Occupational Therapy: Using Meaningful Occupations to Enhance Function Throughout the Lifespan
Emily DeBreto, MA, OTR/L, is a pediatric occupational therapist and certified brain injury specialist. She works with children and young adults who have complex medical conditions at Gillette Children’s Specialty Healthcare in St. Paul, Minnesota. Emily developed the Animal-Assisted Therapy (AAT) program at Gillette and is working to expand the program to Gillette’s outpatient pediatric clinics.
I have always been driven to find a career that promotes function and quality of life. During my undergraduate coursework in psychology, I held volunteer and internship positions in healthcare and education, which later shaped my interest in the field of occupational therapy. One of the most formative experiences for me was the position I held as a personal care attendant. I worked with a child who had a genetic condition that affected her global development. My role was to help her gain independence in daily living, social, and leisure skills so that she could thrive in all of her natural environments. This experience opened my eyes to how I could positively impact someone’s life in a meaningful way. After graduating with a degree in psychology, I had the opportunity' to shadow and interview an occupational therapist (OT) in a pediatric hospital. I was inspired by' the way' the therapist skillfully used play' exploration activities to improve the child’s visual and fine motor skills. During the interview, 1 learned that a career in occupational therapy' would allow me to combine my passion for working in healthcare with my' background in psychology and my love for animals. These experiences are what led me to pursue a master’s of arts degree in occupational therapy'.
My current position as an occupational therapist is within a pediatric hospital that specializes in complex medical and genetic conditions. I evaluate and treat children and young adults on several inpatient units including: rehabilitation, neurosciences, intensive care, and orthopedic-surgical. As such, I work with patients recovering from elective surgeries, injuries, and acute illnesses. In an average day, I provide treatment to five to seven patients, complete medical documentation, attend family conferences,
Occupational Therapy 105 conduct evaluations, and collaborate with colleagues on the rehabilitation team. In addition to my role as therapist, I am the animal-assisted therapy (AAT) program lead. As program lead, I coordinate AAT sessions for physical, occupational, and speech therapists; conduct up-to-date literature reviews on AAT and human-animal interactions; revise and update clinical practice guidelines; and provide hands-on training and mentorship to both dog handlers and clinicians.
Playing an active role in an individual’s recovery and observing the daily progress patients make are the two most rewarding and exhilarating aspects of my career. I am inspired when patients achieve their goals despite the new challenges they are facing. As appropriate to an individual’s plan of care, I implement AAT in my practice to enrich the therapeutic environment and promote functional skills. My role during an AAT session is to facilitate goal-oriented skills while simultaneously collaborating with the dog handler in order to set the patient up for optimal participation in therapy. Skills that I promote during an AAT session may include: visual perception, active range of motion, functional mobility skills, fine motor skills, and/or executive functioning skills. I have witnessed a child move their arm for the very first time after a brain injury while reaching to brush, pet, feed, and play with the therapy dog. I have utilized therapy dogs during the occupation of play to promote visual scanning skills in children who have suffered a stroke as they search for hidden puzzle pieces buried under the dog’s fur. Children who are generally anxious about moving or exploring their environment because of pain or anxiety demonstrate a calmer state simply by being in the presence of the animal. With these barriers removed, I am able to move their therapy goals forward, which is one of the greatest benefits of AAT. One of the biggest challenges with my career is witnessing the grief that patients and their loved ones face, especially when a full recovery is unlikely. Patients and families are coping with a change in function and a new reality, which can be both physically and emotionally devastating. Compassion fatigue exists in this field and reinforces the importance of self-care and work-life balance to avoid burnout.
Occupational therapy is a versatile and exciting career with excellent job security. Individuals who succeed in this profession are detail-oriented, compassionate, and have very strong interpersonal skills. As an occupational therapist, there are opportunities to work with people across the lifespan and in a multitude of settings. Occupational therapists in nursing homes, schools, and medical settings have the opportunity to use AAT in their practice. Additionally, occupational therapy is a wonderful avenue for utilizing and researching AAT. There are also opportunities within the OT profession to be involved in advocacy and healthcare legislation. Professional advancement is possible in this career but dependent upon each work setting. Program development, research, involvement in special projects, committee participation, and professional presentations are some of the ways a therapist can advance professionally. Occupational therapists also have the opportunity to assume leadership roles, including that of a rehab supervisor or manager.
I would encourage anyone interested in this field to pursue volunteer and/ or job shadow experiences in healthcare, education, and/or communitybased organizations. Interviewing an occupational therapist is an invaluable way to learn more about the nature and realities of the field. An excellent resource for learning about the field is the website for the American Occupational Therapy Association (www.aota.org). Another useful resource is the World Federation of Occupational Therapists webpage, found at www. wfot.org. Lastly, the American Journal of Occupational Therapy (AJOT) contains peer-reviewed journal articles on highly varied topic areas.