Abstract
Although therapeutic use of self is considered an integral part of mental health OT practice, little is known about how life experiences may serve to influence its development. Qualitative phenomenology was used to explore perspectives of six experienced mental health OTs about life experiences and use of self in practice. Findings from this study contribute to the understanding about how we integrate what is learned in our lives to our professional work.
Primary Author and Speaker: Susan Krutis
Contributing Authors: Courtney Hunt, Megan Joerger, Marissa Maddalena, Carly Swartz, and Makia Talley
This qualitative study aimed to discover how mental health occupational therapists integrate life experiences into the development of therapeutic use of self. Occupational therapists have long acknowledged the presence of a ‘therapeutic self’ in client-practitioner interaction. While use of self is vital in all practice areas of occupational therapy, mental health clinicians apply these skills in distinct ways with clients who may be experiencing challenging symptoms and behaviors. How therapists acquire the skills they need in using themselves therapeutically may stem from formal and informal learning methods. Acquiring learning from personal and professional life experiences could theoretically be a potential avenue for clinical development. However, little is known as to whether and how life experiences influence a practitioner’s therapeutic use of self, or what types of life experiences may be influential in the process. The following research questions were explored in this study: 1) How do mental health occupational therapists integrate life experiences into their development of therapeutic use of self? 2) What types of positive or negative life experiences do mental health occupational therapists describe as influential to their development of therapeutic use of self? and 3) How important do mental health occupational therapists believe life experiences are for the development of their therapeutic use of self? This research incorporated a phenomenological study design using methods of demographic survey, audio-taped interview, and written creative reflection to answer proposed research questions. Following IRB approval, purposeful criterion sampling with optional snowball sampling led to recruitment of six experienced mental health occupational therapy practitioners. Participants completed informed consent, followed by a brief online demographic survey, and finally completion of a 60-90 minute in-person or web conference audio-taped interview. At the completion of interview, researchers asked participants to complete a creative reflection about their own life experiences and relationship to therapeutic use of self. Thematic analysis procedures were utilized for transcribed interviews in the following progression: immersion, open-coding, development of initial codebook, axial coding, revision of codebook, classification of categories, and finally identification of emergent themes. Qualitative survey data and creative expressions were compared to interview data as a method of triangulation. Results of analysis yielded three overarching themes: 1) It Takes the ‘Ick’ to Make it Polished, 2) Life Experiences Foster Capacity for Pause, and 3) Metamorphosis of Therapeutic Use of Self. Participants revealed experiences in the course of their lives, both positive and negative, that ultimately helped them to more effectively use themselves therapeutically with their clients. In particular, challenging life experiences such as trauma and relationship dilemmas allowed a shift in their ways of seeing and responding to difficult situations with clients living with mental illness. This study has implications for mental health practice as therapists consider their own psychoanalytic processes, at times invisible, as they learn to relate to clients who present with complex needs. Their own learning as a result of enduring life experiences can serve as an important contribution to their professional development. The study has implications for further consideration of ways therapeutic use of self is currently taught to burgeoning practitioners. Future larger-scale study recommended to expand on life experiences and use of self using mixed methods.
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