at preparing for college or university with applications, test anxiety, perfectionism, and burnout. Some days look like all paperwork and behind the scenes work of prepping activities, interacting with doctors, nurses, and other OT’s and health professionals within the area working with mutual clients to help inform and advocate on their behalf. Paperwork, forms, funding letters, reports. It is a smorgasbord of tasks and duties that make for a busy life, however I wouldn’t trade this for anything.

That’s my life as a paediatric OT on the surface. Here are the aspects of my job that bring deeper meaning and purpose for me as a health professional and human. This is what I wake up and look forward to keep pushing for:

1)      Human Connection

In my past speaking events, mental health advocacy, and even now in my current role, human connection has always remained at the top for me as to why I love what I do as an OT. I think early on in school as a graduating OT and even when I entered this role, I wanted to prove that I could do it and put a lot of pressure on myself to be perfect at program development, implementing interventions to be effective immediately, and also put pressure on making the connections with clients and families work right away. The reality is in fact that like everything else in life, including relationships with family members, friends, colleagues, roommates, these relationships take time to develop and ultimately foster trust, understanding, and build a relationship. I’ve really learned to take a step back and understand all of these therapeutic relationships with clients take time to build organically. And while some may never come to successful fruition, man do I ever LOVE this process in working with clients. Working closely with families to help their children work towards achieving their goals and the ongoing connection of being able to give, help others, and serve.

2)      Interprofessionalism & Teamwork

I feel extremely fortunate to get to work with a wonderful team of physiotherapists, speech language pathologists, and rehabilitation assistants every day. I feel as though I’m surrounded by individuals, I can count on to go to with questions about different approaches, assessments and interventions, bounce ideas off of, and discuss mutual client cases. Working as part of an interprofessional healthcare has always been a big draw for me, surrounding myself with intelligent and trained professionals helps me provide better care for my clients, pushes me to be a consistent team member, and helps me know I have people in my corner to tackle challenging days together. Being part of a team makes the tough days a bit better, and I am thankful for the team I have now.

3)      Creativity & Problem Solving

I had a professional look at me last year, while working with a client once and make a comment about “Wow Matt you get to play with LEGO all day for your job, must be nice. I signed up for the wrong job.” In the moment while imprinting teeth marks on my tongue and smiling wide, I had all of the words ready to fight, I simply responded with. “Yeah, it’s GREAT isn’t it!?”

Working with children allows me to express my full creativity and help clients work through difficult and different challenges. Often, I find myself being the problem solver through trial and error and being CREATIVE. Every client is different, have their own unique skills and personalities, and come with challenges presented by their conditions or specific situations that they need help with overcoming. I love being able to help with fine motor skills through creative activities and crafts and playing board games. I love being able to teach and coach, provide support, and break things down into smaller pieces for clients struggling with overwhelming school subjects, anxiety, depression, and burnout in school and at home. I love being able to problem solve and think of creative ways to adapt equipment, table tops for wheelchairs, provide recommendations for home modifications, and work with medical vendors on solutions for clients. I love being able to work with principals and teachers to figure out better ways to help integrate clients into the classroom, figure out seating and sensory needs to help a child attend and focus at school. I love hearing clients walk out of our session “WOAH that’s so cool!!” And I simply love the idea that being creative and thinking outside of the box, can bring such beautiful solutions to the problems clients face every day.

4)      Lifelong Learning

A big part of the job is learning and being challenged every day. I’m always learning about new programs, strategies, interventions, assessments, equipment, procedures, etc. I learn new things from and about clients daily. I like to challenge myself with a course or two every year to not only keep up with my professional duties, but to also add to or improve existing skills and keep growing. For example, last year I took training on primitive reflex integration from recommendations from a colleague, along with specific training on autism and active listening programming. This year I’m going to focus on childhood trauma and psychosensory intervention, along with a business course or two. No matter what field you are in within occupational therapy, lifelong learning is a part of the gig, and for those who love learning new things, it’s a perfect piece of the puzzle.

5)      Client progress

The therapeutic relationship between a therapist and child (and any client for that matter) is based on a foundation of trust and understanding. In OT, we call it building therapeutic rapport and it’s how we start our working relationships with clients. With majority of children I see, a number of them have Autism as their primary diagnosis and they’re usually coming to see me to work on things that they don’t necessarily enjoy and/or are quite challenging for them to do on a regular basis. And with this diagnosis, social skills, communication, and emotional regulation are often quite challenging. So, you might ask, well how do you communicate with and work towards goals for clients that have these communication challenges. Well it comes from starting with trust. Even from a young age, if my client does not trust me and understand that I am there for them and only to help them, I don’t have shit, and therapy really can’t take place. And really it comes down to these three things:

1)  I am going to meet them where they’re at. If my client needs strategies to help with feeling calm, grounded and safe in a new place with a stranger, well I’m going to focus on building my relationship with them through play, their interests, and being there for them on the hard days.

2)  Challenges communicating does not equal unintelligent. The clients I get to work with are brilliant, and when we find ways in therapy to communicate differently other than talking, I gain access to a creative world, a brilliant mind, and a different way of thinking.

3)  Consistency: Being there on the good days, the okay days, and the bad days are the same in therapy with children as therapy with adults. Showing up and staying during times of yelling and screaming for full sessions, to being upset and crying after printing and fine motor exercises are challenging, or being sad after a rough day at school – I try to show consistency in that no matter what happens, I’m there.

With repetition of these foundational rules I’ve made for myself, trust, therapeutic rapport and a relationship can begin to be formed. Sometimes this takes a long time to develop, however the reward on the other side of working through challenges, helping clients achieve their goals, and becoming independent in areas where they might’ve thought impossible, is a really meaningful part of my job and where I find purpose. Going from a year of consistent challenges with emotional regulation, crying, screaming for 50 minutes straight week after week, to the beautiful moment of getting one to then two, two to then three, three to then four and more activities done in a session. To the moments of building blocks of trust, respect, boundaries, and consistency, to building to the first session of increased eye contact, shared attention in a fun game, and “Hi Matt.” To seeing a client, tie their shoes for the first time, print their name independently, to tackling buttons and zippers that were so challenging 6 months to a year before. To figuring out how to coordinate both sides of their body to help with putting a shirt on for the first time independently. To a client adopting strategies to help with anxiety, depression, and burnout in school and discuss the challenges of being a teenager with social media, relationships, and bullying. To clients getting their first job from the years worth of work they did to achieve that longstanding goal. The progress that clients make in therapy can sometimes take years, but it’s the small and big achievements that are celebrated in my job, and it is the absolute best feeling. These are just some of the examples the children and teens work towards every day. Progress takes time, however with investment and consistency from both the client and therapist’s end, beautiful things can take place in therapy and it’s my favourite part of being an OT.

This year is my fifth year working as an occupational therapist and my second in paediatrics. I’ve found my dream job, and I don’t see me working in any other area for the rest of my career. And like many other therapists, through trial and error and trying out new areas of practice, many of my friends and colleagues have found their own passion and area that makes them feel the way I do on a daily basis. Many of the foundational principles are the same, just a bit different in the assessments, interventions, and client base. Becoming an OT has helped me form lifelong friendships, learn from incredible leaders, academics, and other OT’s in the field, and be surrounded by people helping other people. I have so many incredible connections with people in Canada and across the world. Many work in mental health, community based settings, in hospitals, rehabilitation centres, shelters, nursing homes, private practices, teaching students in university and researching for new developments to help further our profession. To working in prisons, international settings, and schools. Occupational therapy is an amazing profession that I feel truly blessed to be a part of. I feel lucky and privileged to have the job I do and work with my clients in BC. To all of my fellow OT’s out there continuing to do amazing things:

Happy OT Month!!!