THE PERFECT THERAPIST

I have been reading about Alice Hortop’s, Belonging Centred Practice theory and recently listened to the podcast by The Brave OT, Carlyn Neek interviewing Alice about how she has developed her understanding of herself and the need to belong. There was a plethora of ideas, concepts and thoughts that I need to personally review, but one that really resonated with me was the discussion around why we never talk about the mistakes we have made in our professional life?

There is this societal need to strive for perfection and be a faultless therapist, yet none of us are perfect and if we are totally honest the mistakes we have made over our careers can lead to us being much more reflective and effective therapists.

Striving to this utopia of perfect practice is one that can only lead to failure as it is not achievable. By putting unrealistic pressures on ourselves, we can impact our own wellbeing and ultimately how we work effectively in collaboration with our clients.

One of my early career with a local contractor. Job done, I thought. was needed physically, psychologically and emotionally, and considering the whole person and those in her life that made her feel like she was part of something. I was initially aiming for the occupational therapy utopia of making someone independent, whereas in reality we are all inter-dependent. I had really failed to understand her needs and dare I say, her wishes. failings was to not listen to my clients and already be working on a solution before even visiting them in their own home. One specific case was a lady in her late 90s who lived in the east end of London. Struggling to use the bath, my solution was to rip the bath out and put in a level access shower, which was arranged

I returned to visit this lady almost a year later as her mobility had decreased and she could no longer manage the stairs. On discussing the shower she said: “I don’t use it, I have never used it, I hate it and would like my bath back.” The strength of her response to the shower took me by surprise. It turned out I had not spent time building up a relationship with her, asking about how she used her bath or what her home meant to her. I just looked at managing personal care and provided a solution.

It turned out she had been born in the property and the installation of an indoor bathroom was a major milestone in her and her family’s life. It was where she bathed, yes, but she also bathed with her husband in that bath, she also had done her large washing in it using a dolly, she had washed her dog in it, and when tired at the end of day she bathed in it, remembering all the lovely times she had spent with her dad, siblings and mother discussing life’s joys and woes. I had removed something that made her feel she belonged and I had left a huge hole in her life. I had made a massive mistake by thinking a bath was just about personal hygiene when it was so much more.

My failure could have been put down to my lack of knowledge or skills, pressure of work, limited supervision, but on reflection it was more about not really understanding what

I learnt so much from her, and my approach to her stair mobility was very different. I had gone in thinking of putting in a stairlift, whereas what she wanted was to be supported to move all her belongings downstairs and use the front parlour as her bedroom.

This is not the only mistake I have made, and I am going to think more about my mistakes in the future and maybe one day write a longer article about some of them.

So, let’s be brave, acknowledge our mistakes, understand what and how we would do things differently and share our learning, because every day is a school day and adds to our professional development.