Getting Your Strength Back: Two Occupational Therapists Share Expertise on Treatment Modalities, Keeping Patients Motivated, and How Covid-19 has Affected the Practice.
“One of the most rewarding parts of OT is the satisfaction and pride that we see on the face of the child or adult when they achieve a milestone/goal that they have been working towards. Sometimes it can even be a skill that they had and have lost and when they regain it, that sense of accomplishment is the ultimate reward.” Today’s woman dreamers, Mubaraka Rupawalla and Asma Lacewala, from Texas and Florida respectively, are occupational therapists with a passion for helping their patients build their strength back. They share their expertise on treatment modalities, the most rewarding part of their jobs, how they keep patients motivated during life’s greatest challenges, and how Covid-19 has affected the world of occupational therapy.
Tell us both of your stories and career/personal journeys.
Mubaraka: I graduated in November 1994 and moved to the US after working in Bombay for 9 months in December 1995. I started working in the USA, and then moved to the UK due to a relocation of my husband’s job, and enjoyed working in Oxford and Cambridge with the NHS system- a socialist system of healthcare. I have worked in multiple different settings and locations in acute care and rehabilitation with adult, outpatient pediatric clinics and school systems and currently working in the early childhood program in Houston Texas which is my true calling. I am also a certified pediatric yoga instructor and have held classes for children as well as taught family yoga. I love to work with babies and to educate parents how to play with their babies through my work and to teach family yoga . I am married with 2 sons and am lucky as we all share a passion for travel, (due to living in several countries) also for hiking and the ocean and am a certified scuba diver.
Asma: I have been a practicing Occupational therapist since 1994. I started my career working with children in KEM hospital in Bombay. In November 1995 I got a job in a Rehabilitation hospital in Boca Raton, FL, along with my best friend Mubaraka. We both came to Florida in November 1995. I worked with traumatic Brain Injury and Spinal Cord injury for 7 years, during which I met my husband, got married and started my family. After that I worked in skilled nursing, acute care and Pediatric outpatient. When my son started school I made a big career move and became an Occupational Therapist for the school system. I absolutely love the school system and have continued with it for 13 years. I am also a certified pediatric Yoga instructor and love to work with children and their families. I live in Fort Lauderdale, FL with my husband and two children. My career has brought me to where I am today, and I couldn’t be more happy with my choice to pursue it.
Tell us your backgrounds and what made you choose Occupational Therapy (OT)?
Mubaraka- In school we had a field trip to a little village where we interacted with a few kids and our role was educating them. However one of them had a genetic disorder that really drew my interest and fostered a thirst for working for people, especially children and with developmentally challenged children or mentally challenged adults. Occupational therapy was a healthcare major that gave me that opportunity and also gave me the opportunity to travel out of India and see the other side of the world.
Asma- Growing up, I had a neighbor who had Down’s syndrome and was the same age as me. We played together when we were little but when it came time to start school, he was not able to attend the same school as the rest of his friends due to his disability. I saw how he wanted to be included in the same schools as all his friends and it made me think that if our education system had some accommodations for children with disabilities he would be so much happier. This made me want to take up a career that would make a difference for children with disabilities, and a career in healthcare was a good match. I also wanted to be able to work outside India for a few years and Occupational Therapy was in big demand in and outside India.
What is the most rewarding part of the job? Was there a particular moment where you felt the difference you were making for your patients?
One of the most rewarding parts of OT is the satisfaction and pride that we see on the face of the child or adult when they achieve a milestone/goal that they have been working towards. Sometimes it can even be a skill that they had and have lost and when they regain it, that sense of accomplishment is the ultimate reward.
Mubaraka- It’s hard to pinpoint a special moment as my long and very rewarding career is filled with many special moments, however just recently we had a small graduation party for one of my babies (client) who has been in my therapy since she was 4 months old and now turned 3 years hence graduating from our program. The parents were so grateful for my services and knew that without the therapy she has received for the last 3 years she would not be as independent as she was and now she no longer needs the special education services at schools and can go for regular education classes.
Asma- Over my 25 years as an Occupational Therapist here there have been several moments where I have felt that I made a big difference in the lives of the patient and their families. One moment that I particularly remember is when an adolescent patient of mine, who had been in coma from a gunshot wound, and we had been doing Coma Stimulation for 3 months, actually just blinked his eyes for “Yes”, to let us know he was able to hear us. The tears of joy in his mother’s eyes and the sense of accomplishment that we felt, made me feel that this was all so worthwhile.
Please tell our audience what therapies, modalities, conditions and age groups do you treat as OTs?
We work with all ages starting from birth via early childhood intervention (which is the program Mubaraka works in), children from Pre K to High School in schools systems (which Asma works in). We both started our career in an Acute Rehab facility working with adults and geriatrics with orthopedic and neurological injuries.
We have worked in hospitals, rehabilitation facilities and long term care. In outpatient clinics with orthopedics, sports medicine, hand clinics, and also in certain work environments providing ergonomic modifications. Occupational Therapists also work in psychiatric units and drug rehabilitation.
The treatment modalities used by occupational therapists are neurodevelopmental interventions, sensory integration, therapeutic listening, interactive metronome, vestibular rehabilitation, kinesio-taping, splinting, and electrical stimulation.
What are some challenges you encounter in your practices and how do you overcome them?
Some of the present day challenges are similar to what most healthcare workers face and that is when a client has to stop therapy due to insurance reasons and we can no longer see them due to reimbursement issues.
Another challenge is keeping the client motivated to have them practice therapy strategies and exercises to see a positive change/improvement as sometimes it can take a longer time and clients may expect a miraculous cure or lack patience.
In these cases an extensive home program that will help the client to keep practicing helps. Sometimes writing a letter of necessity to insurances or offering self pay at reduced rates may help.
How do you keep patients motivated and positive on rough days/rough patches?
One of the main ways to keep clients motivated is using strategies and techniques that will interest them, provide relief of pain and are easy and enjoyable. For example while treating children we incorporate play and for adults we make it meaningful based on their occupation and daily lifestyle.
Being a good listener and being empathetic to their concerns has always been a very important part in gaining client trust and keeping them positive on rough days.
OT is a very hands-on and personalized field. How has Covid changed the practice?
One of the main challenges with Covid is the limited resources including the time that parents have to be a part of therapy during the video sessions to make therapy more effective. Lack of resources in the homes and limited ability to provide hand on therapy. Covid has encouraged us to do more family education, teaching parents to be more hands on while we observe and give instructions/feedback.
What are some tips that you have for parents who children are undergoing OT? What can they do to keep their kids encouraged and help them make progress at home?
Tips for parents who may need Occupational therapy for their children for a long time is to have faith in the therapist, make him/her a part of the essential team who is looking for the best solutions for the child. To follow through with the exercise and strategies. Therapy is not a quick fix, it takes many months and sometimes years to reach the goal you want for the child. Most of the time it is multiple repetitions of the same exercise or routine however you make it fun by incorporating humor, play, change of scenery/location for example a therapy session in a park, or a community outing. To always work with your therapist so that fatigue and boredom does not set in. Therapy should always be creative, fun, playful and the results will be rewarding when done consistently.
As #Dreamcatchers, we have to ask, what is your next big dream?
It would be our dream to be able to use our knowledge and skills to provide therapy to children in developing countries where our services are not commonly available. To be able to educate their families on early intervention and provide them with interventions that they can use to help children with developmental disorders or cognitive impairments. Every child deserves an opportunity to maximize their potential and as Occupational Therapists we train them with ”The Skills for the Job of Living.”