July 25, 2025 • 30 mins
What exactly does an occupational therapist do? Dr. Gus Schlegel takes us on a fascinating journey through this often misunderstood healthcare profession that helps people return to meaningful activities in their daily lives.
Beginning with his own unexpected path into the field through military service during Desert Storm, Dr. Schlegel reveals how occupational therapy's roots stretch back to World War I, when healthcare workers noticed soldiers engaged in purposeful activities recovered faster than those who remained idle. This observation became the foundation of a profession that now counts over 183,000 practitioners nationwide.
Contrary to what many assume, "occupation" in occupational therapy doesn't refer to employment—it means any meaningful activity a person wants to engage in. Whether it's helping an elderly patient dress independently, assisting someone with budgeting after a brain injury, or working with a child who has developmental delays, OTs break complex tasks into manageable components. They uniquely differ from physical therapists by using the activities themselves as therapy rather than repetitive exercises.
Dr. Schlegel's own remarkable journey—from military occupational therapy assistant to PhD in public health—demonstrates the profession's accessible career pathways. His work teaching Haitian students remotely, despite political turmoil, showcases the resilience and commitment of both practitioners and students. His current role coordinating doctoral capstone projects at a university in New York brings his expertise full circle.
Most compelling is the profession's holistic approach, addressing physical, cognitive, emotional and social functioning simultaneously. Dr. Schlegel advocates for more OTs to return to mental health settings, where their unique skills in activity analysis and group facilitation are particularly valuable. By focusing on what matters most to each individual, occupational therapists restore dignity and independence through the everyday activities many take for granted.
Ready to learn more about this fascinating healthcare profession? Listen now to discover how meaningful activity becomes powerful medicine.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hello everyone, I'm Dr Beatrice Ippolit and this is
your World.
Hello everyone, welcome back toa new episode of your World
with Dr Beatrice Ippolit.
(00:21):
Today I have the privilege tohave in our studio a very
special guest.
Last time we had his wife onthe show, dr Sheila Schlegel,
and who helped me to practicehow to pronounce the last name,
and today it's my privilege towelcome with us here Dr Schlegel
(00:46):
, gus.
Speaker 2 (00:47):
Schlegel.
Thank you, it's a pleasure tobe here.
Welcome to the show.
Thanks so much.
Speaker 1 (00:52):
Okay, so before I even go any further, tell us a
little bit about yourself, whatyou do, where you work.
I know that.
You know you and your wife.
You know you used to go toHaiti a lot, so let us hear all
of that.
We did to go to Haiti a lot, solet us hear all of that we did.
Speaker 2 (01:07):
We went to Haiti a lot, and Haiti has really helped
shape us both, particularly metoo.
It's helped drive the directionthat I've gone, even just in my
, my formal education, and sowhen I was planning to obtain my
master's degree, it really ithad to do with Haiti, and so I
received my master's degree.
It really it had to do withHaiti, so I received my master's
in humanitarian servicesadministration oh, okay so after
(01:30):
that, then the the question ofwhat do I do with that?
now, I had a strong interest in,in in public health, so then I
pursued a PhD in public health.
It all was really focused onthe needs of Haiti, and so
that's what's driven me, and sowith that, I was one of the
first founding volunteerinstructors at a really
(01:55):
homegrown occupational therapyprogram in Haiti through the
Episcopal University.
It's the Faculté de Sciences etde Rehabilitation, so it's the
college is in Lille-Gannes,which is kind of south of
Port-au-Prince, and so weeducate homegrown occupational
(02:17):
therapists and physicaltherapists and there's a nursing
program there too, and it'sjust a really super privilege
because, even with all theturmoil that's going on and we
haven't been able to go since2018 was the last time we were
there we're still able to teach.
They have had some verygenerous grants and donations,
(02:38):
so they have internet, they haveZoom and Teams capabilities, so
we educate, we teach over Teams, and so the students are there
in the class and we are on a bigscreen, we have a translator,
and so we teach our material.
And the program initially, whenit was live, was very intense,
(03:02):
so one class at a time over twoor three weeks, and so we were
able to modify that model, andthe reason we did that was
because clinicians were comingfrom France, from Canada and
from the United States down andspending the time there.
But now, since we can't travel,we were able to spread that out
(03:22):
to just a typical trimester,and so now our courses are 15
weeks long, just like you wouldfind here, and that makes it a
lot more manageable for us.
Speaker 1 (03:32):
All classes are being offered, you know, via online.
Speaker 2 (03:35):
All the classes, and so we have, we have labs, and
the really good thing is howmany times you meet per week.
So it's it's one time for threehours, so it's a three credit
instead of breaking it up,because you have to remember too
the students.
They travel from Port-au-Princeand from other places to get to
to Laoguan.
So in order to really cut downon travel time because it's
(03:57):
dangerous to travel we do so.
My class is three hours longand so they might have multiple
classes during that day, butthen on other days they don't
necessarily have to travel.
Speaker 1 (04:09):
Okay.
So then they have to providethemselves with their own
computers, or the schoolaccommodates them to have a
computer.
Speaker 2 (04:17):
You know, and that's a good question.
So we have sent computers down.
Some of the students have thosecomputers, but other students
they're working off their cellphones.
So I was always reallyimpressed I would get these
wonderful papers that werewritten by students and I know
(04:38):
that all they had was just acell phone.
And so they're there workingand typing every single word
with their thumbs to be able toproduce these two, three, four
page papers.
Speaker 1 (04:50):
In a way they really prioritize that education.
Oh yeah, definitely.
Speaker 2 (04:54):
That's wonderful.
Yeah, it's amazing.
They're very resilient students, and so it's such a pleasure to
work with them.
Speaker 1 (05:01):
Okay so.
Speaker 2 (05:03):
It even enhances my love more for Haiti and for the
people.
Speaker 1 (05:06):
Okay, that's wonderful, thank you.
Thank you so much for your timeand service and dedication that
you've been putting throughoutthe years in helping the Asian
people.
Thank you so much.
So what do you do?
What do you have your doctoratedegree in?
Speaker 2 (05:23):
So my doctorate work was in public health.
So I have a PhD in publichealth, okay, and I was able to
get it done.
It took a bit of time,definitely, but now I'm really
in a great position.
I was on vacation on Martha'sVineyard and I got a phone call
(05:45):
from just a random phone calland it was from the program
director of a program in NewYork City and they said we came
across your CV and we reallyliked it and we want you to come
in tomorrow.
Speaker 1 (05:59):
Just like that.
Speaker 2 (06:00):
Just like that.
And I said, oh my gosh, I knowthat I had submitted my CV to a
couple of places, but I'd neverfinished any because we were
going on vacation.
I never really had finished anyof the applications.
And so I said, oh my gosh,that's so nice.
I'm on vacation right now on anisland.
Is it okay if I come next week?
(06:21):
And they said absolutely.
And so I went in and they werejust so kind.
They asked some tough questionsand then afterwards they
offered me a position as thedoctoral capstone coordinator.
So that congratulations.
Yeah.
So, and I've been in thatposition since December and I'm
(06:43):
in charge of overseeing thedoctoral capstone projects that
all of the occupational therapystudents are doing.
So I interface with the facultymentors that are so our faculty
, that work as mentors for thestudents as they're completing
the capstone and also workingwith sites, with sites.
(07:10):
So in fact, I was going to askyou you have such a wonderful
knowledge base too, and we'realways looking for sites to be
able to mentor students in theirparticular interest.
And what the students do isthey during their didactic
coursework.
They certainly at some pointthey're touched by some
condition or some population,and so we asked them to develop
that further, to develop aresearch interest.
Speaker 1 (07:33):
I'm available.
Speaker 2 (07:35):
Yeah, that's great.
Speaker 1 (07:36):
It will be my greatest honor to work with you,
Dr Schlegel.
That would be wonderful.
Speaker 2 (07:43):
And so the students are able to pursue their
interests, and one of the funthings that I tell them is
because they have so many ideasand they want to go this way and
that, and so what I was toldduring my dissertation is, gus,
save the world after yourdissertation is done, because a
good dissertation is a finishedone, and so I get to say that to
(08:07):
the students often and say allthose are really good ideas, and
very often what you do for yourcapstone, because it is an area
of interest, becomes your lifework, and that's certainly my
case too.
My dissertation was on informalcaregivers of people living
with dementia.
Speaker 1 (08:27):
Okay, so today we're going to talk about a very
specific subject.
It's been around, so DrSchlegel will tell us, or give
us a brief description, how longthis profession has been around
and a little bit of prevalenceand exactly what it is.
So what people in the field?
(08:48):
Field, what do they do?
Because not too many people,even people with degrees, don't
even know that much aboutoccupational therapy.
And oftentimes one thing thatI've seen people tend to kind of
like take, when you mentionoccupational therapy, they will
believe that it is the physicaltherapy.
(09:09):
No, ot is something and PT is adifferent thing.
They are two differentprofessions.
Speaker 2 (09:16):
Yes, definitely.
Speaker 1 (09:18):
You know, so walk us through it, dr Stregal.
Speaker 2 (09:20):
Yeah, so let me start way back when I started my
career, when I enlisted in thearmy, the recruiter asked me
well, what do you want to do?
I had to do some tests,physical and everything.
He said you're qualified for alot of different things and I
said well, I want to work withpeople, I want to be in the
medical field and I want to usemy hands.
And so he looked through hisfiles and he said here this
(09:45):
occupational therapy, and sowe'll explain that more.
And so he read what was thereand it had to do with working
with people to help them returnto more independent functioning
or obtain a greater degree ofindependence.
And that just really appealedto me, especially the part that
(10:09):
dealt with working with yourhands and using different
activities and projects,occupations, to develop skill.
And I said that's for me.
And at the time I then joinedand I wound up working just out
(10:32):
of my good fortune in aninpatient mental health setting.
For almost the entire time Iwas deployed.
I was in Desert Shield andDesert Storm, but that's really
where as I've learned over timetoo, that's really where
occupational therapy comes fromis from working with people from
(10:53):
the military.
So during World War I, whensoldiers came back they might
have had some physical conditionor they might have had some
cognitive or some mental healthcomponent and the nursing staff,
they would give them little,little chores and little
activities to do and say here,here, do this.
(11:14):
And they found that the, thepatients, that these recovering
soldiers, they the ones thatwere participating in activities
, they recovered more quicklyyeah, yeah, because they were
engaged, they were doingsomething, and there wasn't a
lot, there wasn't any theory toreally back it up.
They just saw that it workedand so eventually, that's where
(11:39):
the name occupational therapywill come from.
That's where occupationaltherapy comes from, and and so I
and I have to really explainthis because a lot of times my
patients will ask me well, I'mnot, I'm 85, I'm not looking to
find a job.
Are you going to try and findme an occupation?
And I said, well, you know what?
In a way, yeah, I'm going tohelp you get back to doing those
occupations that you want to do, because as occupational
(12:01):
therapists we think ofoccupation as not something that
you do to make money.
We look at as occupations thatare meaningful to you, that you
want to engage in.
And many times some of mypatients they haven't been able
to engage in those occupationsfor a long time just because of
(12:23):
their condition and some of thedeficits that they've had.
So that's kind of my lead-invery often.
And there's always that questionwell, what's the difference
between OT and PT right withinphysical therapy?
And you know, it's not alwaysreally clear either, not just
with patients but with otherhealthcare professionals, and so
(12:46):
I know we were talking earlierabout the difference between OT
and PT.
I like to say that when wethink of occupation, we can use
occupation as a means to an end,or that occupation can also be
the end product that we'relooking for.
And let me explain where aphysical therapist and not all
(13:10):
physical therapists, but inphysical therapy there's, just
because of the nature, theremight be more repetitive
exercises and strengthening andmovement that goes on, where
you're measuring a certainamount of strength and a certain
amount of repetitions and thatreally guides you to identifying
(13:32):
that the patient is makingprogress.
In occupational therapy we,instead of repetitive exercises,
we use very often occupation tobe able to develop those skills
, and those skills that theydevelop then translate into
they're able to participate andcomplete, those skills that they
develop, then translate intothey're able to participate and
complete those things that theyreally want to do.
(13:52):
So let's take dressing, forexample.
If someone really wants todress well, what's involved in
upper body dressing, likeputting on a shirt there's a lot
of reaching involved, there'ssome sequencing involved,
there's some making choices and,and so all of those components
we really know how to break downinto their components.
(14:14):
We say, okay, well, you need tobe able to work on being able
to reach up, maybe to pull ashirt out of the closet or slip
your arms through its sleeve,and that movement can be
simulated by making a macrameproject, and so you might have
(14:35):
seen some of those potholes thathang from the ceiling and
there's a nice plant in thereand there's a lot of knots, and
the knots are very intricate andthey're all connected and so,
and it's beautiful, there'sthere's color and, and so that's
what they might create to beable to practice doing, doing
those movements.
And so the end result theneventually is they're better
(14:57):
able to then reach in and pullout and and slip their arms
through a sleeve.
So that's the means to an end.
We might also work on really theend product.
Okay, you want to be able toreach up, and so there might be
some time where we'll say, okay,well, let's practice reaching
(15:19):
and putting something up on ashelf, and so really our focus
is we want you to be able toreach up.
That's what the patient wants,and we'll practice a lot of
times to pulling the, the hangeroff of the hook, and so that
might be part of the, the careplan too.
But yeah, so it could be.
(15:40):
It can be either, butoccupation is really central to
what about managing theirexpenses?
that too.
That really depends on onwhat's important to them,
absolutely so.
Um, and you would find thatmore with um, people who might
have had a traumatic braininjury or someone who might be
(16:00):
living with a mental healthcondition, and I know that in
the past, when I was workinginpatient and also in community
mental health settings, I'veworked with people on budgeting,
and we might just be startingwith a couple of items.
What's important to you?
(16:20):
Well, I want to buy peanutbutter, okay, well, you have,
let's, let's look at whichpeanut butter is more expensive
and let's make some choices.
So I would bring them flyersfrom the grocery store and have
them put together a shoppinglist and then try to do some
budgeting and so that and, andso we'll do that in a clinic
(16:40):
environment, but then we mightgo out to the store, and so when
I was in the military um, wewould take them to the, the
commissary to, to do someshopping or to the px to do some
shopping.
We, we were able to do that.
So that was real OT and I lovethat.
But here in a community setting, we can do that as well.
So I can go with them too, andI've done that to a grocery
(17:03):
store or to the corner market.
Speaker 1 (17:06):
That's very important .
What about skill building?
Speaker 2 (17:11):
So certainly, it just really depends on where they
are On their needs.
So one of the things that we'revery good at is doing activity
analyses, where we really takean activity and break it down
into different tasks, and alsoreally task analyses, where we
take and we look at a particulartask and really break it down
(17:35):
into its functional componentsand steps.
There's also an occupationalanalysis, so looking at the
occupation really.
So what does it mean to be apainter, what does it mean to be
a teacher, what does it mean tobe a photographer, and what are
(17:56):
all those components that arerequired to do this?
It's very complex if you thinkabout it right.
So really we're looking atphysical, we're looking at
cognition, we're looking atemotional and also social and
putting that all together toreally work on all those areas,
and that's a big thing thatdistinguishes us from other
(18:17):
professions.
Speaker 1 (18:18):
That's wonderful, and so, according to research, it
seems that the profession isgrowing.
Like I mentioned earlier,according to research, there are
approximately 140,000occupational therapists in the
US, with around 183,000practitioners nationwide.
Speaker 2 (18:41):
Yes, yes, and I appreciate the last number
because that really it reallycatches kind of what
occupational therapy practiceslook like.
So we have occupationaltherapists look like.
So we have occupationaltherapists.
Right now entry-level programsare master's programs and
(19:03):
doctoral programs, like the onethat I work in, but there are
also occupational therapyassistant programs.
That's what I studied and becamethrough the Army and I worked
as an occupational therapyassistant for for five years and
also during the time that I wasin school for my, my therapist
(19:25):
degree.
And so the assistants, they workand support the, the clients
and the occupational therapistsin carrying out the care plan,
the occupational therapists incarrying out the care plan, the
occupational therapists, they'rethe ones that have that deeper
understanding of theory and areable to develop the care plan,
(19:46):
and so together there's thisreal connection between the
therapists and the assistantstogether.
And so that's where you, thatwhole number is, the 183,000
that you mentioned.
So so there's really two tracksthat you can.
To me that's appealing becauseyou don't limit someone who
might come from a backgroundwhere they don't have six years
(20:10):
to dedicate to to education anddon't have I mean, schools are
expensive now don't have allthat money.
They can go, like I did, jointhe military and get their start
in our career, in ouroccupational therapy that way.
Or they can go to a communitycollege and get their career
(20:32):
start, maybe in two years, withan associate's degree and then
later there are also bridgeprograms where you can
transition from, like I did,from OTA the assistant to OTR,
the registered therapist.
Speaker 1 (20:48):
This country, believe it or not, it's built on
immigrants.
Speaker 2 (20:52):
Yes.
Speaker 1 (20:54):
So it's like, whatever people may want to say,
but immigrants, we are thebackbone of this country yes but
one thing that I've noticed andI even had they you know my own
personal experience in thatarea as well when you you first
(21:16):
came to this country there isreally nobody to help you
navigate the system.
Many people they tend to be ontheir own.
Like myself, I did navigateeverything on my own.
I'm grateful to everything thatGod had allowed me to
(21:40):
accomplish, but it was not easy.
It was like, in a way, easy forme because when I came to this
country I didn't have a husband,I didn't have any children.
So it's like you know, when youdon't have a family, so you tend
to move around through, youknow things much easier compared
(22:03):
to those who came with a family.
So the idea or the tendency ishey, I have a family, I have to
feed.
It's like many people who wouldlove to get an education.
It's like many people who wouldlove to get an education but
because of their life situationsor don't know exactly how to
navigate things around,sometimes can get stuck one
(22:25):
place.
Speaker 2 (22:39):
They can, and so that's what makes really the
associate's degree attractive.
A lot of the programs they'regeared toward supporting those
people that want to earn adegree may have to work full
time during the day, and there'sreally alternative formats that
are popping up.
There are online evenoccupational therapist programs,
and so the programs they can beas creative as the needs are,
(23:04):
and so that's a real good thing.
And, like you mentioned theimmigrants, I'm an immigrant,
I'm from Germany and so I wasactually.
I joined the military, the USmilitary in Germany.
I was recruited there and, ohand yeah, my mom lived here and,
(23:24):
and so I was able to, and I Ihad gone to school here to gone
back to Germany, and that'swhere I was recruited then by
the okay, so for occupational so, and we go by OT, you know for
sure OT is fine.
Speaker 1 (23:42):
What are the benefits in mental health?
Speaker 2 (23:46):
If you look around at the different inpatient mental
health settings and evenoutpatient settings, there's not
a lot of occupationaltherapists, not as many as there
used to be, and so one of thethings that I like to promote
with my students is to considerworking in mental health,
because there certainly is abenefit.
When occupational therapistsstarted to kind of not work in
(24:10):
mental health as much, they wereattracted to working in
pediatrics or in hospitals inacute care and that that left a
real void and that void wasreally quickly filled with
activity therapists.
There are rehab therapists,music therapists.
They all have their relevanceand importance and I've worked
(24:32):
with really good art therapistswho are just amazing.
But one of the things that wereally bring to the table is
that ability to work with groupsand also work with individuals
In our curriculum we have,because other occupational
therapists before us have reallyset the groundwork, this couple
(24:54):
of people that you work with.
Speaker 1 (24:55):
are they children, adults?
Speaker 2 (24:59):
In a mental health setting?
Yeah, in general.
So that's a really goodquestion.
It could be children.
So a really well-developedmental health program will have
children.
They might have just a unit thatis just strictly for children.
They might have a unit that'sstrictly for adolescents,
(25:19):
because they all have differentneeds, right, adults, and that
might be just general mentalhealth conditions.
There's dual diagnosis unitsand so occupational therapy has
a role in every single one ofthose, because as OTs, we work
in pediatrics, we work withdevelopment, and so when we're
(25:39):
looking at the especiallychildren, they could be a five
or six year old who for somereason are now in an inpatient
setting and we can look at thatbigger picture and and look also
not only at helping them withsocial, emotional, learning and
(26:00):
mindfulness and using some ofthose, some of those strategies,
but also working on justphysical skill development, fine
motor, all those things thatthose kids should be working on.
That might have been delayedbecause there was so much focus
on something else.
(26:20):
They really just couldn't workon developing fine motor because
they were, they really had alot going on in terms of their
emotional state.
So it's kind of this balance asyou're working on development.
Speaker 1 (26:38):
For the most part will you work with an
interdisciplinary team.
Speaker 2 (26:42):
Oh, absolutely yeah, and that's one of the good
things about occupationaltherapists.
We don't like to work in theasylum, we like to reach out and
make connections with otherdisciplines.
So we're real team players andwe cover that in our curriculum
too how to interact and workwith other disciplines,
recognizing when to makeappropriate referrals.
(27:05):
We work on simulations wherewe're working with other
disciplines.
I was involved for five yearsin one of the universities that
I worked in with simulationswith social work, with nursing,
with PA and with physicaltherapy, and so we all looked at
(27:29):
the case and that was I alwayslearned something from the other
disciplines.
Speaker 1 (27:33):
What about psychologists and psychiatrists?
Speaker 2 (27:36):
So we had the social workers, but absolutely you
could include those too, becausewe interface with psychologists
and psychiatrists a lot oftimes on mental health units.
Speaker 1 (27:49):
When you were to develop treatment plans for
clients or patients I don't knowhow you call them it depends on
the setting.
Speaker 2 (27:57):
It depends on the setting.
Yeah, it goes for you.
We're flexible.
Speaker 1 (28:02):
So how that normally goes.
Speaker 2 (28:05):
So we would do, I think, like most any other
discipline, we would do aninitial evaluation and look at
certain areas.
That is strongly driven by thefacility that we work in, but
also by funding.
As a clinician with a mentalhealth background, I would
(28:30):
always encourage clinicians Iencourage my students to really
look at the psychosocial aspectsof the client.
Even if they have a hipfracture.
You need to understand whatdrives them, their context, Not
only context externally andgeographically and who's around
(28:54):
them, but also their beliefs,values and what drives them.
So that's just equally importantand you need to really know
that to be able to know best howto access a client.
And so that evidence-basedmodel I like to bring up a lot
and I think it's just reallyvaluable when a clinician is
(29:17):
deciding on what type ofintervention to encourage the
client to participate in, and wehave to consider what our own
strengths are as a clinician.
Am I skilled to be able to dothat?
Is that something?
Is that an intervention that Ireally value and have found good
(29:39):
success with?
But I also need to understandmy, my clients perspective and
is that something that they wantto do?
And here's a good example.
Speaker 1 (29:47):
I'll share this with you and that was, oh, you know
what you?
You just nailed it because thatwas going to be my next
question, that example.
Hello everyone, I'm Dr Beatrice Ippolit and this is
your World.
Hello everyone, welcome back toa new episode of your World
with Dr Beatrice Ippolit.
(00:21):
Today I have the privilege tohave in our studio a very
special guest.
Last time we had his wife onthe show, dr Sheila Schlegel,
and who helped me to practicehow to pronounce the last name,
and today it's my privilege towelcome with us here Dr Schlegel
(00:46):
, gus.
Speaker 2 (00:47):
Schlegel.
Thank you, it's a pleasure tobe here.
Welcome to the show.
Thanks so much.
Speaker 1 (00:52):
Okay, so before I even go any further, tell us a
little bit about yourself, whatyou do, where you work.
I know that.
You know you and your wife.
You know you used to go toHaiti a lot, so let us hear all
of that.
We did to go to Haiti a lot, solet us hear all of that we did.
Speaker 2 (01:07):
We went to Haiti a lot, and Haiti has really helped
shape us both, particularly metoo.
It's helped drive the directionthat I've gone, even just in my
, my formal education, and sowhen I was planning to obtain my
master's degree, it really ithad to do with Haiti, and so I
received my master's degree.
It really it had to do withHaiti, so I received my master's
in humanitarian servicesadministration oh, okay so after
(01:30):
that, then the the question ofwhat do I do with that?
now, I had a strong interest in,in in public health, so then I
pursued a PhD in public health.
It all was really focused onthe needs of Haiti, and so
that's what's driven me, and sowith that, I was one of the
first founding volunteerinstructors at a really
(01:55):
homegrown occupational therapyprogram in Haiti through the
Episcopal University.
It's the Faculté de Sciences etde Rehabilitation, so it's the
college is in Lille-Gannes,which is kind of south of
Port-au-Prince, and so weeducate homegrown occupational
(02:17):
therapists and physicaltherapists and there's a nursing
program there too, and it'sjust a really super privilege
because, even with all theturmoil that's going on and we
haven't been able to go since2018 was the last time we were
there we're still able to teach.
They have had some verygenerous grants and donations,
(02:38):
so they have internet, they haveZoom and Teams capabilities, so
we educate, we teach over Teams, and so the students are there
in the class and we are on a bigscreen, we have a translator,
and so we teach our material.
And the program initially, whenit was live, was very intense,
(03:02):
so one class at a time over twoor three weeks, and so we were
able to modify that model, andthe reason we did that was
because clinicians were comingfrom France, from Canada and
from the United States down andspending the time there.
But now, since we can't travel,we were able to spread that out
(03:22):
to just a typical trimester,and so now our courses are 15
weeks long, just like you wouldfind here, and that makes it a
lot more manageable for us.
Speaker 1 (03:32):
All classes are being offered, you know, via online.
Speaker 2 (03:35):
All the classes, and so we have, we have labs, and
the really good thing is howmany times you meet per week.
So it's it's one time for threehours, so it's a three credit
instead of breaking it up,because you have to remember too
the students.
They travel from Port-au-Princeand from other places to get to
to Laoguan.
So in order to really cut downon travel time because it's
(03:57):
dangerous to travel we do so.
My class is three hours longand so they might have multiple
classes during that day, butthen on other days they don't
necessarily have to travel.
Speaker 1 (04:09):
Okay.
So then they have to providethemselves with their own
computers, or the schoolaccommodates them to have a
computer.
Speaker 2 (04:17):
You know, and that's a good question.
So we have sent computers down.
Some of the students have thosecomputers, but other students
they're working off their cellphones.
So I was always reallyimpressed I would get these
wonderful papers that werewritten by students and I know
(04:38):
that all they had was just acell phone.
And so they're there workingand typing every single word
with their thumbs to be able toproduce these two, three, four
page papers.
Speaker 1 (04:50):
In a way they really prioritize that education.
Oh yeah, definitely.
Speaker 2 (04:54):
That's wonderful.
Yeah, it's amazing.
They're very resilient students, and so it's such a pleasure to
work with them.
Speaker 1 (05:01):
Okay so.
Speaker 2 (05:03):
It even enhances my love more for Haiti and for the
people.
Speaker 1 (05:06):
Okay, that's wonderful, thank you.
Thank you so much for your timeand service and dedication that
you've been putting throughoutthe years in helping the Asian
people.
Thank you so much.
So what do you do?
What do you have your doctoratedegree in?
Speaker 2 (05:23):
So my doctorate work was in public health.
So I have a PhD in publichealth, okay, and I was able to
get it done.
It took a bit of time,definitely, but now I'm really
in a great position.
I was on vacation on Martha'sVineyard and I got a phone call
(05:45):
from just a random phone calland it was from the program
director of a program in NewYork City and they said we came
across your CV and we reallyliked it and we want you to come
in tomorrow.
Speaker 1 (05:59):
Just like that.
Speaker 2 (06:00):
Just like that.
And I said, oh my gosh, I knowthat I had submitted my CV to a
couple of places, but I'd neverfinished any because we were
going on vacation.
I never really had finished anyof the applications.
And so I said, oh my gosh,that's so nice.
I'm on vacation right now on anisland.
Is it okay if I come next week?
(06:21):
And they said absolutely.
And so I went in and they werejust so kind.
They asked some tough questionsand then afterwards they
offered me a position as thedoctoral capstone coordinator.
So that congratulations.
Yeah.
So, and I've been in thatposition since December and I'm
(06:43):
in charge of overseeing thedoctoral capstone projects that
all of the occupational therapystudents are doing.
So I interface with the facultymentors that are so our faculty
, that work as mentors for thestudents as they're completing
the capstone and also workingwith sites, with sites.
(07:10):
So in fact, I was going to askyou you have such a wonderful
knowledge base too, and we'realways looking for sites to be
able to mentor students in theirparticular interest.
And what the students do isthey during their didactic
coursework.
They certainly at some pointthey're touched by some
condition or some population,and so we asked them to develop
that further, to develop aresearch interest.
Speaker 1 (07:33):
I'm available.
Speaker 2 (07:35):
Yeah, that's great.
Speaker 1 (07:36):
It will be my greatest honor to work with you,
Dr Schlegel.
That would be wonderful.
Speaker 2 (07:43):
And so the students are able to pursue their
interests, and one of the funthings that I tell them is
because they have so many ideasand they want to go this way and
that, and so what I was toldduring my dissertation is, gus,
save the world after yourdissertation is done, because a
good dissertation is a finishedone, and so I get to say that to
(08:07):
the students often and say allthose are really good ideas, and
very often what you do for yourcapstone, because it is an area
of interest, becomes your lifework, and that's certainly my
case too.
My dissertation was on informalcaregivers of people living
with dementia.
Speaker 1 (08:27):
Okay, so today we're going to talk about a very
specific subject.
It's been around, so DrSchlegel will tell us, or give
us a brief description, how longthis profession has been around
and a little bit of prevalenceand exactly what it is.
So what people in the field?
(08:48):
Field, what do they do?
Because not too many people,even people with degrees, don't
even know that much aboutoccupational therapy.
And oftentimes one thing thatI've seen people tend to kind of
like take, when you mentionoccupational therapy, they will
believe that it is the physicaltherapy.
(09:09):
No, ot is something and PT is adifferent thing.
They are two differentprofessions.
Speaker 2 (09:16):
Yes, definitely.
Speaker 1 (09:18):
You know, so walk us through it, dr Stregal.
Speaker 2 (09:20):
Yeah, so let me start way back when I started my
career, when I enlisted in thearmy, the recruiter asked me
well, what do you want to do?
I had to do some tests,physical and everything.
He said you're qualified for alot of different things and I
said well, I want to work withpeople, I want to be in the
medical field and I want to usemy hands.
And so he looked through hisfiles and he said here this
(09:45):
occupational therapy, and sowe'll explain that more.
And so he read what was thereand it had to do with working
with people to help them returnto more independent functioning
or obtain a greater degree ofindependence.
And that just really appealedto me, especially the part that
(10:09):
dealt with working with yourhands and using different
activities and projects,occupations, to develop skill.
And I said that's for me.
And at the time I then joinedand I wound up working just out
(10:32):
of my good fortune in aninpatient mental health setting.
For almost the entire time Iwas deployed.
I was in Desert Shield andDesert Storm, but that's really
where as I've learned over timetoo, that's really where
occupational therapy comes fromis from working with people from
(10:53):
the military.
So during World War I, whensoldiers came back they might
have had some physical conditionor they might have had some
cognitive or some mental healthcomponent and the nursing staff,
they would give them little,little chores and little
activities to do and say here,here, do this.
(11:14):
And they found that the, thepatients, that these recovering
soldiers, they the ones thatwere participating in activities
, they recovered more quicklyyeah, yeah, because they were
engaged, they were doingsomething, and there wasn't a
lot, there wasn't any theory toreally back it up.
They just saw that it workedand so eventually, that's where
(11:39):
the name occupational therapywill come from.
That's where occupationaltherapy comes from, and and so I
and I have to really explainthis because a lot of times my
patients will ask me well, I'mnot, I'm 85, I'm not looking to
find a job.
Are you going to try and findme an occupation?
And I said, well, you know what?
In a way, yeah, I'm going tohelp you get back to doing those
occupations that you want to do, because as occupational
(12:01):
therapists we think ofoccupation as not something that
you do to make money.
We look at as occupations thatare meaningful to you, that you
want to engage in.
And many times some of mypatients they haven't been able
to engage in those occupationsfor a long time just because of
(12:23):
their condition and some of thedeficits that they've had.
So that's kind of my lead-invery often.
And there's always that questionwell, what's the difference
between OT and PT right withinphysical therapy?
And you know, it's not alwaysreally clear either, not just
with patients but with otherhealthcare professionals, and so
(12:46):
I know we were talking earlierabout the difference between OT
and PT.
I like to say that when wethink of occupation, we can use
occupation as a means to an end,or that occupation can also be
the end product that we'relooking for.
And let me explain where aphysical therapist and not all
(13:10):
physical therapists, but inphysical therapy there's, just
because of the nature, theremight be more repetitive
exercises and strengthening andmovement that goes on, where
you're measuring a certainamount of strength and a certain
amount of repetitions and thatreally guides you to identifying
(13:32):
that the patient is makingprogress.
In occupational therapy we,instead of repetitive exercises,
we use very often occupation tobe able to develop those skills
, and those skills that theydevelop then translate into
they're able to participate andcomplete, those skills that they
develop, then translate intothey're able to participate and
complete those things that theyreally want to do.
(13:52):
So let's take dressing, forexample.
If someone really wants todress well, what's involved in
upper body dressing, likeputting on a shirt there's a lot
of reaching involved, there'ssome sequencing involved,
there's some making choices and,and so all of those components
we really know how to break downinto their components.
(14:14):
We say, okay, well, you need tobe able to work on being able
to reach up, maybe to pull ashirt out of the closet or slip
your arms through its sleeve,and that movement can be
simulated by making a macrameproject, and so you might have
(14:35):
seen some of those potholes thathang from the ceiling and
there's a nice plant in thereand there's a lot of knots, and
the knots are very intricate andthey're all connected and so,
and it's beautiful, there'sthere's color and, and so that's
what they might create to beable to practice doing, doing
those movements.
And so the end result theneventually is they're better
(14:57):
able to then reach in and pullout and and slip their arms
through a sleeve.
So that's the means to an end.
We might also work on really theend product.
Okay, you want to be able toreach up, and so there might be
some time where we'll say, okay,well, let's practice reaching
(15:19):
and putting something up on ashelf, and so really our focus
is we want you to be able toreach up.
That's what the patient wants,and we'll practice a lot of
times to pulling the, the hangeroff of the hook, and so that
might be part of the, the careplan too.
But yeah, so it could be.
(15:40):
It can be either, butoccupation is really central to
what about managing theirexpenses?
that too.
That really depends on onwhat's important to them,
absolutely so.
Um, and you would find thatmore with um, people who might
have had a traumatic braininjury or someone who might be
(16:00):
living with a mental healthcondition, and I know that in
the past, when I was workinginpatient and also in community
mental health settings, I'veworked with people on budgeting,
and we might just be startingwith a couple of items.
What's important to you?
(16:20):
Well, I want to buy peanutbutter, okay, well, you have,
let's, let's look at whichpeanut butter is more expensive
and let's make some choices.
So I would bring them flyersfrom the grocery store and have
them put together a shoppinglist and then try to do some
budgeting and so that and, andso we'll do that in a clinic
(16:40):
environment, but then we mightgo out to the store, and so when
I was in the military um, wewould take them to the, the
commissary to, to do someshopping or to the px to do some
shopping.
We, we were able to do that.
So that was real OT and I lovethat.
But here in a community setting, we can do that as well.
So I can go with them too, andI've done that to a grocery
(17:03):
store or to the corner market.
Speaker 1 (17:06):
That's very important .
What about skill building?
Speaker 2 (17:11):
So certainly, it just really depends on where they
are On their needs.
So one of the things that we'revery good at is doing activity
analyses, where we really takean activity and break it down
into different tasks, and alsoreally task analyses, where we
take and we look at a particulartask and really break it down
(17:35):
into its functional componentsand steps.
There's also an occupationalanalysis, so looking at the
occupation really.
So what does it mean to be apainter, what does it mean to be
a teacher, what does it mean tobe a photographer, and what are
(17:56):
all those components that arerequired to do this?
It's very complex if you thinkabout it right.
So really we're looking atphysical, we're looking at
cognition, we're looking atemotional and also social and
putting that all together toreally work on all those areas,
and that's a big thing thatdistinguishes us from other
(18:17):
professions.
Speaker 1 (18:18):
That's wonderful, and so, according to research, it
seems that the profession isgrowing.
Like I mentioned earlier,according to research, there are
approximately 140,000occupational therapists in the
US, with around 183,000practitioners nationwide.
Speaker 2 (18:41):
Yes, yes, and I appreciate the last number
because that really it reallycatches kind of what
occupational therapy practiceslook like.
So we have occupationaltherapists look like.
So we have occupationaltherapists.
Right now entry-level programsare master's programs and
(19:03):
doctoral programs, like the onethat I work in, but there are
also occupational therapyassistant programs.
That's what I studied and becamethrough the Army and I worked
as an occupational therapyassistant for for five years and
also during the time that I wasin school for my, my therapist
(19:25):
degree.
And so the assistants, they workand support the, the clients
and the occupational therapistsin carrying out the care plan,
the occupational therapists incarrying out the care plan, the
occupational therapists, they'rethe ones that have that deeper
understanding of theory and areable to develop the care plan,
(19:46):
and so together there's thisreal connection between the
therapists and the assistantstogether.
And so that's where you, thatwhole number is, the 183,000
that you mentioned.
So so there's really two tracksthat you can.
To me that's appealing becauseyou don't limit someone who
might come from a backgroundwhere they don't have six years
(20:10):
to dedicate to to education anddon't have I mean, schools are
expensive now don't have allthat money.
They can go, like I did, jointhe military and get their start
in our career, in ouroccupational therapy that way.
Or they can go to a communitycollege and get their career
(20:32):
start, maybe in two years, withan associate's degree and then
later there are also bridgeprograms where you can
transition from, like I did,from OTA the assistant to OTR,
the registered therapist.
Speaker 1 (20:48):
This country, believe it or not, it's built on
immigrants.
Speaker 2 (20:52):
Yes.
Speaker 1 (20:54):
So it's like, whatever people may want to say,
but immigrants, we are thebackbone of this country yes but
one thing that I've noticed andI even had they you know my own
personal experience in thatarea as well when you you first
(21:16):
came to this country there isreally nobody to help you
navigate the system.
Many people they tend to be ontheir own.
Like myself, I did navigateeverything on my own.
I'm grateful to everything thatGod had allowed me to
(21:40):
accomplish, but it was not easy.
It was like, in a way, easy forme because when I came to this
country I didn't have a husband,I didn't have any children.
So it's like you know, when youdon't have a family, so you tend
to move around through, youknow things much easier compared
(22:03):
to those who came with a family.
So the idea or the tendency ishey, I have a family, I have to
feed.
It's like many people who wouldlove to get an education.
It's like many people who wouldlove to get an education but
because of their life situationsor don't know exactly how to
navigate things around,sometimes can get stuck one
(22:25):
place.
Speaker 2 (22:39):
They can, and so that's what makes really the
associate's degree attractive.
A lot of the programs they'regeared toward supporting those
people that want to earn adegree may have to work full
time during the day, and there'sreally alternative formats that
are popping up.
There are online evenoccupational therapist programs,
and so the programs they can beas creative as the needs are,
(23:04):
and so that's a real good thing.
And, like you mentioned theimmigrants, I'm an immigrant,
I'm from Germany and so I wasactually.
I joined the military, the USmilitary in Germany.
I was recruited there and, ohand yeah, my mom lived here and,
(23:24):
and so I was able to, and I Ihad gone to school here to gone
back to Germany, and that'swhere I was recruited then by
the okay, so for occupational so, and we go by OT, you know for
sure OT is fine.
Speaker 1 (23:42):
What are the benefits in mental health?
Speaker 2 (23:46):
If you look around at the different inpatient mental
health settings and evenoutpatient settings, there's not
a lot of occupationaltherapists, not as many as there
used to be, and so one of thethings that I like to promote
with my students is to considerworking in mental health,
because there certainly is abenefit.
When occupational therapistsstarted to kind of not work in
(24:10):
mental health as much, they wereattracted to working in
pediatrics or in hospitals inacute care and that that left a
real void and that void wasreally quickly filled with
activity therapists.
There are rehab therapists,music therapists.
They all have their relevanceand importance and I've worked
(24:32):
with really good art therapistswho are just amazing.
But one of the things that wereally bring to the table is
that ability to work with groupsand also work with individuals
In our curriculum we have,because other occupational
therapists before us have reallyset the groundwork, this couple
(24:54):
of people that you work with.
Speaker 1 (24:55):
are they children, adults?
Speaker 2 (24:59):
In a mental health setting?
Yeah, in general.
So that's a really goodquestion.
It could be children.
So a really well-developedmental health program will have
children.
They might have just a unit thatis just strictly for children.
They might have a unit that'sstrictly for adolescents,
(25:19):
because they all have differentneeds, right, adults, and that
might be just general mentalhealth conditions.
There's dual diagnosis unitsand so occupational therapy has
a role in every single one ofthose, because as OTs, we work
in pediatrics, we work withdevelopment, and so when we're
(25:39):
looking at the especiallychildren, they could be a five
or six year old who for somereason are now in an inpatient
setting and we can look at thatbigger picture and and look also
not only at helping them withsocial, emotional, learning and
(26:00):
mindfulness and using some ofthose, some of those strategies,
but also working on justphysical skill development, fine
motor, all those things thatthose kids should be working on.
That might have been delayedbecause there was so much focus
on something else.
(26:20):
They really just couldn't workon developing fine motor because
they were, they really had alot going on in terms of their
emotional state.
So it's kind of this balance asyou're working on development.
Speaker 1 (26:38):
For the most part will you work with an
interdisciplinary team.
Speaker 2 (26:42):
Oh, absolutely yeah, and that's one of the good
things about occupationaltherapists.
We don't like to work in theasylum, we like to reach out and
make connections with otherdisciplines.
So we're real team players andwe cover that in our curriculum
too how to interact and workwith other disciplines,
recognizing when to makeappropriate referrals.
(27:05):
We work on simulations wherewe're working with other
disciplines.
I was involved for five yearsin one of the universities that
I worked in with simulationswith social work, with nursing,
with PA and with physicaltherapy, and so we all looked at
(27:29):
the case and that was I alwayslearned something from the other
disciplines.
Speaker 1 (27:33):
What about psychologists and psychiatrists?
Speaker 2 (27:36):
So we had the social workers, but absolutely you
could include those too, becausewe interface with psychologists
and psychiatrists a lot oftimes on mental health units.
Speaker 1 (27:49):
When you were to develop treatment plans for
clients or patients I don't knowhow you call them it depends on
the setting.
Speaker 2 (27:57):
It depends on the setting.
Yeah, it goes for you.
We're flexible.
Speaker 1 (28:02):
So how that normally goes.
Speaker 2 (28:05):
So we would do, I think, like most any other
discipline, we would do aninitial evaluation and look at
certain areas.
That is strongly driven by thefacility that we work in, but
also by funding.
As a clinician with a mentalhealth background, I would
(28:30):
always encourage clinicians Iencourage my students to really
look at the psychosocial aspectsof the client.
Even if they have a hipfracture.
You need to understand whatdrives them, their context, Not
only context externally andgeographically and who's around
(28:54):
them, but also their beliefs,values and what drives them.
So that's just equally importantand you need to really know
that to be able to know best howto access a client.
And so that evidence-basedmodel I like to bring up a lot
and I think it's just reallyvaluable when a clinician is
(29:17):
deciding on what type ofintervention to encourage the
client to participate in, and wehave to consider what our own
strengths are as a clinician.
Am I skilled to be able to dothat?
Is that something?
Is that an intervention that Ireally value and have found good
(29:39):
success with?
But I also need to understandmy, my clients perspective and
is that something that they wantto do?
And here's a good example.
Speaker 1 (29:47):
I'll share this with you and that was, oh, you know
what you?
You just nailed it because thatwas going to be my next
question, that example.
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