Occupational Therapy: A Holistic View on the Job of Life

Still wondering what occupational therapy means? No, it is not about helping you find a job…. But it can help you do your job… better.

Listen in as we chat with Louise, Occupational Therapist (OT) at Simply Counselling Services. 

She shares her views on the importance of having a holistic view of health and how, at the end of the day, she really is a detective.

If you would like to book a session with Louise or learn more about her click here.


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Nicki Kirlin, Jenna Fortinski, Louise

Jenna Fortinski  00:03

Thank you so much, Lou, for joining us. So all start us off this time around. Sounds

Nicki Kirlin  00:09

good to me.

Jenna Fortinski  00:10

The famous question, Lou, tell us a little bit about yourself, your career family where you’re from hometown. Fun fact.

Louise  00:18

Fun fact. Yes. Well, first of all, I want to say thank you for having me here, because it’s a real honor. And I am so impressed with this business, this podcast and everything. So thank you for having me here.

Jenna Fortinski  00:33

Thank you. Thank you.

Louise  00:35

I really, really do feel honored to be part of your company.

Jenna Fortinski  00:39

Oh, thank you. That’s so nice.

Louise  00:42

But back to me. So I grew up in New Zealand, North Coast. On on sorry, on the east coast of the North Island in a little bay of about 180,000 people on a little beach front. I just grew up there with my family, my parents, my younger brother, older sister, big family. So a little bit like your family, there was lots of people did lots of celebrations, birthdays, and everything. It was very on both sides. And both sides mingled together as well. So smaller town, big family. Nice. And then in 1996, I graduated and went down to a tiger University, which is right at the bottom of the South Island. So I went as far as Yeah, and 17 and I got into the OT school there. And so I did that schooling there. In Otago for into I graduated in 2001. And so got my degree there. It’s the same as the Masters here. So I didn’t have to do any upgrading or anything. Yeah, so I had a very summery childhood. And yeah, and then decided to come over for one year to Vancouver. I wanted to snowboard work with child and adolescent and then head back. Yeah. Wow, that was 2001

Jenna Fortinski  02:13

Oh my god. Yeah.

Nicki Kirlin  02:16

And you’re still here? Yeah. Yeah. My gosh,

Louise  02:20

yeah. here and traveled between three times now I’ve had jobs between Alberta and BC just go back and forth. Yes, I’ve got lots of experience here. And yeah, it’s nice. I’ve got my own family here. Now. My own friends. I’ve lived close to half my life here now.

Nicki Kirlin  02:38


Jenna Fortinski  02:39

So when was the last time you were home?

Louise  02:42

It was when was that three years ago? Okay. This time three years ago. Yeah, so it was nice to get my son back so that he could see where I grew up. Yeah, yeah. He wanted to stay. He didn’t want to. Yeah, of course. Nana was like, yeah,

Jenna Fortinski  03:00

that’s fine. Yeah. Oh, my goodness. I know that taught you talking of the beach sounds real nice. Right about now after this COVID stuff and absolutely, yeah. Being stock raid. So yeah. Well, we’re glad you’re here. Yeah.

Louise  03:18

It’s been an interesting journey here. And I love it. I love it just as much as New Zealand.

Jenna Fortinski  03:24

Yes, point. Good for you. Fun fact.

Louise  03:27

Fun fact. So yeah, I’m not sure if you guys wouldn’t would believe this or not. But so I grew up in a very musical family. So I played a lot of instruments. And so I had an auntie in a band. My brother was in a band. We just had music playing all the time, playing music, listening to music, all different types of all different genres. And so I’m still a little bit like that. So I just actually gave my flute away to a friend of mine in Vancouver who is in a band like a hip hop band, so he uses a flute that means no way. Yeah, and he was a good friend it’s meaningful to me to give it to somebody that was my friend yeah afford one really wanted he was using like a keyboard for the flute. Oh, yeah. And I didn’t play it much. So I that was my last instrument that I gave away. But I still have the music going all the time. You know, anybody that’s around like my family would say so. I recently got this is the fun fact. I recently got these new headphones. Bone conducting headphones. Have you heard of them? No. It really increases your sensory experience of what’s going on. So they sit on here in the on the lobe? Yeah, the lobe or whatever this bone is in here. Yeah. And they sit there they don’t go in your ears. Yeah, but they vibrate when something gets louder or more bt but the best thing is, is you can sing so you can hear if you match because you can hear yourself better. So it’s like your Oh yeah, yes. So you can really see if you’re in tune or not. So I dance a lot when I’m making dinner Yeah. I find it fun. Not sure if my son and my husband they like keys Keep it down because you know, you don’t know how loud you’re singing right? And especially if it’s on tune you’re like, yes. And so yeah, I just go up and shimmy up next to them and I just really enjoy the music experience.

Nicki Kirlin  05:32

Wow, that’s incredible. So it will it will tell you when, when you’re in tune with with the sound then basically, we can hear

Louise  05:40

it. Okay. Yeah. New ears. Okay, are on the top there. Got it here. Yeah, but it also blocks out anything in the background, so I can’t hear anything in the background. I can just see Mel’s saying, Can you please

Nicki Kirlin  05:59

they’re not saying that. No, they’re

Jenna Fortinski  06:01


Louise  06:02

Beautiful job. Please keep it down.

Jenna Fortinski  06:05

They’re saying is that Mariah Carey in my house? Exactly. All right, great

Louise  06:09

weekend, a friend a good friend of mine went away in his acreage. And so I thought that it would be really fun to go out there and walk the dog so I was dancing and singing because nobody else was around. Yes, I found out they have security cameras so but I just love it you know going to concerts and all that

Jenna Fortinski  06:33

music lover Oh yeah.

Louise  06:35

And yet the I used to play the bongo drums more when a kid just before I came here Yeah. Wow. Wow. Like that beat

Nicki Kirlin  06:44

that was gonna be my next question for you. Which is what is your favorite genre of music? What do you love to listen to more than anything else?

Louise  06:50

That’s really really difficult. Yeah, cuz I love of course, like I like hip hop MBD and dancy type. Okay, things. You know, the concepts have been to have been more, you know, bt or health, right? Yes. Yeah. But then the other day, I got into going back, and I was like, Oh, these 80 songs. Yeah. Oh, yeah. That’s loving We are the world today. Ya know,

Jenna Fortinski  07:24

how appropriate.

Louise  07:25

Yeah, yeah. today’s world. Wasn’t many women in that song. Yeah. Yeah. No, that’s that’s my fun fact.

Jenna Fortinski  07:33

Oh, thank you for sharing. for sharing

Louise  07:37

no demo today. Yeah, exactly.

Jenna Fortinski  07:39

Stay tuned, maybe at the end.

Nicki Kirlin  07:43

special episode featuring. The one piece that you didn’t Well, you kind of maybe shared a little bit was what do you do? So you’re an occupational therapy?

Louise  07:54

Yes. Yeah. I am an occupational therapist. Yep. graduated in 2000 or 2001. And okay, well, it’s different. Yeah. Yeah. Zealand. Yeah.

Nicki Kirlin  08:04

Fantastic. Okay, so then can you tell us a little bit about what does occupational therapy mean?

Louise  08:11

Hmm, that’s a good question. I think I might bring it back. Yeah, absolutely. I would prefer to say what is occupation mean? Okay. Yeah. Because that’s the core of what we do that sometimes very missed and misunderstood. Okay, I would say so, what I thought that I would do would take a world health Federation definition. Okay. So if you were to get an OT from somewhere else, yeah, myself, then there is a world definition. Okay, which kind of keeps us together that core, right. So occupation is the everyday activities that people do as individuals, in families and with the communities to occupy time and bring meaning and purpose to life. So occupations include things that people need to want to, and are expected to do, within context of the person. So it’s very contextual, right? You would look at what’s meaningful in the person’s life in different areas, but also what fits for them as a person, okay? their thoughts, their feelings, their learned history, who they are as a person was super client centered. And so what the client wants to work on, that’s what we do. Yeah,

Nicki Kirlin  09:31

that’s really interesting, because I think we there’s a, there’s a common understanding of what occupation typically means the word itself, right? And so what you’ve just described I think, is very different from what you typically think of when you think of occupation, right? So I think that’s so fantastic that you’re able to define it in that way, because it gives you a true window into what you actually do. Beyond this common conception of what occupational a job that’s right.

Louise  10:00

As part of our job as we have other people doing that, yeah, how does one occupy their time, and even if we wouldn’t agree with their values of how and what they choose to do with their time, if that is what you know, we, we can have the right to say, Hey, I’m not going to support you in that, in some people have labeled that the dark side of occupation, you know, right. But then if you look at the context of the person, you can see this harm reduction going on, there’s, you know, like those sort of concepts in there, we occupy our time a lot into personally, right. And so that’s where a lot of OTS will be into attachment sciences and trauma based care, because that, that understanding of systems and context so we never, ever separate the person from the environment, social, physical, cultural environment, and what they’re doing at that time, you we never just look at a person that’s very medical model to us, right. And we moved away from that when we came about in World War One. So we want to be very holistic, holistic is probably the right word to say for it to look at the person in context. Only.

Nicki Kirlin  11:15

Yeah, fantastic. So that’s the occupation piece. And then there’s the therapy B’s, so how do those pieces get married together?

Louise  11:23

So the therapy piece would be dependent on where you work? Great. So say, because we’re trained in the physical side, and psychosocial, okay, yeah, so we have actually quite a huge psychosocial background. A lot of our models are based in a psychosocial around. And I think we’ll probably get into that a little bit later. So the therapy could look like for somebody that has had a hip replacement, the therapy would be to get them what what, what do they want to be doing? Again, what’s important to them, if they don’t want to go get their groceries, now get your groceries, get it delivered? Yeah. Right, if you don’t want to clean your teeth, and we may need to figure out something else. But what is your, you know, teeth wouldn’t be if you couldn’t like move anymore, because if you help, or whatever the therapy would be working with the mental health side, as well as the physical, and that can look very different depending on So is that a bit broad?

Nicki Kirlin  12:25

No, I don’t think so. I think I think what you’ve provided is, like it’s a, it’s a very accurate description of the two pieces sort of coming together. Yeah. And how they meld together, that it’s a function of sort of two very specific areas that work together to provide a holistic approach to care, right? Yeah, that’s, I think that’s coming across in what you’ve shared, for sure.

Louise  12:48

Yeah. Because, you know, you look at a physio, the physio is going to treat the muscle, the joint, the psychologist is probably going to look at the thoughts, mind or whatever. But what shows up for a person when they have to go home after a hip replacement, and that on their own married, right, what’s going to show up for them a huge amount of anxiety, I’m assuming, and, you know, fear, and, you know, so we work with that as well. But in vivo in the moment, we would be there to support them as they’re doing things that are important.

Jenna Fortinski  13:22

I was just gonna say that, like looking at that, therapy, the word therapy overall, as getting someone to be able to do what it is that they want to do, whether it’s do feel, you know, do physically whatever, right, so it’s always about getting the person to where they want to be. And that’s what therapy is right across the board, whether it’s occupational therapy, physio, therapy, psychology, right? So it’s, it’s all about getting the person to where they want to be. So I think that that’s a beautiful way to kind of capture what we all do in this, you know, we come from different origins, but we’re all you know, towards that same goal of getting people doing what they want to be doing or feeling what they want to be feeling.

Louise  14:07

So you can see how overlap II we get Yes, yeah, definitely. If we get too rigid with not wanting to overlap with somebody else, then we’re being very reductionist. Yes. In our training and our approach. And that’s just my opinion.

Nicki Kirlin  14:22

Yeah, yeah. Yeah, no, absolutely. And I and I think, what’s sort of unique about occupational therapy based on what what we’ve been chatting about is, is that is that it’s almost like you fill that gap, you know, like that gap in care that we usually that we don’t typically think of that when a person does leave after having some sort of major surgery or spirit experiencing some sort of the medical treatment, right, or LS. Yeah, absolutely. And then you kind of come in and you can fill that gap really nicely for that holistic kind of view of care, right. So I think that That’s fantastic. What a great job to have. Yeah.

Jenna Fortinski  15:04

So interesting. Okay, so

Nicki Kirlin  15:06

on that note, then where do OTS usually work? We’ve kind of maybe given the the listeners a few perspectives on where they might be working, but give us give us some different examples of where you might see an OT working. And what can that work look like to?

Louise  15:22

Yep. So I think we’re going to be seeing a lot of OTS, in hospitals in rehab centers in long term care, as well. A lot of private OTS and, and then depending on what area you work in, we can be set, you know, in mental health adult in a hospital, okay. Or we can be adolescent in a hospital in an inpatient or an outpatient. Okay. We can work in schools, I’ve worked in schools before developmental centers. And so did you want some examples? Oh, yes, yeah. So we’ve talked about the one like a hip replacement. Right, right. And that we would be looking to, actually a big part of what we do is called activity analysis. So we kind of break down the task of what they want to do, and figure out what part of the person is it that we want to activate? Okay, how we can adapt the environment to help them. So we’ve, we’ve done the hip replacement type thing. Another example, I guess, is in residential care. So you think of somebody that is just sitting in a chair all day, normally locked to the side, married, no proper positioning their spines out there, they’re not really sitting in a good position to breathe, and eat and you know, just the air all day. And this is this is a person Yeah, right. Yeah. And so how can we adjusted the cheer so that the person can sit in a functional, optimal, optimal functional kind of thing, so they can reach their hand out? So they can interact with a friend and play chess? Yeah, you know, and so we may adapt the cheer, hold them up in some way, and facilitate that game with another person in the residential thing? So they’re getting that kind of leisure side of things. But isn’t that like, what that age group needs? Yeah. occupied, something that’s somewhat meaningful to them. Yeah. engaged in life with another person. Yeah, right. But when they lift in, a lot of other staff members don’t have time, or the knowledge to kind of Prop in know how to position them. Especially if you’ve had a stroke, that specificity and things like that we can we can really adapt the environment to kind of help with that. after a car accident, you could be looking at adapting a car to get them back into physically, but then of course, there’s more than likely going to be some trauma out, you know, on there. So, you know, we kind of, again, looking at, is it meaningful for you to drive? If it is, then we have to do some behavioral activation exposure work, but not always just thrown into it? Right? Like, there’s got to be exposure and relief. So how can we just grade that a little bit? titrate it right. And so that’s, that’s an example with, you know, you’d get funding to work with in that area. Mental Health with adults, that’s, that’s where we get a really into that occupation. Yeah, paid or unpaid work. So we believe that we occupy our time by doing things that we don’t get paid for. Right, right. Yeah. And what is meaningful to you, you want to be engaged with your children? Again, you want to be engaged with your grandchildren again? What is it that you want to play with them? What is it that you want to do? What job? Do you want that? Can you get your groceries, that’s very adult mental health, and then we have our adolescents or children in the schools really reductionistic you’re there just to do a pencil grip or sensory strategy. It’s, you know, the context, of course, and so we can do things. You know, it does get a bit tricky. Under 18. There’s a lot there is a lot of overlap in there. And we don’t want to get boxed into a sensory strategy specialist or something like that. Because it’s, it’s not really what we do. Right? Right. Yeah, it’s

Jenna Fortinski  19:32

a part of what you do, but only a very small part, right? A

Louise  19:36

very small part of a person Yeah, exam, then we don’t separate the full person, right from the environment or the tasks. Yeah. So if you’re doing an assessment, especially in the sensory realm, you’re gonna want to be doing it in a contextual type way because it is one way that we can enable participation in life and the sensory realm can get in the way. Participation in life, but is very contextual. We can’t just throw out strategies. Right? Yeah.

Nicki Kirlin  20:07

It’s interesting because I, in reflecting on what you’re saying, Lou, I hear a lot of the pieces that you’re that are a focus are simple, but they mean so much in a like in the in the broader picture of a person’s overall functioning. Yeah. So I think that the work that that you do is so critical and so essential. It’s pieces that you wouldn’t normally think of in the context of helping somebody heal or on their healing journey. But they’re so critical. It’s so essential. Yeah, so that’s

Jenna Fortinski  20:44

Yeah. And it’s so true to life that and I think this goes across the board, that it’s not until you’re without that you realize how critical it is, right? So it’s not until you’ve been in that car accident, and you’re fearful to even just look at the car that you realize, Oh, I need extra support, or until you’ve had that hip replacement, and I can’t just get up and walk away, like, you know, there’s so many things, I think that we take for granted in a way. And that we don’t really, truly have an appreciation for until we’re without. And I think that’s where, like the value of what Lou does as an occupational therapy really is highlighted is that you help people to live their lives. Yeah. Meaning, right. Yeah, in a meaningful way. Yeah. Being able to do what they want to do. Yeah, right. Yeah, or need to do. And so yes, I think that that’s such a beautiful way of looking at what Lou does for a living. And because I think that it’s very easy, especially in my world, in the psychology world, I think we tend to think of OT, OT says, Yeah, you’re my sensory person. So I just need you to look at this person and figure out the sensory stuff. And that’s why doing this conversation is so important for people to really, truly understand the value of what occupational therapy can bring to somebody’s life.

Louise  22:09

Yeah, yeah, this is awesome. ot in Australia. Yeah. And she made this model, I guess, because she a pediatric co team. like myself, I’ve really only really focused on that, and asked for the sensory stuff all the time. So she made this regulation rocket, that’s what she calls it. So the rocket has all the parts of the person. The self awareness, the executive function, you know, the the sensory piece, there’s the all the, we call them. Personal factors. Yeah. Yeah. And then and the base that the rocket comes off of. That’s the environment. Yes. And if the environment, social, physical, what we’re going through now, yeah, the context, the cultural. Yeah, right now of what is happening with COVID, this is going to make a rocket either take off or like, go up and then fall or, and we’ve got to know we’re, what are you wanting to do? We can’t just randomly regulate, right? Why do you want to regulate? What tasks do you need? And so then we can break it down with our activity analysis to see how we can support you.

Jenna Fortinski  23:15

Yeah, right. Yeah, that’s incredible. It’s fast. It’s really cool.

Nicki Kirlin  23:19

Yeah. So baby, but what a beautiful way to illustrate the connection between those two pieces, right, between the environment and yeah, you know, the person.

Louise  23:29

And the spirituality Yes, of it is at the core of all of our models, right, that spiritual part of the person. And that’s where we really start to overlap with some of this psychology. You know, Dr. Scott Miller is very, you know, from feedback, informed treatment is really into that over evidence based practice. Yeah, we, you know, we have evidence for our models, but we do what the person wants. Exactly, yes.

Nicki Kirlin  23:58

Okay, so we might have touched on this a little bit, but was there anything that you wanted to add around? Who like, who would you usually work with in it like, and I guess that’s such a broad question, because you could be working with anybody who’s who’s ever had any kind of occupational concern, right? So I guess there’s not a specific audience or a target client base that you would work with and really, right. It could be anybody,

Louise  24:24

anybody. person in an environment Yeah, doing something. I can figure out how to help you. If you can, and, and and you become to start to see people in the community and you’re like, oh, if I could only adapt that thing there, they wouldn’t be able to, they would be able to do that without any struggle. And when we we derived out of the out of the war years, that’s when ot came about, Oh, okay. Yeah, out of the moral era, and we wanted to move away from the medical model and there were these like these Soldiers right right they they wanted they were injured but traumatized as well. Yeah, right and OTS were able to witnesses with a basket weaving comes from and all of that though geez we’re able to take them and do something meaningful. So they weren’t sitting around doing nothing and injured with you know, they they’ve been injured. Right and traumatized. So you a lot of OTS really are into the trauma, trauma stuff because we are very well trained in neuroscience. Yeah, right. Yeah. Interesting.

Nicki Kirlin  25:30

Okay, so what would you say then is the most common concern that you have helped people with? Is it more from the physical realm of things or the mental health realm?

Louise  25:42

I think I’ve done both, okay, in pediatrics, okay. And so I really feel more comfortable talking about my, like, the pediatrics. So under 18. And I have worked on the physical side. But the most experience that I have, and the most common thing I get asked for is for self regulation, okay, from a parent for their child, or their team. So trying to find this strategy to help them the other person regulate. And so even the teenager would say, could you give some strategies to the parent, no interest, some ways for the parent to regulate? So always kind of coming back to this, why do you what, like, Where are you getting dysregulated? And how, in what task, right? Because nobody is dysregulated all the time. I know, it may feel that somebody is in the family, but nobody is normally around doing certain things. Interesting. Okay. Yeah. So we do have that understanding of the volitional system as well, which is how, you know, effective you feel like you live your life, and in that system, as well as interests and values. So what is it that you want to regulate for is do you get dysregulated with your friends playing blocks? Or do you get dysregulated? Because you have to do meth or you have to sit in a certain classroom? There has to be a occupation in there. Okay. Yeah, so I get asked for these strategies yet. You can’t really just give them out. So yeah, and I think I mentioned that before because that is the most common thing I’ll get asked. And then secondly, around developmental coordination disorder, which is in the DSM, so I should go back that sensory processing realm is sensory processing disorder is not in the DSM. So people may Google they will see sensory integration therapy, which is trademarked came out in the 1960s you need there’s 800 people in the world that do that. Wow, sensory integration very, very, very specialized. I’m not trained in that but somebody will look on Google and say, okay, sensory integration is what we need this ot to do that so then sensory processing derived out of that about 10 years ago and then one ot said that that she actually wanted it do become instead of the DSM right so made a system of diagnosis Yeah, so then we will have a parent or a teenager saying I have Sensory Processing Disorder This is not evidence based This is not anything that we you know, we don’t treat this diagnosis. We treat the occupation okay. The you know, what, what kind of life do you want? So yeah, really getting that straightened out right from the beginning, so that we don’t start therapy and then have this real misunderstanding, right? of what’s meant to be happening now there is self regulation like kits I guess that’s like the zones of regulation, that mot but you know, when that started, that’s what I would use now all the schools use it. So you know, kids like I hate the zones, you know, because they’ve been because it’s been used as a behavior management rage. Interesting. Yeah. So you have you know, this is about the body’s you know, if you’re in the red zone, you’re normally quite heightened. Okay. Yeah. So your energy is heightened. Blue Zone, you’re more like funky. Low Energy, right?

Jenna Fortinski  29:30


Louise  29:31

it’s in the green. Nobody really, we don’t want you to just be in the green zone. Well, yeah. Yeah. You know, what’s the greens? Yeah. You know, we’re not trying to get back to the green. We want you to function in an occupation or something that you want to do. But we need you to understand that when your energy’s running high, which we need it to run high, when you’re excited or you’re running away from something, we need that part but when you’re running high, you may not fit the environment. So we’re looking for the just straight fit. Always trying to help them learn that we’re not trying to fix people. Yeah, we’re not trying to regulate them. We’re trying to help them monitor themselves over time. So all interventions have to be developmentally appropriate. I would never expect me myself to see a very young one. And now just be able to do this. This is planting a seed. You know, there’s no regulation interoception curriculum is a new one now evidence based FASD. And learning to know your body. This is self awareness. Yeah, to take time, yes, that when you start talking with a young one about their body related to their emotion, and then related to the action, then you’re you’re bringing in a system or a framework or a language for them to understand themselves better. Yeah, so that’s, I’m not sure I’ve rambled on about the, about the people that I’ve Oh, the main concern is,

Jenna Fortinski  31:02

yes, yeah.

Nicki Kirlin  31:04

But I think that a lot of what I’ve heard in what you’re saying is really around that piece. And I think you said it early on around optimal functioning, right? Like, that’s always your end goal is what is that optimal functioning for when you came in via contact? That’s right, absolutely. And their wishes and their goals in what they need in their lives. So it’s very specific, right? So you’re almost like a detective, trying to understand, you know, what’s happening in their environment and in their, in their greater context to ultimately help them function in the best way possible.

Louise  31:33

Right. It’s funny you use that word, because there is there is a lady that I quite I, she did quite a bit of training with her, and she calls it the sensory detective. Oh, interesting. Okay, yeah, she’s very holistic. So she’s saying you can’t go in into a self questionnaire and give random strategies, you have to be a detective in the area, and how does it relate? Yes, that’s exactly what it’s like.

Nicki Kirlin  31:56

That’s, that’s amazing. What interesting work? Yeah, would be right, because it brings you into a whole different sort of experience of your clients life in a general sense, right. And so you get a window into so many different facets of what’s going on for them, which is truly, I think, fascinating. Yeah.

Jenna Fortinski  32:14

One of the things that I picked out from what you were saying, and I think it’s, it’s good to go back and really pointed out is that when people are approaching you with self regulation concerns, to me, it sounds like people are coming to you thinking that it’s spontaneous, the the reactions or whatever that person is experiencing. And so whoever’s asking for the other person to be regulated, it’s the assumption is, is that it’s spontaneous. And that it’s, it’s an isolation, right. And so I think it’s really important to clarify that, again, what’s beautiful about what Lu does is that there’s so many factors and facets that go into what’s happening in that moment. It’s not spontaneous, there’s so many things that are contributing to it. And so that’s what occupational therapy is, is that it looks at each and every one of those little facets that’s contributing to the difficulty in the regulation of self. Right. Yeah,

Louise  33:13

I mean, the executive function is huge. Yeah, I mean, we will say this and concussions hit injuries. Yeah. ADHD, autism. I mean, ADHD is made up of in the DSM is made up of executive function difficulty, right. Right. And and that’s very related to the sensory realm as well. So you if you’re doing like a functional cognition, you’d like a functional assessment is looking at that part of the executive function. Where is that getting in the way? Yeah, right. But the best way to do that assessment is in the person’s environment. Yes. Right. Yes. So that you get, I mean, you’re looking at somebody’s executive function. And then you have them doing a pen and paper, and then you’re saying, Yeah, happens in the world?

Jenna Fortinski  33:59

Yeah. Real World world? Yeah. It’s a tough one. Yeah, yeah.

Louise  34:08

And there’s lots out there about executive function. Now. I think even psychologists are rolling this way. Yeah. Smart. But scattered book. Yeah, that a lot. Speech Language therapy is huge in that, yes. Yeah. They’re doing awesome work.

Nicki Kirlin  34:23

Yeah. So let’s make that bridge there. Then how does ot kind of fit in with counseling? How does counseling fit in with oT? Or what is what is the relationship there between those two functions?

Louise  34:34

I really love this question. And I actually when I thought about it, I thought I’d take myself my bias out. And I wanted to hear from my group, but there’s a group that I’m involved with international one, a lot of the OTS use act and so we have some really good conversations, so throw it out to them. And then I put some of the ones that you know, I agreed with also but where there was a big agreement, I put them into points. Okay. And so it wasn’t coming just from my perspective. Okay. Right. So the first point was that they felt the wording was backwards. Yeah. They said, Have you have you? Have you written that wrong? Have you got that muddled up?

Nicki Kirlin  35:19

In terms of saying that? How does counseling fit in with oT? Yeah.

Louise  35:23

So overwhelmingly, which people were saying around the world that were trained in counseling skills, and therefore it’s OT, it’s the counseling fitting into County, and that we have them available for us within our practice. And so I asked them, What are the areas that counseling skills and what else and they said, well, counseling, skills, adaptation, so that we can adapt their physical or help with the social environment exposure. Coaching is another realm of skills that we’ve kind of have in there, and that always use those to promote function. So that’s, that’s where said we’re doing it to promote occupation to not symptom reduction. Right. Okay. Yeah. Although symptom reduction, we feel similar to act acceptance and Commitment Therapy, that when we are engaged in a meaningful life, if we can get rid of these symptoms, like chronic pain, you know, then then we’re living a life of meaning. Yes, so that that was overwhelmingly answered. Yeah. Another one was that about the psychosocial base that we have? Do these people not know that we’re trained in the sacred? So? Yeah, and so a lot of our frames of references for very similar so we have one that I’m one of my favorites is the intentional relationship model. And that’s out of moho, which is my favorite kind of part of OT, and then it includes the term therapeutic use of self. Okay. And so what this literature says is a practitioners planned use of his or her personality, insights, perceptions and judgments as part of the therapeutic process. Oh, interesting. Yes. Similar to Yeah. Similar to Scott Miller’s work. Yeah, all of that. Absolutely. And so we seven modes, people were talking about advocating collaborating, empathizing, encouraging, instructing, problem solving, motivational interviewing, they were kind of the core ones that we were trained in. And then I went even deeper, and I was like, but what about the techniques? What are you guys trained in? Because I have my books. I’m trained in New Zealand, what about other people? These were, what came out, active listening, the use of silence, demonstrating empathy, instilling hope, and the use of humor in touch, if appropriate, if appropriate, of course. Interesting. Yeah. So we feel like we had these core competencies in our training, which is bio psychosocial because of the, you know, that that extra part? And so yeah, they really felt strongly that counseling fits into ot. Yeah,

Jenna Fortinski  38:26

just saying. That’s it. And it’s so true, right? Like, it’s absolutely true. Because, like we said at the beginning, you guys look at everything. Psychologists look at one component. And, and I think that’s where ot hasn’t gained enough. Like, it hasn’t been given enough. Yeah, recognition. Yeah, I was gonna say cloud, I don’t know what word to give it, right? Because you guys do look at the whole environment. And I think as psychologists, we’re very restricted, and, and I think it doesn’t give the same justice that you guys do. Not to say that, like, psychology isn’t a good option. It’s just that if people only knew what more occupational therapy could offer, especially for people who have real limitations in what they’re doing, yes, what they’re trying to do, right.

Louise  39:25

And we know when we just stay Yeah, we nothing Yes, right. We don’t feel right. Yeah,

Jenna Fortinski  39:31

yeah. And there is so much connected like the bio psychosocial model, of course, like, our thoughts are connected to our body and we know that there are impacts on our body with how we feel and how it impacts our body. So there’s so much that’s interconnected. And I do agree with those sentiments of all the other OTS that you know, counseling fits in to ot right I don’t think it’s the other way around. And I agree with od because we are very limited in what we look at when we Look at a person, right? So yeah.

Nicki Kirlin  40:02

And what I hear too is what a beautiful opportunity for collaboration as well. Absolutely. Right. And a counselor or psychologist to be working together. Yeah. You know, collaboratively for a client is like the opportunity that’s available there for a person to feel better is and is amazing.

Louise  40:20

Yeah. So yeah, I love working with the psychologist tandem Ryan, because we have a different, different lens. I don’t like to stay in assessment roles. I like to stay in intervention roles, right? I like to do more than paperwork. And I just don’t want to be reductionist. Yeah, what I, you know, I did all the schooling, I’ve done extra training. And so you will find it is kind of delving in, you know, CBT, and especially act because, you know, functional contextualism is the core or the base of the person and context. Yeah, internal altoon. It’s same as us. Yeah.

Nicki Kirlin  41:05

Yeah, so interesting. Yeah. Okay, so what is your favorite part about what you do about your work?

Louise  41:13

The flexibility and the options, right? So, in the past 20 years, I’ve worked with all sorts of children, but in developmental like zero to two, you know, I can do that. And not really my thing, but so glad I knew it. Yeah. And then I can go work in a school that’s with somebody that they may want sensory strategies for, but they have cerebral palsy. So you can kind of move around case management, you can do inpatient, outpatient, I’ve kind of done it all. But I’m settled now. Right? Yeah. So the flexibility and the option options are really,

Nicki Kirlin  41:48

there’s never a dull moment, ya know, and always got something new and different to

Louise  41:53

work through. Yeah, it’s like, you know, if you’ve, you’ve met one it and talk to them about their career, you’ve really just met one.

Jenna Fortinski  42:01

Yeah. Right.

Louise  42:02

their career? Absolutely. Because it’s so diverse. Yeah.

Nicki Kirlin  42:07

So what is one thing that you wish people knew about your work?

Louise  42:12

I think I think I’ve kind of covered that. I think going back to the sensory stuff, okay. Yeah, in the occupation stuff. So that when when people ask for something sensory, you’re not asking for me to do a questionnaire? Yeah, sensory profile is a questionnaire from the 90s. You got to understand that I want to know more what’s what what’s going on for that person? Where we may use some sensory strategies. So what is the the occupational disruption? Yeah, kind of what are they stuffing doing? So of course, I mean, with children, their job is to play, go to school, interact with their peers, so you’re going to get a lot of interpersonal stuff is a lot of social skills, kind of type. Things that are dudes would be taught to do, and interpersonal things, because you’re working with that age group. So.

Nicki Kirlin  43:03

Okay, so then I guess just one question that I have that’s more relevant to kind of what we’re facing right now as an across the globe. What are you seeing is sort of the most common impacts or concerns that are related to our experience of living in this time of COVID? How is it impacting your clients?

Louise  43:26

Definitely in the area of what we call occupational d? d? privation?

Jenna Fortinski  43:32

deprivation? Yeah, right.

Louise  43:34

That would be Yep. So so they’re not so the teenagers are not able to do what they’re meant to be doing. And they’re not occupying their time in meaningful ways anymore. They can’t see the most meaningful thing for a teenager is to connect with their peer group most of the time, or to be connected in some way, even if it’s over social media, right? But then when you’re not having that in person interaction, it’s really affecting them that way. And just not really, you know, they rely a lot on their peer group as well for who they are their identity. So suddenly, they’re not with them, or they see on social media. Oh, look, they were allowed out. I wasn’t allowed. Interesting, and getting all muddled up with their sleep. Yeah, right. Not not engaging in new things. Because Well, I don’t want to do school right now. And I can’t go anywhere and see, you know, they’ve lost lost set creativity of how to spend their time in meaningful ways. And I see, yeah,

Nicki Kirlin  44:40

so what’s been your main piece of advice, or help or help in clients that have those concerns? What How have you been helping them through that?

Louise  44:49

I think really going to their value system. So we’re going back to that volitional part of our models, right? Like what what do you really want to do right? Now and how can we create that here? Yeah, so So how can we be creative? So that creativity of how do we help them engage and participate in things? Different things? How can I explore different parts of themselves? Right? Yeah, yeah,

Nicki Kirlin  45:15

that’s fantastic advice.

Jenna Fortinski  45:18

I think, Oh, my God, Lou, you are unbelievable, you’re fascinating, what you do is fascinating, you bring immense, immense value to the team here at simply counseling, I just, I cannot sing your praises enough. I feel so grateful and honored that you’re part of my team. And, and that you were able to work with you and consult with you, it’s, it’s such a gift. And, you know, just doing this podcast and getting the word out there about what you do, and how important what you do is for people and for people to know that the the option is there to access support with somebody like yourself, and that, you know, occupational therapy is, you know, just as valuable, if not more than psychology services. And I think, you know, we really need to sing that from the rooftops, because I think it’s important for people to know how how valuable occupational therapy can be in their lives. So thank you.

Nicki Kirlin  46:18

So how does a person find out about getting support from? Yes,

Jenna Fortinski  46:22

so if you would like to get some support from Lou, which, in fact, actually, some extended health care plans actually cover which is great for Occupational Therapy, which is so good, and thankfully, the benefits companies are coming along with that stuff. So please visit the simply Counseling Services website, simply counseling, services.com. And Lou’s got a profile on there, you can book with her online if you’d like to book a first appointment, or feel free to fill out a contact form and we can get back to you and get you in to see her. She’s amazing at what she does, if you haven’t realized it already yet.

Nicki Kirlin  47:01

Thank you so much, Lou, for your honest answers. Yes. And you’re sharing your experiences and your wisdom and your knowledge. It’s been a fantastic chat.

Jenna Fortinski  47:11

Yes, I really enjoyed it. Thanks, you guys. Thank you. Before we before we end, we have to ask Lou Yes. For her quote. So we end every episode with a quote. So Lou, if you could share with us what quote you have chosen? Well,

Louise  47:27

I thought because I’m studying with psychology. And that I would find a quote that fits for both OT and psychology. However, this is from Dr. Steven Hayes, who is a psychologist, one of the founders of acceptance and Commitment Therapy act. And so without going into too much detail, it’s pretty simple. I love that you’re ready. We hurt we we care and care where we hurt. And so it’s flipside of the same coin. If we are going to engage in a meaningful life, there is going to be some type of pain or discomfort there. discomfort is the pathway to a meaningful life. Yes, nothing comes without that. So I like that. It’s the flip side of the same coin.

Jenna Fortinski  48:26

Yeah. Excellent. Thank you.