The art of occupational therapy

I believe that people are at their best selves when they are busy doing things in life that are important to them. That is why I became an occupational therapist. When life throws curve balls, it can really shatter your sense of self. I’m proud to be an occupational therapist because I focus on who a person is, what a person does and who a person wants to become. We find ways to problem solve around barriers and re-engage in meaningful activities to get there.

Here at CAMH’s Addiction Medicine Clinic, we work with people who have substance use issues. These are people who are also often coping with trauma, chronic pain, mental health issues and/or social marginalization. Supporting clients to harness self-motivation, learn effective coping skills, set meaningful goals and work towards achieving those goals is the most rewarding part of my job.

I became an OT because I like that it has a wide scope for helping people get back to doing the activities that are meaningful to them. As an OT working on a forensic general rehabilitation unit in particular, my work often involves managing a clients’ risk while also exploring their strengths and developing plans to help them in their recovery.

Recently I led the implementation of a strengths-based risk assessment: the Structured Assessment of Protective Factors for Violence Risk (SAPROF) on my unit. The SAPROF aligns closely with occupational therapy theory and highlights how meaningful activities like work, school and environmental variables – like being in supportive housing – can protect people from engaging in violent acts or reoffending. It has been a powerful tool in advocating for my clients and has validated the role that forensic OTs have in managing risk.

This photograph was taken by a client I was working with who passed away last year who was here for treatment for his chronic pain and alcohol use. We were working together to help him build his daily routine and get back into some activities he used to enjoy, but he was feeling so low he was having a hard time figuring out what that was. I was co-facilitating PhotoVoice at the time so I invited him to join. He’d never really done photography before but he had some experience in the film industry years ago. Nevertheless, he would trek here each week to group and, camera in hand, he now had one more reason to get out each day. He had a purpose. We asked everyone to take a photo that represented their personal recovery and this was his.

I keep this photo in my office and it makes me smile thinking of him here in what I discovered was his favourite place. It’s also a reminder of why I love what I get to do –working with people to get back to what they let go of, or to try something new, and ultimately to find something that gives them a sense of purpose.

It’s been proven that working with plants can evoke a sense of achievement, and pre-vocational skills such as attention span and sense of responsibility can be improved upon, too. That’s why I incorporate gardening into my work with clients. The Sensory Garden in particular is designed to engage the human senses in different ways; it helps the clients who work or visit the garden to focus on the task at hand. It provides a safe space for meditation, reflection and mindfulness.

In our gardening work we also grow a variety of herbs and vegetables, which we use in client cooking groups to make things like tomato salad, Pico de Gallo, kale chips and mint tea. It’s rewarding to watch clients take pride in the work they are doing and to see how it positively impacts their recovery.

There’s a quote I love that says, “Our mind is garden, our thoughts are seeds. You can grow flowers or you can grow weeds.” In the work that I do, I’m trying to sow seeds of hope.

I have a picture of myself as a one-year-old watering my parents’ garden. I’ve just always loved plants. You can feel the oxygen and the energy when you’re around them. The delightful colours, smells and textures of the flowers make my soul happy.

Like a true botanist, I like to take cuttings from developed plants and propagate them to grow new plants. And I like to give plants a second chance at life. A local shop had recently thrown away a few roses. I brought them back here to the Sensory Garden, planted and fertilized them, and they’re doing fine.

Gardening is something I need to do. Before coming to CAMH I had a big garden of my own and I miss it. So having the garden and the solarium here to work in is nice for me; it’s a weekly activity that I can look forward to.

OTs in CAMH’s Forensic Service work with clients under the Ontario Review Board. As part of this, we balance risk management and recovery by leveraging the protective nature of occupation. We know that many factors such as gainful employment, social support and a structured routine support recovery and reduce the likelihood of relapse as well as re-offending, and work in collaboration with the interdisciplinary team and clients themselves to make this happen.

We complete assessments and introduce interventions to help address barriers to community living, work with clients to get them back to doing activities that are meaningful to them and offer vocational opportunities for personal skill development.  And for all of us, it’s a privilege to advocate on our clients’ behalf and to combat stigma surrounding mental illness.

There’s a quote from the American Occupational Therapy Association that states, “Occupational therapy practitioners ask, ‘What matters to you?’ not, ‘What’s the matter with you?’” I think this summarizes the occupational therapy values, and why I chose the profession as well.

I feel very privileged to learn about what is meaningful to my clients and to support them to be able to do these things by considering more than just their diagnosis. We often take for granted how important it is for our well-being to be able to do the things that we want to do and need to do in our daily life, until we are unable to.

As an OT trained in providing holistic care, I bring the OT lens and clinical experience to my current non-clinical role in CAMH’s Simulation Centre to inform the development of simulation scenarios that address the need for a more integrated model of care; a model that considers the mental, physical, cognitive and spiritual aspects of a person, as well as their environment and occupations.