A day in the life - Occupational Therapy
My name is Wendy Bates. I am a Senior Occupational Therapist who started working in Tusla six months ago. Working in Tusla is a new, exciting development for occupational therapists who are looking to grow their understanding and application of trauma informed practice. Tusla as an organisation encourages occupational therapists’ innate skills of innovation, problem solving and collaboration, through the just right challenge of independent working within a supported environment that is created through regular clinical, managerial and peer supervision.
As occupational therapists, our overall goal is to facilitate better engagement in the activities that are important or meaningful to a child or young person. This may include participation in family life, play, self-care and learning activities. Within Tusla, occupational therapists work from a trauma informed perspective. Occupational therapists already have these skills. Occupational Therapy’s holistic philosophy recognises the interconnectedness between the child/young person in care’s environment and their participation in occupations. The child’s environment includes both physical and social supports and barriers, with the child’s support systems playing an important role. In addition, occupational therapy understands the child’s inherent need to engage in occupations and the power that meaningful experiences have in developing positive mental health and well-being.
The following is a day in the life of an occupational therapist working in Tusla:
I start my day by checking my emails and prioritising my tasks for the day. Some days this might mean a quick call to the multi-disciplinary team to clarify tasks that need to be followed up. Just like building healthy co-regulation and connection is important for the children and young people we work with, so too, is it a necessity within the multi-disciplinary team working. Being integrated in our formulation, understanding of activities that are required and having our own needs supported is crucial in providing a positive and meaningful service to the children and young people notified to us.
A notification for a sibling group, new into care has been received by the team. This was discussed at the last team meeting, and it has been allocated to me to begin gathering information to start the process of developing the children’s individual therapy plans. Occupational therapists are sometimes like detectives. They bring a strengths-based approach to understanding a child/young person in care’s unique story, which includes their preferences and needs. Occupational therapist’s ability to creatively problem solve and create conversations by asking the right questions that facilitate curiosity around the activities that the child needs and wants to do and also the environments that they engage in, are strengths that occupational therapists bring.
In the afternoon, I meet with a 12-year-old girl, who has been in care since she was 3 years old. She is in Sixth Class and Foster carers have expressed concerns about her school performance. She is due to transition to Secondary School and has never been assessed by Occupational Therapy. Working in Tusla, we intervene at multiple levels; directly with the child by building their skills, with birth families and foster carers, with communities to support caregivers, by promoting new programme development to meet children/young people, birth and foster carers needs and on the macro level by advocating for policy or legislative change. For this young person, it is agreed as a multi-disciplinary team that I will work directly with her and complete an Occupational Therapy assessment that will provide an understanding of her sensory, learning, and environmental needs to support school participation.
Transition to Secondary School is such a key developmental milestone for any young person and for a child in care, it is particularly important. Children who have experienced trauma need additional support and understanding to ensure that they experience a “felt safety” that allows them to engage satisfactorily. Occupational therapists’ skills in understanding the child’s needs, preferences, and their ability to assess the environment, can provide that comfort and security by creating the “just right challenge” through education of caregivers, building of the child’s skills, and also modifying activities or the environment to meet the child’s needs.
My day ends by writing clinical notes, checking emails, and ticking off my “to-do” list. Every day is different and the ability to plan, organise, prioritise, and collaborate are vital for working within the busy Tusla environment. All these traits are within all occupational therapists. Routine and structure are strategies that we bring to the people attending our services and in turn are intrinsic to the way that we manage our clinical work.