Making Therapy Delicious
One cannot think well, love well, sleep well, if one has not dined well. -Virginia Woolf
I decided to start a blog with the encouragement of many of my close friends and colleagues, as well as my family. The thought was to write about my clinical practice, giving other therapists a window into how to translate the discoveries we make from Sensory Integrative theory, development, and current neuroscience into practical applications for treatment in our Madison, WI-based clinic. I would give you the full background but this is a blog, not my biography. If you are interested in that, check out About Us.
Why is an occupational therapist blogging about her adventures in the kitchen?
One thing my daughter suggested was to let others get to know me beyond my clinical teaching and to include some of my favorite recipes. At first I laughed that suggestion off. Why is an occupational therapist blogging about her adventures in the kitchen? Anyone who knows me, knows that I love to create with food. Even more so if the person that I am cooking for has dietary challenges (gluten, dairy, animal protein, etc.). So what does this love of kitchen creation have to do with clinical practice?
It dawned on me that what appeals to me most about cooking is intimately related to my approach to clinical treatment.
Imagine, as a chef I have my basic ingredients, kitchen gadgets, and recipes that form my cooking fundamentals. From there, I experiment with adapting proportions and ingredients based on the individuals for whom I am cooking, the ingredients that I have, and my imagination.
In the clinic, we are always looking at the individual, their overall clinical presentation, and their functional goals. One all too familiar case is of the child who is having trouble paying attention in school. Although we know the functional area of difficulty, we still need to examine the necessary foundational ‘ingredients’ that s/he needs to accomplish their task. How well does this child process different types of sensory input? How does their ability to process sensation impact their arousal level? What is their overall responsiveness to sensation? Are they able to sort out what environmental stimuli are relevant moment to moment? What are their postural abilities? Do they have the underlying vestibular and proprioceptive activation necessary to support statically sitting in a chair? Does poor postural stability impact the ability for them to focus their eyes and ears?
Once we know what ingredients this particular child has to work with, we are then able to begin to use the tools that we as therapists have access to, including but not limited to: swings, scooter boards, balls, Therapeutic Listening, Astronaut Training, and the most important tool: therapeutic use of self. The combination of therapy tools, along with the variety of other therapeutic techniques, and years of experience all mix together to create a function based treatment plan.
So, let us examine a clinical recipe I find useful for every child, adolescent, and adult that I work with who is having trouble focusing their attention. While they all may have difficulties with different aspects of sensory processing that do not necessarily need to be addressed, the majority of them have a great deal of difficulty with their ability to hold supine flexion. Many look fine at first glance, but with a more precise eye we see that they do not have adequate flexion at the neck. The development of neck flexion is directly connected to our ability to attain, maintain, and shift our eyes and ears from the most salient targets, moment to moment, in our daily life. One often overlooked ingredient is the ability to position our eyes and ears on the target. Although subtle, this is essential ‘spice’ in our development is necessary to take in more refined information about the environment. If this fundamental ingredient is missing, the final dish, although still visually appealing, lacks substance and falls short of expectations.
Through the Vital Links blog, I hope to introduce new ways to not only help you ‘cook’ in your clinic, but possibly in your kitchen as well. I plan to highlight essential topics and activities that I feel are key ingredients to a successful clinical recipe. As a therapist first and a cook second, I promise to share with you the crucial information necessary to develop your own clinical cookbook.