Reflection on Occupation-Based Practice

Learning to utilize occupation-based practice in everyday interventions has been one of

the most rewarding aspects of attending graduate school at TUN. The power of meaningful
occupations as an end and as a means is quite striking, and I am happy that I have attended a
program where occupation-based practice is strongly encouraged. When I first began the
program, it was really difficult for me to imagine how to take an occupation and make it
therapeutic. How do I create the just-right challenge? How do I appropriately grade activities
or choose which one is the best focus of treatment? And how do I establish preparatory or
purposeful activities which will help me reach eventual occupation-based goals? All of these
questions really challenged me in the beginning. I had to learn how to gather an occupational
profile, complete activity analyses to identify barriers to participation, and plan appropriately
graded activities to promote success while still challenging the client. Even after having a lot of
practice doing these things on paper and during classroom labs, I still did not realize that it
would be much harder to complete real-world evaluations, goal-planning, and interventions.
During fieldwork, I tended to struggle with devising creative ways to tackle basic
problems, and I had a hard time brainstorming how to target specific deficits using meaningful
and engaging occupations. Thankfully, I had a great fieldwork educator (FE) who really helped
me to understand how to identify specific barriers and then devise client-centered interventions
to address them. She helped me learn to tease out interests while expanding the occupational
profile during the evaluation process. She also helped me think of creative ways to address
various disabilities (i.e. talking to a patient who has little awareness of his deficits status post
brain injury about sports and current events in order to target memory, sequencing, problemsolving, and other higher cognitive skills). I was also able to begin better taking into account the

effects of the environment, social contexts, and developmental implications while planning
interventions for patients. By the end of my first level II placement, I was much more
comfortable and confident trying new things if I thought they might be meaningful and engaging
for my clients. I look forward to completing my second level II fieldwork placement in
outpatient pediatrics, as I believe building occupation-based practice into play will align closely
with my previous work in child life and will allow me to continue learning and growing as an
occupationally-based practitioner.