Navigating the Emotional Landscape of Pediatric Occupational Therapy

Occupational therapists are strong people. They help others through incredibly difficult times while addressing the biopsychosocial factors that influence treatment outcomes. This work requires fortitude and stamina – surveys show that most OTs appreciate giving their best efforts and talents to patients.

Every area of practice, client and day can be different and create unique struggles and triumphs. In the world of pediatric occupational therapy, the very strengths that allow you to work incredibly well with younger patients may be the same factors that can cause personal stress sometimes.

“For me, the biggest challenge is not letting the work overwhelm me emotionally,” says Abby Brayton, a pediatric occupational therapist for over nine years on the West and East coasts. “I am a very sensitive person, which is a great quality to have as an OT, but it can also pose a challenge when interacting with families that are going through emotionally challenging situations on a day to day basis.”

Brayton says that early intervention, in particular, can present emotional challenges, because “any given day, you may encounter a family who just found out that their child has autism, another family who is coming to terms with the long-term implications of having a child with a disability, and a mother who is distressed because her child is not eating as much as she (or her pediatrician) would like.”

“It is an emotional rollercoaster for parents as they move through the new territory of having a child with special needs,” Brayton says. “I personally am very affected by the emotions of those surrounding me, so I have really had to learn to separate the emotions that I encounter during my work day from the rest of my day.”

Tools to Grow, a site geared specifically toward pediatric occupational therapists, offers a ton of in-depth articles and forms which can be easily accessed for daily and special activity use. It also offers great community support for personal aspects of being a pediatric occupational therapist.

Learning to manage emotional stress, in particular, is essential for a long and satisfying career. This requires intentional self-awareness and effort in self-care. The following are some practical tips and points of evaluation to reduce emotional fatigue and improve everyone’s experience in the therapy process.

Clear Boundaries and Limits

Initial sessions are the time to set boundaries and expectations for the child and even with the parents. These boundaries will take into account factors such as health, development level and age.

Location will also play a role in boundaries for behavior. If you’re in a home, you are a guest. In terms of correction, what role do you play versus the parent? This needs to be clarified. If it’s an outside setting, will having visuals like posters with rules and expectations help with reinforcement?

Who’s leading? Will this be an adult-directed or child-directed endeavor, or a combination?

Once boundaries and expectations are set, it’s important to hold to them completely at the beginning to set the tone for the rest of the therapy. Be kind, but be very clean and firm. And know when it’s time to pause and temporarily disengage for the benefit of everyone.

Observe and Respond, Don’t React

From the start, pay attention to the energy levels of your patient and be prepared to learn their habits and drives. Some kids bounce around. Some kids are lethargic. Some kids grab everything. Some kids could care less.

When you know who you’re dealing with, you can be ready for them each session and set reasonable expectations and responses for your time together. You can use their wants to your advantage by motiving them according to their natural makeup. Preferences can be one of your greatest assets for driving productivity. Contrarily, ignoring or trying to entirely change someone’s personality will only work against your mission.

Dig Deep into Patient History

Taking a detailed look into all available records may give you hidden insight into your patient and appropriately set your expectations. Medical records and conversations with parents and teachers (if applicable) can greatly aid the occupational therapy process, because you are less likely to over- or underwhelm your patient. Other issues not being addressed in the therapy process may still affect the therapy process.

Take a Team Approach

It’s important that you have the compliance and support of the parents and child, to the greatest degree possible. Proactively communicating your needs and their roles is important. Your needs are tied to the treatment of the patient, so it’s reasonable that you would express a desire for cooperation.

If the child has an already established plan, you may consider talking to past therapists and learning about the nuances of your client. Learning their strategies can only help you and reduce frustration, if those strategies were beneficial and effective.