Jammin’ OT

Jammin’ OT

My life has a continuous soundtrack. I listen and move to music as often as possible, all day long, and I select it with care. Time to energize and focus? Maybe Steely Dan or Tom Petty. Need to get centered and calm down? Al Green or Carly Simon. Want to really pump it up? B-52s! Aretha! From this, you probably can guess my age and musical type. Let’s just say that I was born into a household that always included at least one teenager, Elvis was #1 on the charts all my first year of life, and it just went on from there.

My husband has played jazz on the stereo all our lives together, and I have always liked it. But when I went and saw Stanley Clark actually make his music, everything changed… I was enchanted! Watching how he produced such an amazing array of notes and percussive rhythms with just his hands on a big bass was enthralling. Stanley’s movements and facial expressions brought the sounds to life. What I had taken for granted as I listened to a CD, I could fully appreciate as I saw how this incredible music was made: by one emotionally engaged, skillful musician.

I now enjoy lots of jazz, and as I watch and listen, I appreciate each musician’s amazing skills. They are so comfortable with their instruments and totally in the moment with their music. There is no separation between person and instrument. They approach their well-practiced songs with confident familiarity, and then they initiate variations that seem to sometimes surprise even themselves. A well-worn piece can suddenly take on a whole new sound, or one of the players heads off into a solo that completely retranslates the song, then comes back into the fold for some reassuring restructuring, back to the familiar song we know and love.

A great OT session can be a lot like jazz. It can start off simple and mundane: Shall we work on getting dressed today? Are you ready to complete that job application? Time to practice writing. But as the session progresses, so may its complexity, tempo and tune.

Jam #1: Working on a task that my client hates. We start talking about how the day or week has gone. My client shares anticipation of an upcoming birthday… great! (right?) or maybe not so great… we are talking about the meaning of this milestone, worries about celebrating alone, or what it’s like to turn 7 or 27 or 77. What you hoped to have accomplished by now. The session’s beat gets slower and heavier. I reflect back with empathy. This approach is well received, and the beat picks up a bit. I share an idea for some just-right way to celebrate, and we head into a brisk and up-tempo. Fun and exciting… now to weave in the core task, while using this newfound energy to fuel it!

Jam #2: I have a co-therapist in the session. Our clients seem bored and disengaged. My partner and I make eye contact. She arches her eyebrows and I nod. She pulls up a karaoke app on her iPad and tunes up a song they love. I hand one of the clients a paper towel tube and say, “Sing it, Ruthie!”. We have turned this boring session into a karaoke party. Getting up and moving is less of a problem now, and coming to OT will be less of a chore next time!

Jam #3: My typically exuberant client looks very down today. Things have tanked physically, emotionally, or socially. Suddenly the tempo drops down to a slow beat. No panic… just a different song than what I expected. Time to gently ask, then wait and listen. Client takes the lead. My tasks must wait. This is an investment session, where the usual goals must go on the back burner while we solidify the therapeutic relationship. Next time we’ll go for a hard-driving jam.

Every session can be a beautiful song, if you follow your clients’ lead, improvise as needed, and stay loose.



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