U is for…

Understanding

Today’s post relates to occupational therapy, creative writing and life in general.

To understand: To perceive the meaning or explanation of, grasp the idea of, or comprehend: to be thoroughly acquainted with or familiar with.

(Polatajko 2010, p. 59)

For me, when I was practicing, the most important meeting I had with my clients was the first one. The one where I completed the initial interview, found out what the reason for referral was and what the difficulties for that client were, and also, most importantly, what they wanted to achieve. When first seeing a client I would allow plenty of time for this, time to get to know them. I would often “only” see two new clients in a day (working in a community setting seeing people in their own homes). Now when you have to fill in stats for how many clients you see and when these are compared with the stats of other professions this can possibly look a little lax. I have heard students commenting on facing the same challenge, and believe me it is a challenge. We don’t have unlimited time, budget or resources, sometimes we can cut client meetings a little shorter but do we then really get to understand them or their needs?

Take for example a time when you have had to complain to someone about something. When were you satisfied that the person dealing with your issue understood what it was? Was it when they went, ‘yeah, yeah, have your refund.’ or when the person listened to what you had to say and reflected it back to you. Even if the outcome of the latter wasn’t what you desired I reckon most of us would still consider that to be the more positive outcome.

So why does it take an occupational therapist so much time to understand their clients?

Because we are dealing with their occupations, the things that they do everyday and the activities that form their identity. Polatajko (2010, p.58) suggests that:

Constructing an understanding of occupation requires a careful examination of the doing, the doer, the context or situation in which the occupation is found, and the relationships among these elements.

Could you do this in 30 minutes? Can you even do it in 2 hours (the average length of my first meetings)?

You need to understand a person on their own terms, understanding about their past and present, about their beliefs, values, culture, religion, family, etc. etc.

One thing about social media that has been really interesting for me has been communicating with my friends using facebook, twitter and more recently blogging. The latter has been a revelation and reading my friends’ blogs (their stories) has really helped me understand them a little better. People write about things we don’t talk about. I have suggested to students that blogs can be useful sources of information for understanding the impact of a particular health or social condition on a client. On Twitter at the moment there is a hashtag discussion on the use of social media (generally) in the NHS, #nhssm. Why not check it out.

Understanding a client’s narrative is an important part of clinical reasoning (Boyt Schell and Schell, 2010). I think it helps us connect to our clients by forming trust, they trust that we know them and we can trust that we are providing the best intervention for their needs and in their best interests.

In creative writing I think it is just as important that we get to know and understand our characters. A number of writers create detailed character sheets identifying a whole host of characteristics that may never make it into a completed story. They do this to understand the psyche of their character, to know how they would respond in different situations, what another character’s words might make them feel, what choices they would make when faced with the challenges we throw at them. I have just ordered a Kindle copy of Psychology for Screenwriters: Building the Conflict in Your Script(sponsored link) which I hope will help with my character creation.

Returning to the example I gave earlier of you getting someone to address your complaint, if you knew that the person saying, ‘yeah, yeah, have your refund’ had just been made redundant does that make their reaction anymore understandable?

How often do you spend time listening to people, getting to know your characters, reflecting on why people react or live in the way they do? What insights has this given you?

Thanks for reading

References

Boyt Schell, B.A., Schell, J.W. 2008. Clinical and Professional Reasoning in Occupational Therapy. Philadelphia: Wolters Kluwer/Lippincott, Williams & Wilkins.

Polatajko, H.J. 2010. The Study of Occupation. In: Christiansen, C.H., Townsend, E.A., 2010. Introduction to Occupation: The Art and Science of Living, 2nd ed. New Jersey: Pearson, 57-79.

(I have a feeling that a closer read of this chapter will be very useful to my PhD)