‘It’s not just enough to give a patient something to do with his hands. You must reach for the heart as well as the hands. It’s the heart that really does the healing’ (Punwar & Peloquin, 2000). According to me, an occupational therapist must follow some personal philosophies that guide his practice. They not only make clinical choices clearer but also help to ‘reach the heart’ of the client in various, unlined ways. I have few philosophies to follow which are simple and have always guided my interventions and treatment plans.
First one is being responsible to expand personal knowledge. This is necessary as knowledge is what advances practice and forms a base for treatment planning. Whenever I see a client, I am required to think through my knowledge base. For example, if I am seeing a child with cerebral palsy for the first time, my evaluations must be precise and specific to the condition.
Evaluations for another diagnosis or usage of less advanced ones shall not only waste the session time and provide insufficient information but also lead to reduced insurance payment and inhibit my professional development. Most importantly, it can wear out the child and he may grow negative emotions towards the therapy room and me. Punwar & Peloquin (2000) stated that shaping of practice for a therapist is associated with his knowledge base and philosophy of the profession. I have developed this philosophy over time during my clinical placements.
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My teachers were able to instate it in me by demonstrating true professionalism in updating knowledge on a regular basis. They did so by attending workshops, seminars, reading journals or visiting the library to read books from ‘new arrival’ shelves. They would also try newly learnt therapy methods and techniques in real life situations. Overall, their practice was worth clients’ time and money because of the awareness and information they retained.
Secondly, following ethical guidelines is necessary to ensure safety and comfort of the client, their caregivers and the therapist. The Occupational Therapy Code of Ethics (2015) gives a clear guideline for ethical decision making. Ethics also helps in protection for the profession, its position for public image and viability (Corbett, 1993). Corbett (1993) also states that ethics is what creates trust among the system and enhances guidance for its members throughout their career.
My father is a man who follows ethics faithfully and he inspires me every day to become like him. I grew up following his career development and see him make ethical decisions on daily basis which has helped him grow into the successful and respected businessman that he is today. Someday, I would like to gain the same respect for being a true ethical therapist to my clients and their families. Confidentiality is another important philosophy that I have been following. It is related to making ethical decisions for what client information can be shared and in which context.
It is essential for a practitioner to follow it in order to protect the client as well as himself. Being naïve about sharing information can have serious consequences like termination of students’ fieldwork, denial for promotions or getting fired, and ruination of well-established therapeutic and professional relationships (Duncan & Townsend, 2012). Sometimes I feel that following these philosophies can be challenging. As I am new to the profession, with insufficient experience, I think my knowledge base is not yet wide enough.
And hence, I follow someone else’s advice or make a therapeutic decision based on my best guess. I want to overcome that by constantly reading up new literature and attending workshops in the future. Making ethically correct decisions are arduous to follow at all times. The ethical guideline provided by The Occupational Therapy Code of Ethics (2015) is not a detailed step by step instruction for each situation that can be followed blindly. But a practitioner is obliged to the profession, client and the third party to follow it anyway (Corbett, 1993). For new comers like me, consulting a specialist or having a mentor at workplace can improve and ease such decision making. I can also join formal or informal groups that discusses such problems with me.
Joining such groups and discussing a case with an expert can affect the confidentiality of my client. I am yet unsure about how to deal with the dilemma. But my mentor, a professor from India, advices me to ensure that I trust another expert practitioner before disclosing any information and to always avoid naming the client. To ‘reach the heart’ of a client, I believe that a therapist must try to follow these three philosophies of taking the responsibility to expand their knowledge base, making ethical decisions and maintaining confidentiality. A client can easily sense and notice them in their therapist which can enhance the building of therapeutic relationship and establishment of rapport.
References
- American Occupational Therapy Association. Occupational Therapy Code of Ethics. (2015). Retrieved from https://ajot.aota.org/article.aspx?articleid=2442685
- Corbett, K. (1993). Ethics and Occupational Therapy Practice. Canadian Journal of Occupational Therapy, 60(3), 115-117. doi: 10.1177/000841749306000301
- Duncan, E., & Townsend, E. (2012). Foundations for practice in occupational therapy (5th ed., pp. 14-22). Edinburgh, Scotland: Elsevier.
- Punwar, A. J., & Peloquin, S. M. (2000). Occupational therapy: Principles and practice (3rd ed., pp. 7-20). Philadelphia, Pensylvania: Lippincott Williams & Wilkins.
