124 – Lessons from a Career in Occupational Therapy

On October 15th 2021 I was honoured to be asked to give a short guest talk to the graduating class from Central Queensland University. The topic was left up to me and so I thought about what I would want to know if I was back in their shoes, about to step into the world as an OT for the very first time. So here it is, my lessons from a career in OT.

Look after yourself, look after others, and always keep Occupied


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Brock Cook 0:02
G’day all and welcome to another episode of occupied this episode I absolutely love I was honored to be asked to give a short presentation for the graduating class of Central Queensland University. Today, actually, and they left the topic up to me and after a bit of thought bit of what should I talk about a bit of freaking out, I developed this presentation of lessons from a career in occupational therapy. G’day, my name is Brock Cook, and welcome to occupied. In this podcast we’re aiming to put the occupation in occupational therapy, we explore the people, topics, theories and underpinnings that make this profession so incredible. If you’re new here, you can find all of our previous episodes and resources at occupied podcast.com. But for now, let’s roll the episode. Alright, so yeah. Hi, thank you, I was absolutely flattered to be asked to come and talk to you guys. This morning. When I was first asked, the topic was left really broad, which is fine with me. But I started thinking about what I would have liked to hear when I was graduating many, many moons ago. And I started thinking about well, what if I was able to sort of, I guess, restart my career, but keep all of the the knowledge and stuff that I’ve gathered over these many years? What if I could do it again, but with my current learnings intact, and I think that’s where I’m going to try and distill some of that down for you guys today. And hopefully, there’s something that that you guys can can take out of it. So I’m going to try and present at least some of the major lessons that I’ve taken from a career in occupational therapy, which is still the best career option, in my opinion. So that’s excellent. So one of the first lessons commonly referred to as outcomes razor, for those of you into a bit of philosophy is generally that the simplest explanation is usually the best one. And there’s a little bit more to it than that. One thing not to get confused is that the easiest solution is the best one. But what I would like to really highlight is that the the main component of outcomes razor is to try and make sure that more you’re making choices and decisions that using as fewer assumptions as you possibly can. And when I’m referring to this, I’m thinking about with the clients that you guys are going to work with. This key concept to me, was really important with regards to interviewing and analyzing interviews. So it taught me that I need to be continually working on my own self awareness that I’m not consciously or subconsciously filling in gaps of the person’s story of their experience, that I’m not passing any judgment on their situations that I’m being able to come to a conclusion with as minimal assumptions as I possibly can. And I’ll give you an example of this from earlier in my career. I was working with a lady on an acute inpatient Ward, mental health ward. And she just come in we were sitting in ward round. And she was telling us her story. And she told us that she back in the day used to date, Peter Andre. Now I understand that many of you are quite young, and may not get that reference that Peter Andre, and I can guarantee you that in the 90s. He was viewed as cheesy as that photo is now the default reaction from the whole team, including myself at the time was she must be psychotic. She must be delusional because you wouldn’t make a story up like that. You wouldn’t want a story up like that. Well, it turns out it was true and her she was also the father of her child, which again, no one had believed until she had brought in newspaper articles and photos and

enough proof that the whole trading team was rather embarrassed. So that was an example of our bias, filling in the gaps to her story. to come out with what turned out to be the wrong outcome in the end. And I’ve never forgotten that story, mainly because it’s Peter Andre. And it’s super awkward still, either way. Another lesson that I’ve learned throughout my career is around this concept of the dark side of occupation. And this some semantic controversy around this one. But the understanding of the concept is that it’s looking at those occupations that we are commonly ignoring, or not really viewing as occupations, because they’re illegal, they’re not really health promoting, they’re awkward for us to talk about. So things like drug use, things like general delinquent behavior, graffiti, all of those things that we commonly don’t view as occupations, per se, we might view them as something else. But we don’t often consider them as persons occupations. I’ve worked with people, for many, many years who have used substance misuse, as a form of meeting a social need. It’s not necessarily a chemical dependence that keeps them going, but more a method for them to connect with peers. Try and make friends, try and keep friends, that kind of thing. So if you’re working with someone in that instance, and you’re trying to or even if they want to, and you’re encouraging them to either reduce their use or stop using using in the ideal situation, then just taking that away, because it’s bad, isn’t going to work, because there’s still this need that needs to be filled. So I’d encourage you to Don’t forget about those occupations that aren’t commonly viewed aren’t commonly discussed or might be somewhat awkward, including sex and sexuality, which is a big hot topic at the moment, within the profession about it being discussed more openly, without the people that we work with. One of the biggest lessons I learned was seemingly the most obvious and that was don’t forget the people. Don’t forget that. We are working with people. We live or we were part of a profession that prides itself on being science base prides itself on being unique, and being able to assist people in a very structured way at times. And I know that throughout most university courses, if not all university courses, those various structures, things like assessments, interventions, frameworks, models, all of those kinds of things are really heavily leaned on to get across to you, how Oaties operate, and how we think and that sort of thing. And that’s 100% valid. I think that myself, in my career, when you first graduate, there’s this inkling to try and impress and be the best ot that you can be when you first get your first job. And a lot of that seems to revolve in all I did in my head revolve around, trying to get my head around the assessments used and all of that sort of stuff as quickly as possible and be the most efficient or the best at administering them and that kind of thing. And I think, although that is a very, very important aspect to the profession. For me. It was a while later, maybe a couple of years after I graduated, when I realized that in focusing on that I was focusing not as much as I should have been on the fact that I’m working with a human being and their experience. I’m trying to make them fit into the interventions and the assessments that I had, rather than the other way around. So just a reminder that don’t forget that we are humans working with human beings and that’s sometimes more complex than just administering assessments and looking for the outcomes that we’re hoping to find anyway.

One of the biggest, this is probably one of the biggest revelations I had. So hopefully at this side at this stage, we’re all aware of the P O we all know that the internet action between that person, the environment and the occupation where they intersect is representative of occupational performance. And we all know that on a basic level, what OTS do is we can modify, adjust, support each of those individual components. So we can help change the person, the environment or the occupation, in order to improve or increase that person’s occupational performance. One of the biggest revelations I had, however, was that when you’re engaging with the person that you’re working with, you then become part of their environment. So for the longest time, in my head, conceptually, I would look at the person’s environment, the person’s occupation, and the person themselves. And me as this kind of outsider that was enacting an influence over these three things for the individual, without realizing that I’m part of that person’s environment, the other health professionals working with that person, they’re also part of their environment during that period that you’re working with them. So anything that you bring to that table, whether subconsciously or consciously is going to have an impact on that person. Now, some of you may have heard of phenomenon like transparence. This is exactly what this is talking about. If I go into a room, and I’ve just had a really crappy day, it’s nothing’s going right, I’m feeling really down, I can’t even bring myself to throw on a smile, that’s going to have an impact on the people that we work with, because I’m part of their environment. And me walking into that room with a negative outcome, or sorry, a negative. Or, for lack of a better term, it’s going to have an impact, because I’m going to have an impact on their occupational performance, because all of a sudden, their environment has taken a on average, sort of dip towards the negative. So being really self aware about what you’re bringing to the table, in every interaction is super, super important, because you are a part of that person’s environment. Following on from that, the ability to be able to work out where you’re at before those interactions is probably one of the biggest and most important skills that you will have learnt at university, whether you know it or not, I for one can say that during university, we did a lot of reflection and a lot of reflective assignments and reflective exercises. And it probably wasn’t until, I reckon 18 months to two years out of uni, that it finally clicked for me like, hey, this stuff actually works. And it’s kind of important. Being able to reflect on interventions you do. Being able to reflect during interventions and adjust and change your skill set. Even your communication skill set on the fly is taking steps towards your own growth, and improving yourself as not to be the best therapist that you could possibly be. It’s something that I feel every uni does really well in terms of teaching you how to do it. But making sure that you’re aware that this is a really valuable tool, whether you see that yet or not. Keep it in the back of your mind. Because one day, if you don’t yet see its value, you’ll think and you’ll be like I remember when Brock said that he said this would happen. It’ll just click.

In saying that, to flowing on from this, again, communication is key. Now I’m coming from this, I’ve worked my whole career in mental health where if you don’t have good communication, you don’t really have anything. It really is key in the fields that I’ve worked in, but it goes for all fields of OT. And what I mean by that is there’s a growing level of evidence out there that states that if you’re able to or sorry that your ability to develop a really good therapeutic relationship with that person is arguably the biggest factor in ending up having a positive health outcome with that individual. Not saying that all the other stuff isn’t important as well. But like I was saying earlier, when you tend to come out of uni and you’re focused on that really structured stuff. Don’t forget that the basics are essentially where your big impact is coming from as well. So really on terms of learning all your assessments and learning your interventions, keep learning and keep developing your communication skills as well. It’s something that even now I am still improving. Still learning still reflecting on so that I can improve myself. It really is a lifelong pursuit to improve your communication. Something that’s near and dear to my heart, and I’ve done a number projects and presentations and all sorts of stuff around this particular concept is occupation is means the only thing that separates occupational therapy from every other health profession is occupation as means being able to do anything you want and justify it as ot because it’s got an occupational outcome isn’t really good enough nowadays, using occupation as the therapy is the difference. That’s what we do. I’ve had people discuss this with me on a number of well with with a number of very different opinions. And my argument always is, Will cold and flu tablets technically have an occupation as ns, they’re designed to get you back doing what you want need to do. So are they OT, I don’t know. But they don’t have occupation as means a tablet isn’t an occupation that’s engaged in to help improve you. That is the difference that we provide, that is the difference we bring in our unique contribution to that health space. So something to keep in mind, and to, even in my career would be constantly reflecting on and am I doing the most to promote occupation as means within my practice.

The last thing I wanted to bring up before I am happy to take any questions is, and this is something I get asked from the graduates at the university I work at and students from all over the world through the podcast asked me or I hear frequently from them is I don’t really know if I know enough, I don’t really know if I’m ready. I can sum that up really, really quickly, you are ready, you know more than you actually believe that you do. And I can guarantee you that there’s going to be situations when you first start working, you may have already experienced this, when you went on placement, that you’re going to get there and you go, Oh, wait, I do know how to do this, or I do know how to work out how to do this. These are the skills that you’ve you’ve gained through this university course these are the skills that make you a good OT is being able to not just know everything, but being able to work out how to work it out. We’re not generally we’re not an overly prescriptive profession, we’re a profession that aims to team up with the people that we work with, we’re not a hierarchical, have all the answers type profession, we’re not you don’t no one generally should be coming to an OT, because they just want to be told what to do and then go home. Were a profession that works with the experts in those people and that is the people themselves to troubleshoot the answers and support them to come up with the fixes themselves in a lot of cases. So all of those skill sets as obscures they might be you will have and that is the beauty of this profession. And that is why this profession is also so broad is because that, that ot skill set, like I said, I’ve worked my whole career and mental health side from now. But if I decided one day, I’m going to go and work in geriatrics. I have the skill set to do that. Yes, there’s gonna be some basic, like assessment modality process type learning that I’ll get on the job, but from an OT perspective, I have the skill set to be able to work with any population. It should be the same skill set across any practice areas and at the core skill set. I mean, so and you’ve got that. So back yourself. I know a lot of people say fake it till you make it. I don’t necessarily like that but back yourself because you’ve got this. And yeah, welcome to the profession, the greatest profession on Earth, and best of luck.

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Transcribed by https://otter.ai