u/limerenceandwhimsy

Hey! I’ve posted a few times on this app but not quite as straight forward as this. I accepted a job in an outpatient clinic where I would be the only OT helping build a caseload. The goal was to be a generalist in a under served community where I could work with pediatrics and orthopedics, which I felt would be a great opportunity to get into the ortho realm because there’s very limited opportunities for that in my area. Since beginning I’ve had imposter syndrome but I feel like with my ADHD I keep catastrophizing, internalizing any poor outcomes, and just feel like a shit therapist. I also compare myself to my old classmates who don’t appear to be struggling quite as hard for me. I quest my questions are:

1. How do I truly know if I’m doing enough to help someone?

2. How do I manage when parents only bring their kids to 3-4 visits before no showing and having to be discharged? It can’t always be because of me right?

3. How do i feel enough even though i generate half the income of the PTs? ( they double- I one on one)

Any advice is appreciated!

Cross posted

Hi! Long rant/word vomiting. I work in rural clinic as the only OT, so I’m providing a wide variety of services but primarily pediatric and orthopedic based. I had a Fieldwork an additional experience in these areas so it’s not totally out of the realm of my abilities. I do have mentorship for the orthopedic section, but I’m kind of on my own for the pediatrics. I feel like the majority of my caseload our kiddos with very short attention span and high impulsive behaviors. I try and find the just right level why still holding accountability (if fitting ofc) but I’m not sure how things progress or if I’m doing enough. For example, I’ve been working with this one kiddo for about eight months. We used to be less than 30 seconds per task across a session whether preferred or un preferred. Now we can do about 4 to 5 minutes in a preferred task with just some support to initiate. Another kiddo used to shut down with any challenge or redirection with meltdowns lasting 20 minutes and we’ve had a lot less of that but today I tried to redirect him from kicking over a physical therapists set up game and he hit and screams. He did calm down within 2 minutes of co regulating and leaving the area with choices. I keep trying to tell myself that showing up and being a constant presence for these kiddos is important, but it’s so hard for me to not feel like I’m not like I’m falling short or as if I don’t have these amazing skills like the therapist I see online. Also y’all, the burnout is REAL.

Hey guys! I’ve been processing for about a year and I’ve been building my pediatric caseload. When I was finishing my Fieldwork, I feel like the majority of the students were being seen for fine motor or sensory, but the majority clinic is executive functioning and regulation based. This is especially evident for kiddos 4-6 right now. Those are you who’ve been practicing longer. Do you feel like since Covid you’ve seen an increase influx of kiddos where this is the primary concern?

Hello! Advice needed please for those who’ve worked in the field longer than I have.

When working with a kiddo who throws things (wooden blocks, etc) and you try to reduce access to items and they shove into you/hit/throw themselves to the ground even if unsafe- what would you recommend doing to support yourself and them? I was working with a kiddo who was just going for it and when I tried reduce access to the item they threw themselves back and I could only reach their arms (I quickly moved to trunk) to try and prevent them from falling onto the very many blocks (the kiddos balance and coordination is not good at all). There was a struggle but I couldn’t really get them stable without just outright dropping them. I sat them on the table and just blocked the hits and verbalized “we do not hit” and offered moving to quiet space or mo where they re regulated and sat on my lap. I feel discouraged because I feel like I restrained/did something wrong but I did my best in the moment. Idk- any constructive advice would be appreciated.

Hi. I work in an outpatient clinic where I’m half adults half kiddos (I had fieldworks in both). I feel like I’m getting discouraged working with kiddos with executive functioning deficits where progress isn’t linear. For example, I’m working with a kid who when they come in they won’t stay in the waiting room and any attempt to redirect them they get very dysregulated. Attempts to give a waiting task, closing doors, providing options of how to wait don’t really work. Then when we get into the session attention and engagement in a task (whether or initiated it or not) is decreasing over the past two session. I’ve seen this kiddo for 20 visits and I know I’m trying my best but I feel like maybe I’m just not a good OT? I think I just need some motivation, I’ve been practicing for 8 months and feel like I know nothing.