In this two part interview, I talked with Rob Ferguson, an occupational therapist in the University of Michigan Health System whose practice involves the use of virtual contexts, virtual reality, gaming, and other computer technologies to help clients reach their occupational goals.
In this episode, I interviewed Dr. Kate Eglseder, an OT with 20+ years experience with SCI rehabilitation. In this episode, she shares what she’s learned through her clinical practice and research with partners of people with SCI.
If you haven’t listened to the episode, find OT Uncorked on your favorite podcast player and take a listen. In this 30 minute conversation, Kate talks about the role of OT in giving clients and their partners permission to ask questions and explore what sexuality and intimacy looks like after injury. While Kate’s experience is with the SCI community, the ideas she gives apply to any client we serve in any population.
One major take-away is that addressing these issues is well within our scope of practice. If you have your OTPF sitting on your desk like I do, take a glance at the tables detailing occupations, client factors, performance skills, and contexts and environments through the lens of sexuality, sexual activity, relationships, and intimacy. I challenge you to see how many of these skills/categories relate! I bet you’ll notice, just as I did, the many ways we can support people’s participation in relationships and expression of sexuality.
Kate and I briefly mentioned the PLISSIT model, which is frequently mentioned in research and practice across many disciplines as a way of approaching sexuality. The original 1976 article is linked above, but I outline the model here, too.
The main idea is to initiate a channel of communication, giving clients Permission to talk about sexuality, intimacy, sexual activity, etc. As OT practitioners, whether comfortable or experienced with talking about the nitty gritty of people’s sexual participation or not, we can easily give permission. When I worked in an inpatient facility, I would introduce myself, then give a brief summary of what occupational therapy is and why, in broad terms, they were referred to us. Sometimes, it sounded something along the lines of:
“As an occupational therapist, I care about how you occupied your time before you came into the hospital, and how you’ll occupy your time after you leave. I want you to feel prepared to do what you need and want to do, even with the new challenges you’re experiencing. During therapy, we will address self-care, hobbies, home maintenance, employment, school, sexuality, sleep, and what ever else is important for you to return to…”
My current introduction is not perfect, and certainly doesn’t capture the full breadth of occupational therapy, but for now, it gives me the opportunity to tell them a little bit about why I’m coming into their room, and, I hope, conveys my true hope to help them engage in meaningful occupations. Additionally, I have seen faces perk up when I mention sexuality in my list of what we can address in therapy, and more importantly, I have heard people voice their previously secret concerns to me regarding their relationships and sexuality after injury. This first part of the PLISSIT model is so important and is truly something any OT working with an adult population (or parents of younger individuals for whom this may become a topic of concern in the future) can do without any further education.
The next part of the PLISSIT model, Limited Information requires only basic knowledge of how a diagnosis or health status may affect sexuality. This can include topics of self-image, self-esteem, social and community participation, reproductive function, communication, bladder and bowel care, dressing, child rearing, religion and spirituality, sleep and rest, problem-solving, or self-advocacy, to name only a few. When sharing Limited Information, the idea is to plant the seed. I have found this helpful when working with people who have no idea what questions to even begin to ask.
Offering Specific Suggestions does not require you to have a degree in sexology – it can simply involve applying what you already know about occupation, body systems, social participation, positioning, routines, etc. Our expertise applies to all occupations and performance – you know more than you think you know about sexuality and intimacy! Don’t know how to answer a client’s questions? That’s ok. You as an OT have access to a myriad of resources that you are well-trained to navigate and synthesize, and can bring your findings back to your patient. Beyond the information you provide, your clients will appreciate your honesty about what you know and what you are still learning.
Finally, Intensive Therapy rounds out the PLISSIT model, and refers to more intensive, expert approaches. As with Specific Suggestions, if you are not an expert in sexuality and intimacy, that’s ok! You have access to other professionals who may be more prepared to address the specific questions or concerns. Most OT practitioners I know are great at connecting people, so use those skills and help bridge gaps in clients’ experiences by working as a team.
Regardless of your current role as a practitioner, I hope this episode has helped you realize how prepared you are as an OT or OTA to be part of a team that supports client sexuality.
Check out the list of resources below, including an article that Kate and I published together!
2017 Ménage à Trois, California Red Blend
Resources mentioned in this episode:
Eglseder, K. (2017). The lived experiences and occupations of intimate partners of individuals with spinal cord injury related to sexuality – abstract. American Journal of Occupational Therapy, 71, 1.
Eglseder, K. (2016). Addressing sexuality in the clinic: Simple steps for practitioners. OT Practice, 21(17), 21-23.
Eglseder, K., & Demchick, B. (2017). Sexuality and spinal cord injury. The lived experiences of intimate partners. Occupational Therapy Journal of Research, 1-7.
Annon J. (1976). The PLISSIT model: A proposed conceptual scheme for the behavioural treatment of sexual problems. Journal of Sex Education and Therapy, 2, 1-15.
Taylor, B., Davis, S. (2007). The extended PLISSIT model for addressing the sexual wellbeing of individuals with an acquired disability or chronic illness. Sex and Disability, 25, 135–139.
Eglseder, K., Webb, S., & Rennie, M. (2018). Sexual functioning in occupational therapy education: A survey of programs,” The Open Journal of Occupational Therapy, 6(3). https://doi.org/10.15453/2168-6408.1446
Please add to the conversation by commenting below.
The opioid epidemic is a crisis affecting people of all ages, races, and wealth. How do we as OTs respond to the urgent need we see around us? In this episode, you’ll meet Dr. Jenna Yeager, an OT who is working to equip OTs with the skills and tools they need to treat our clients holistically in light of this epidemic.
In this episode, Jenna talks about her role on the AOTA Ad Hoc Committee on Opioid Drug Abuse, which created this report to present to the Representative Assembly regarding next steps for our profession regarding this issue.
Interested in learning more about pain management? Start here! Earn CEUs by reading this article, Opioid Guidelines and Their Implications for Occupational Therapy, published by AOTA and take the exam at the bottom.
Jenna references an article written by colleague Donna Costa, entitled “Occupational Therapy’s Role in Countering Opioid Addiction,” which can be found in the January 2017 issue of OT Practice
I also recommend Ashely Uyeshiro Simon and Chantelle Collins’ article in AJOT from May 2017 about a Lifestyle Redesign® program for chronic pain management. If you are unfamiliar with the Lifestyle Redesign® process, I HIGHLY recommend you check it out here. The result of research at USC, Lifestyle Redesign® is just about as OT as it gets – it promotes healthy habits and routines for the management of chronic conditions. Extensive research has been done to apply this process to a range of populations, including people with chronic pain.
As always, CommuOT is a fabulous resource for OTs and OTAs to share ideas and resources. This post from October 2018 highlights features of the SUPPORT act, and how it affects OT’s role in pain management.
Do you have experience with the treatment of chronic pain or opioid abuse? Please join the conversation by commenting below.
In the FIRST episode of OT Uncorked, I met with Dr. Amy Lamb, president of the American Occupational Therapy Association.
When we recorded the episode, Amy had just delivered her Farewell Address as President of AOTA at the 2019 AOTA Annual Conference and Expo in New Orleans, Louisiana. After taking photos with her adoring fans, Amy and I met backstage in her green room over a glass of champagne.
I may have brought cheap champagne and scoured the convention center for glasses, only to find waxy paper cups to drink from, but that didn’t stop Amy and I from toasting to our fellow OTs, and to her dedicated volunteer work as President these past 3 years.
In this episode, we kicked off the official launch of OT Uncorked by having some fun. Over the years, Amy Lamb has shared her vision for the OT profession and worked tirelessly to advocate for positive change for OTs, OTAs, and the people we serve. We have heard her speak at conferences, watched videos in which she shares updates with members of AOTA, and read her letters and posts regarding policy and other updates relevant to our practice. You may know Amy through her work as president of AOTA, but how well do you the woman behind the title?
Spoiler alert: After listening to this episode, you’ll want to sit down for a glass of wine with Amy, too!!
In the episode, Amy and I talk about all the mostimportant topics – like Karaoke, journaling, and Harry Potter, to name a few… Sitting just a few feet away from us, Amy’s husband, son, daughter, and extended family listened in on our recording – a real studio audience! They shared laughs with us and their faces were beaming with pride, because behind every great leader is a tribe of people filling her up, so she can pour over into the lives of all she serves.
Thank you, Amy, for your many years of service to AOTA!
Visit your favorite Podcast app to find this episode and all OT Uncorked episodes
Spotify | Apple Podcasts | Stitcher | Overcast | Podbean | Google Play Music
If you weren’t at the 2019 AOTA Conference and Expo in New Orleans, you can still listen to Amy’s powerful Farewell Address, along with the other main stage addresses, by logging onto AOTA.
In Episode 2 of OT Uncorked, I met with Lauren Sheehan from NeuroLutions at the 2019 AOTA Annual Conference and Expo to talk about the role of OT in the rehab tech industry. Lauren has worked for 2 start ups during her career and is an example of how OTs can make a seat for themselves at the table in tech companies producing rehabilitation technologies.
We recorded this episode [in a very loud convention hall] after a Tech Lab about brain-computer interface technology that promotes closed-loop motor learning. If you think that’s a lot of techy sounding words, you’re not wrong. I made this diagram to show you one example of a BCI that can be used by OTs to help clients whose upper limb function is affected by a neurologic condition, like stroke:
Rehabilitation technologies using these closed feedback loops are being produced by companies all over the world, but many of them don’t have an OT on the design, research, or implementation teams! [gasp]
Listen to Episode 2 to find out how Lauren got involved in the rehab technology start up scene and what role we can play as OTs in influencing the creation of these tools!