The Therapeutic Use of Self

Often, meeting a therapist for the first time may feel like a blind date. There is excitement, anticipation, nervousness, and for some, maybe even a little bit of dread. What will they be like? Will we connect? Will they talk too much? Will they talk too little? Will they explain things to me so I can understand? Will they value what is important to me? Will I even like them? All questions that are more than justifiable. After all, you are inviting this person into your world. You are inviting them into the sacred of your family’s journey. Did you catch that? THE SACRED. It is a space where you are sharing your most vulnerable. The hard, the raw, the scary, the unknown, and the struggle. The triumphs, the success, the love, and the joy. Every bit of it is SACRED.

While all occupational therapists have somewhat of a common ground for therapeutic philosophies, we all differ in our approach. In our profession, this differing in approach can be impacted by the “therapeutic use of self.” The therapeutic use of self is the “planned use of his or her personality, insights, perceptions, and judgments as part of the therapeutic process” (Punwar & Peloquin, 2000). To oversimplify, how I use myself in order to encourage children to engage in occupation. The therapeutic use of self is a concept that is developed through years of experience as an OT. Not only that, but it is shaped by my worldview and my experiences outside of OT (travel, raising children, places I’ve lived, relationships that I value, etc.). It is this use of self that creates a strong and meaningful relationship with our clients, which in turn contributes to successful participation in occupation.

Let me call out the elephant in the room. While ultimately, an experienced therapist should shift their use of self to accommodate the needs of the client, this doesn’t always happen. Sometimes, it IS the “therapeutic use of self” that is the culprit in a therapeutic relationship gone bad. Their personality rubs you the wrong way, their insight and perception into difficulties you may be having feels dismissive, they have perceived notions/judgement that doesn’t align with where you have been or what you have accomplished. Not all therapist/client relationships are a good fit. I tell my families all the time THAT’S OK! It is common knowledge that we do not click with every single person. The same applies to the therapist/client relationship. Embrace this idea.

With that said, the process of using oneself therapeutically requires the therapist to look inward. I believe sharing this process of introspection with our clients or clients “to be” is one of the most valuable pieces of information I can provide. This shouldn’t be a blind date scenario. When choosing a therapist, you should be able to have a small insight into who I am and what has molded me as a therapist. So, without further ado, here is just a short list of my own personal insights, perceptions, and experiences that impact my “therapeutic use of self,” which ultimately impacts how I deliver and spur my clients on to successful participation in occupation.

Philosophies in my therapeutic use of self

1. Your child is fearfully and wonderfully made with a plan and a purpose. They are not someone that needs to be “fixed.” They are uniquely designed. They have their own set of talents and gifts that are waiting to be used in the world around them. They were meant to LIVE FULLY, regardless of whether it looks differently than others. As a therapist, I am called to partner and assist you in unlocking their unique talents and gifts so they can thrive.
2. It is an honor and a privilege to be welcomed into this journey and I treat it as such. As stated above, this is a sacred journey. I recognize that this journey is one of grief and victory and I am given the privilege of being welcomed into your family. It is holy ground that must be walked with patience, kindness, love, and empathy.
3. I believe that walking this journey alone is not how it was designed to be. It takes a village. Surrounding yourself with a support system is of vital importance.
4. Your priorities are my priorities. I believe wholeheartedly that this is what sets the profession of OT apart from all other professions. We have a unique ability to see life as the “big picture.” What is important to you, MUST be what is important to me. My expertise and guidance will always be a part of the process, but your priorities and goals will always guide treatment. You will be heard and seen.
5. Your child can do hard things. I believe in the “just right challenge.” I will push them to engage in activities that push them to do hard things that they can and will accomplish through hard work.
6. We must believe in the abilities of our children. We are living in an age of helicopter parenting that is suffocating the capabilities of our children. We need to step back and allow our children to assess risk independently to form life skills down the road.
7. Speaking of risk. I believe in the power of risky play for childhood development. This is true for both the neurotypical and neurodiverse. Engagement in risky play allows children to analyze their capabilities, form self initiated boundaries, and build competence and confidence.
8. I believe in the power of education and inclusion. It is my passion to raise a generation of children who are inclusive. To accomplish this, we must create an open and safe dialogue between the community and parents of children with disabilities.
9. I believe that nature and the outdoors is the ideal setting to work on real life goals. I empathize with the frustration of parents when clinic skills are not transferred to real life. I have a large burden on my heart to work on real life goals in a real world environment.
10. Empathy drives me. No, I have not walked in your shoes and I am not living out your exact situation. However, my heart is to understand to the depths of my soul what you are walking out and to share the weight of the associated feelings. I believe empathy to be one of the most powerful therapeutic tools. It is what drives connection and impact.
11. I believe in the power of prayer. I don’t expect or require that the clients I work with ascribe to this same belief. I respect whatever your belief system may be. However, please know, you and your child will be added to my prayer list!

There it is. Just a small glimpse into Kim Wilson, MS, OTR/L. If I ever have the privilege of meeting you in person one day, I hope this list makes it feel more like two friends catching up rather than a blind date. I can’t wait to meet your family!

“You’re child is fearfully and wonderfully made with a plan and a purpose. They are not someone who needs to be “fixed.””