Collected thoughts on narrative in occupational therapy documentation


About ten years or so ago I wrote about the potential power of using writing and hypertext as a qualitative methodology for understanding human narrative.  I got that idea back in high school, actually, after reading the Langston Hughes poem, Theme for English B:

The instructor said,

      Go home and write
      a page tonight.
      And let that page come out of you—
      Then, it will be true.

I wonder if it’s that simple?...

The poem is all about identity, and expression, and trying to understand point of view.  I struggle with this concept of documentation as representation of life.  Can documentation represent life, really?  I think it can when I read Langston Hughes, but when I focus in on a short essays like in the Humans of New York series I can't read more than one or two of them.

I object to them, mostly, because when I read them I feel like someone is distilling a life into an evocative photo and 60 seconds worth of reading.  It is just too neatly packaged.  The impression that I believe the reader is supposed to be left with is one of a point of understanding.  Instead, I am left with the idea that someone's life has just been Facebooked into farcical representation of actual reality.

I don't know if 'Facebooked' is an actual term.  I just made it up.

What is worse, the distillation, or reading the distillation and believing that it is real?

I believe that people's lives are messy or complicated, full of commas and ellipses and misspellings and confusion and misplaced modifiers.  How can we represent or understand reality in a tightly controlled text box read by a disconnected set of eyeballs?

I try not to be guilty of the same thing here, but it might be misconstrued because I also write clinical vignettes.  When I write my stories here, I am not attempting to encapsulate the life of the people I am writing about.  I am attempting to encapsulate how that intersection impacted me.  It is selfish expression, to be certain.  I try to use it for good though.  The whole idea is to find ways to understand what I am trying to accomplish for other people.

The problem with my writing here now is that some ideas are spread out over a ten+ year span.  I think there is a lot more to it than all this, but I wanted to collect some of the thought I had on this in one spot for future reference.

Writing as occupation

Destruction and deconstruction of occupational therapy documentation

The best way to discharge a patient


.

Comments

Post a Comment

Popular posts from this blog

On retained primitive reflexes

Each year I receive several emails from colleagues about 'retained primitive reflexes.'  I am also seeing an increased number of reports from local 'health care' providers who are documenting these alleged problems so I thought I would write a summary of my opinion on this topic.   Predatory 'health care' providers including some OTs, PTs, chiropractors, and behavioral optometrists are creating a new 'market' for treating this alleged 'problem.'  Parents should be very wary of these practitioners and other professionals should challenge these practices whenever they are seen. The following is the kind of information that causes concern and was provided to me by a colleague as a sample from a student's IEP: The student continues to demonstrate the following retained primitive reflexes that at times interfere with his ability to demonstrate appropriate adaptive responses: Fear Paralysis Reflex, Moro Reflex, Palmer Reflex, Tonic Labyri
Read more

Deconstructing the myth of clothing sensitivity as a 'sensory processing disorder'

Please note first that there is no formally recognized clinical designation of  'sensory processing disorder.'   It is a term constructed by occupational therapists that has not been formally recognized by the larger medical community. In our clinic we receive many referrals from local pediatricians when parents have concerns about children being overly sensitive to their clothing.  Most often the children referred are from four to seven years old and the families are severely disrupted by the children's behaviors and responses to clothing issues.  Commonly, children will have severely constricted tolerance for certain outfits, want to wear the same clothes repeatedly, complain that clothing is itchy/scratch/bumpy/wiggly/ouchie, and this all leads to disruption of daily dressing routines.  There is no doubt that the behavioral concerns are very real. The pediatricians tend to be appropriately conservative and provide families with good behavioral management suggestions
Read more

A Critical Appraisal of Therapeutic Listening

Image
History: According to Frick (2002, p. 358), auditory training has been used in Europe since the mid-1900s to address sensory processing disorders and these techniques have been recently popularized in the United States. Frick has based her Therapeutic Listening program on the work of Dr. Alfred Tomatis and Dr. Guy Berard, both of whom are French physicians. Both the Tomatis and Berard programs are delivered by specific machines using earphones but these devices do not have FDA approval and have been banned in the United States (Barrett, 2003). Frick (2001) states “With the advent of new technology, similar altered music has become available on compact disc. The discs do not replace either the Tomatis Method or the Berard Method. The compact discs do provide a less intense way to access both the auditory and vestibular systems to impact neural function and integration and are easily available to clinicians in a variety of practice arenas.” The CDs referenced on Frick’s webpages are ass
Read more