Ten years ago, I was an undergraduate student at The University of Florida, majoring in Psychology, but having a difficult time applying the science I was learning to the real, hard problems people face. I learned this most prominently as a volunteer crisis and suicide hotline counselor, where I would pick up phones by myself from 3:00am to 6:00am on weeknights and weekends. While I could provide emotional comfort, therapeutic techniques and deescalation, there were limits to how I could tangibly help if I decided to pursue an advanced degree as a therapist or psychiatrist.
I thought long and hard about my professional future, and at the end of the day, couldn’t move past a gut feeling that the psychotherapy field had too many limitations for my comfort level, too much theory, and perhaps there was nothing that I could do about it. The psychotherapeutic techniques I observed and studied were the “best practice” at the time. As I graduated with my degree, I pressed my healthcare dreams on pause. That is, until I learned about occupational therapy. Once I discovered the field, I knew I had found the missing piece of my mental health paradigm. A profession of which is focused on “doing” at it’s core. Healing can be achieved through action. Action over inertia. Tangible, real tools to empower complex humans.
Fast forward to today. As I turn on a documentary on Netflix, “Stutz”, I am flabbergasted — but not surprised. Produced by Jonah Hill, and admirably so, Stutz is an effort to share the psychiatrist Phil Stutz’ therapeutic approach with the general public. Phil Stutz is famous for his work with Hollywood elite, but more importantly, for his departure away from traditional psychotherapy approaches by focusing more on action and less on “listening”. I already can my conscience heating up, “But OT’s have been doing this for WAY LONGER than Stutz’ has even been practicing!!! ARGH!”. Ah, the familiar angst of a misunderstood occupational therapy practitioner, with echoes of “but wait, what is occupational therapy again…?”
I can’t blame anyone for not understanding the scope of the field of occupational therapy. It’s confusing. While in graduate school, one of our first assignments was to memorize our “elevator speech” so that when someone would ask us what OT was (presumably in an elevator) we could respond succinctly without confusing anyone. While I always feel like I’ve had an intuitive understanding of our framework, I also didn’t truly “get it” until I was two years into graduate school. Here is my elevator speech: we are a profession that provides therapeutic treatment services through supporting someone in the act of DOING meaningful activities.
Throughout the last 5 years, I’ve worked with individuals who have parkinson’s disease who need therapy to assist with balance, dressing, and eating safely. I’ve worked with children with down syndrome, autism, cerebral palsy and more who need therapy to assist with achieving developmental milestones so they can participate in their school curriculum. But most relevantly, I’ve also worked with people experiencing mental illness and addiction who need support DOING things, like sleeping, eating and paying bills, managing their time, taking medications, and creating a life for themselves outside of addiction and other occupations that may have taken over their daily life. We help people through DOING. If there is a gap, we help a person bridge it so they can participate in a way that is healthy and meaningful to them.
Unfortunately, occupational therapists are not always qualified mental health providers (QMHP) in certain states. This limits the scope of our practice, and the type of care we can provide. In California, there have been many lobbying efforts and advocacy aiming at OT’s becoming qualified mental health providers, especially given the provider shortage, however, we are still not there yet. Given this, it’s not surprising to me that understanding and awareness of OT within mental health is still infantile and growing, despite there being thousands of us equipped with the tangible tools and skills to help people in immense ways. I guess this is my own version of the movie “Stutz”, except instead it is called “Support Occupational Therapy”. I have hopes and dreams that maybe one day, we will see more of us out there, working one on one with adults, and helping give people tangible tools for healing and growth.