November 4, 2024 • 49 mins
Today we're diving into all things mindfulness in occupational therapy. Our guest today is a fellow Canadian OT who works in mental health, Sarah Good.
In this episode, we explore how mindfulness can be used as a powerful intervention to enhance occupational engagement and not just as an end in itself. Sarah shares her unique approach of seeing clients in their homes or outdoor settings, integrating nature into therapy to help clients reintegrate socially post-pandemic.
We also discuss how our clients find us and are funded for occupational therapy with a mental health focus and the flexibility of online versus in-person sessions. Alongside practical insights, Sarah and I delve into the profound impacts of using mindfulness within Acceptance and Commitment Therapy (ACT), offering real-life strategies for therapists and clients alike.
Sarah's Mindful OT Mastery Program is opening for registration Nov. 18-21, 2024. Be sure to click the link to be notfied when it's time to register. Her array of resources for clinicians can also be found on her website.
The Ask for OT campaign is running nationally and in many provinces. Here are a few links that can help you improve access to Occupational Therapy through benefits plans.
Alberta - SAOT Ask For OT
Nationally - CAOT Ask For OT
I love hearing how you relate to these episodes. Reach out on social to share your insights or tag me in a share.
If you're a busy OT business owner who would like to THRIVE without the HUSTLE, the Acceptance and Commitment Therapy-based ACTivate Vitality program might be just what you need. Click the link to learn more.
To see how Jane can help you focus more on your clients than your costs, book your personalized demo today. If you're ready to get started, you can use the code VITALITY at the time of signup for a one-month grace period applied to your new account.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Sarah (00:00):
We're not doing any of this for the sake of just Being more mindful, like
(00:04):
it's exactly, it's always an interventionto facilitate occupational engagement
in some way, form or another, right?
Exactly.
And I'm only interested inbringing mindfulness to my clients
if it's going to help them withtheir occupational engagement.
you know what?
What are we trying to accomplish?
And that's what it gets down to.
Sometimes people think, oh, if I'm doingmindfulness, it's got to be just for the
sake of training someone in mindfulness.
Carlyn (00:25):
you're listening to the Brave OT Podcast with me, Carlyn Neek.
This podcast is all about empoweringoccupational therapists to step up,
level up, blaze some trails, and maybeengage in a little conscious rebellion.
In service of our profession, ourclients, our work, our businesses,
and living our mission wholeheartedly.
We are all about keepingit real, doing hard things.
(00:47):
Things unhustling, being curious,exploring, growing through our
challenges, and finding joy,fulfillment, and vitality as we do so.
Really, we're OT ingourselves, and each other.
I hope you love this episode!
I just want to take a moment to saythat I really appreciate you as a
listener to The BRAVE OT Podcast.
(01:08):
I enjoy having these conversations,as you can probably tell.
And it was really rewardingto hear how they impact you.
So I welcome a message from you onFacebook or Instagram, I'll make sure
to put those links in the show notes.
Or you could even share a postabout this podcast and tag me in it.
It helps the message, reach thepeople who really need to hear it.
(01:29):
Today we are diving into all thingsmindfulness in occupational therapy.
Our guest today is a fellow CanadianOT who works in mental health.
Sarah Good.
I know we have an international audienceand our American colleagues will
certainly notice our Canadian accents.
Since we both see clients in thecommunity, you'll notice us saying "out
(01:50):
and about" a lot in this conversation.
And it made me giggle when Ilistened back to it, because
Americans like to tease usfor how we say that phrase.
the American accent is alittle bit more out and about.
Whereas Canadians tendto say out and about.
but it's exaggerated and we'recriticized for saying, "Oot and aboot."
See, if you can notice the differenceas you listen to this, but I wanted to
(02:13):
make sure to give a shout out to my palWalker in North Carolina on this one.
We've had some goodconversations about it.
And so I thought I would make referenceto out and about in the title.
in addition to talking about being outand about, we will explore how mindfulness
can be used as a powerful interventionto enhance occupational engagement
And not just an end in itself.
(02:34):
Sarah shares her unique approach toseeing clients in their homes and
outdoor settings And integratingnature into therapy to help her clients
reintegrate socially post pandemic.
We also discuss how our clients findus and are funded for occupational
therapy, with a mental health focusand the flexibility of working
online versus in-person at times.
(02:55):
Alongside practical insights,Sarah and I delve into the profound
impacts of using mindfulness andacceptance and commitment therapy or
ACT, offering real life strategiesfor therapists and clients alike.
I hope you find it impactful.
Today's episode is sponsored byJane, a clinic management software
and EMR that helps you handle yourclinic's daily admin tasks so you can
(03:19):
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time of signup for a one month graceperiod applied to your new account.
Sarah.
Thank you so much for joiningme on The BRAVE OT Podcast.
Sarah (04:10):
thank you.
I'm excited to be here.
I've enjoyed listening to your episodesbefore and reading stuff you post
different places and definitely feela connection to the work you do.
So I'm happy to be here.
Carlyn (04:20):
I think we do have a lot of overlap, not only in the cities we've
lived, but the ways we've practiced.
And, I think one of the things I loved yousaid when you filled out the form to book
this is that, You often want to jump in onthe conversations when you're listening.
And I find that too, sometimes whenit's like a podcast that it's like, Oh,
this is, I have something to contribute.
(04:42):
You just, why don't they hearme talking at them in the car?
Sarah (04:46):
Indeed, yes, you get a lot of interesting people on here and
I sometimes have other questions Ithink, Oh, that'd be interesting.
Yeah.
Please tell us a littlebit about what you do.
So I'm an Occupational Therapist inOttawa, Canada, and, I see people in the
community, primarily people who are livingwith mental health issues, particularly
mood issues, and, so often post traumaticstress disorder, depression, anxiety,
(05:10):
and often, as well, persistent pain.
So those, often an overlap, butsometimes those are the two main areas.
And, I work with adults, so I get tobe out and about through our beautiful
city a fair bit, which is good.
I try to see clients in their homesor outdoors as much as possible.
And, Outside of that, I'm a motherand a spouse and I spend a lot
(05:31):
of my free time outdoors as well.
I like cross country skiing andswimming in the lakes around here
and paddling and cycling and walking.
love to do that.
And I also find mindfulness meditationhas been a big part of my own, big
resource for my, for me over the last, alittle more than 20 years of being an OT.
(05:52):
It's been a big resource.
for my own personal well beingand professionally as well.
So that's another part of me and youteach these skills to OTs also, don't you?
I do.
Yes.
Yes.
I run a program for occupationaltherapists who want to learn mindfulness
for their own well being, but also,really a ways to bring it to whatever
(06:12):
their occupational therapy practices.
I've had people who work with kidsand seniors and everything in between
in hospitals and private practice.
Yeah.
So I've really enjoyedgetting to know OTs.
Throughout the world, but doing that.
I feel like if there was a Venndiagram of all the things we do,
we're almost Almost, except I'm inCalgary, but I did live in Ottawa.
(06:34):
And so it's, I love the journey too,because, I really relate to that
element of teaching, using a skill thatmakes a really big difference for my
clients, but that when I learned it,I integrated it into my own life, and
that was game changing, and I couldn'tnot share that with other therapists
for their well being too, right?
(06:55):
So I'm also teaching therapists stuffthat is for them, and I'm focusing a
lot more on acceptance and commitmenttherapy, which I know you use as
well, and, But that's the frameworkthat I'm using to, support my mental
health clients in the community andteaching OTs for their well being, but
also for that skill of, like, how theycould apply that in their practices.
(07:15):
yeah, this is very exciting.
Absolutely.
And your own well being, right?
You're probably using ACT, yourself.
Yeah.
Yes, exactly.
that's, I think, my favorite thingabout being an occupational therapist
is I get to learn these differentthings that just help me as a human.
Yeah.
And then offer them to other humans.
it's a really privileged spacethat we get to be in to be able
to dive into these things as well.
(07:36):
And BRAVE, right?
When you think about that bridge, likethat, it's easy for us, like that path
of, okay, I'm doing this type of work.
I need to learn this skill to helpmy clients and then to go, maybe
teach other people some of thisoutside of a clinical practice.
that's a big leap to make.
How did that come about for you?
(07:58):
Yeah, that was a big leap, for meand I think, probably for lots of us.
so I trained, I used mindfulness myself,start with that as, when I was, A new
graduate, I actually started doingmindfulness meditation, in using, I
got, I signed CDs out of, the hospitalwellness center, and I went to take
them to, the hospital I worked in atthe time, had this lovely interfaith
(08:20):
chapel, so I used to just Go in therefor 10 or 20 minutes at lunchtime and,
turn my pager off and listen to the CDs.
So that was the way I sort ofintroduced it to myself and thought,
okay, this is helpful to just havea few minutes every day at lunch
to start practicing this myself andthen I started reading more books.
And so I was very much self taughtand in there, I had kids and so forth.
(08:42):
And then, 10 years ago, I then decidedto train as a mindfulness meditation
teacher, which was definitely a gamechanger for me, because as I've been
self taught, I was doing the mindfulnesspractice for 10, 20 minutes a day, but
I hadn't thought of ways that couldactually impact my time, that I wasn't
sitting and doing the meditation.
(09:02):
So bringing mindfulness more to myinteractions with other people, clients,
family members, my time walking in nature.
Eating, whatever else.
I sort of hadn't self taughtmyself of that so much.
So, when I trained to be a teacher,that was really, the game changer
of, wow, there's a lot of ways I canbring this into my day to day life.
And it really encapsulates, theidea of occupational therapy.
(09:24):
I mean, everything that we do thatoccupies our time, we can bring, you
know, mindfulness attitude to it.
So I trained as a mindfulnessmeditation teacher at the Ottawa
Mindfulness Clinic and started teachingthere the program they have for
people living with persistent pain.
And then when COVID started, I gotmore, connected with OTs online as a
(09:45):
way to, as I run a private practice,it's just me, myself, and I, so it
was nice to be able to connect withcolleagues throughout the world.
And, and I started exploring more.
people interested inlearning more about this.
So I put out there, you know,would people be interested in that?
If I put together a video onjust introducing people to what
mindfulness is, and I had hundredsof people sign up to see this video.
So that, okay, we'retaking it to the next step.
(10:07):
So proof of concept right there.
That was like just a little tester.
Carlyn (10:11):
Let's see.
Is maybe anybody, hopefully acouple of people who are interested.
Oh, hundreds, hundreds.
Okay.
I'll make the video.
Okay.
So maybe video shared the link and then Ioffered it as a program, which I designed
to be an eight week program startingin the fall of 2020, with the idea of
there being some asynchronous stuff wherepeople can watch videos, read things,
(10:31):
do meditation practice on their own, andthen also have group calls where we come
together and can share what we're doing.
What's hard or what questions peoplehave, or how do I really apply it
to this particular area of practice?
so that's been continuing.
So there was that, the bridge for you wastaking that training to be the trainer.
(10:52):
then you started to see where you hadthat potential to be able to deliver that.
As a service, but it was first integrated,not as a clinical skill for you as
it was as a personal thing to do.
And then it expanded from there.
Yeah.
Yeah.
Really neat.
Yeah.
When did you start your program for OTs?
(11:13):
Around the same time.
So I had taken a course to learn how tocreate a course in 2019, or I signed up
for one at the kind of October, 2019, andthen was just too busy in my practice.
So my practice is similar toyours in that it's a mental health
private practice for adults.
It's typically beencommunity based where I go.
(11:34):
And.
Funded by third party referrals.
So I'm getting the referralsfrom mostly long term disability.
Actually, I used to do more veteransaffairs, but right now it's mostly
been long term disability orpeople, paying privately and, so
meeting them out and about now it'stransitioned to a little bit more.
mostly online and I miss going outactually and meeting people in class.
(11:54):
So I get excited when I havethat opportunity again, but I was
just so busy with that practice.
There was so many referrals comingin that I really didn't apply
what I learned in that course.
And so when the pandemic hit in 2020.
It was time.
And similar to you, I'm reachingout online to connect with other
OTs and going, okay, well, I guessthere's no time better than now
(12:16):
to reach out for connections.
So I threw out like my first littlelead magnet as a email list builder.
Right.
And it was about Just basic buildingroutine and structure, because as you
and I both know, when people have beenout of the workplace for a long time,
then that starts to be limiting andnegatively impacting their mental health.
(12:39):
go off work because of their mentalhealth, but then that actually
starts to perpetuate it a little bitbecause they've lost that structure
and routine and occupation andreward and socialization and stuff.
And so I decided to put togethera little kind of like, how do
we maintain some basic structurein our kind of quarantine times?
And that sort of started the ballrolling and then threw out like anybody
(13:02):
interested in learning more about ACTand all sorts of people and then turned
that into ACTivate Vitality, whichis my program that I offer for OTs.
And OT business owners aretechnically my niche at this point.
You don't have to havea business to benefit.
It just tends to be the group that tendsto want to sign up for the program.
(13:24):
And then my ACTivate Vitality planner.
So it grew and evolved.
You have one?
I have one.
I see it's been nicely used too.
It looks, lived in.
Yeah, so I'm a Fountain pen user.
So then it gets a little leaked onthe front here, but that's okay.
It's been a while.
I love that.
Yes, I find some people don't wantto write in it because they're
afraid of not doing it perfectly.
(13:44):
I'm like, no, that's I wrote inthere like get coffee stains on it.
give it a lived in used feel.
But yes, it's been similar to you.
I throw things out and tryand are people interested?
And this year I ran an ACT,Practical ACT for OTs course,
which people really liked that.
So I think I'll get some feedback, dosome revisions and offer that again, I
recorded it all, but sort of figuringout what people want and figuring out
(14:08):
how to deliver it, do it kind of low key.
And then see if you wantto fine tune, right?
Absolutely.
Yeah.
that is similar.
experience for me.
I've, put things out there, and then Ithink, okay, for instance, I said it was
an eight week course to start, becauseI thought I'll release one asynchronous
unit a week, and then we'll have one call.
And then I started, then peoplestarted showing up and feeling bad.
(14:30):
Oh, I'm way behind.
I haven't, I thought,we can do my homework.
Yes.
To be, you know, there's no rush to this.
then changed it to just giving peopleaccess to the material without calling
it week one, week two, and saying, Workthrough it at the pace that works for you.
I do have it, structured so people can'tget access to all the material at once.
There's no binge watching of videos.
But other than that, people goas slowly as they want through
(14:52):
it and then come to the calls.
I love that.
And so did you find that givingsome flexibility around that, helped
them actually go at their own pace?
Yeah, I think so.
And then what's come out of that as wellis some people wanted to stick around
for to be able to move through it longer.
So then I've offered, extensionsfor not, if people sign up for the
(15:14):
program, they get the asynchronousstuff for, as long as I'm running it.
So there's no deadline to that.
But the group calls, I've nowgot people who have graduated.
We have a group as well,a membership program.
So people can stick around with that,and they're not in the same calls as
people who are just starting on week one.
So some of the people who are in thathave been coming for 2 years to the
(15:34):
membership, a couple times a monthof just checking in and so it offers
a different level of support just.
Yeah, finish the program, and it cangive them accountability and give me
accountability to keep up with ourown practice and as people switch
jobs or have started training in someother things, how they integrate it.
So that's been helpfulto see the longer term.
(15:56):
Yeah, application of it.
I like that too.
I've also had people around for a coupleof years and I thought, oh, wow, I wasn't
sure that's what people would want.
But that's it.
if you're paying attention and responsiveand finding ways to meet the needs in
a way that works for you, then why not?
Yeah.
so this program that you're talkingabout with the mindfulness for the
(16:17):
OTs, is that something that peoplecan sign up for at any time, or
do you launch it periodically?
Sarah (16:24):
I launch it periodically just so that then I can offer the calls, sequence
we do twice a month for a few months.
so I'll be offering it in October2024 is the next offering of it.
and if people are interested in it atother times, then people can send me an
email and I'll let them know when the nextoffering will be, because I tend to plan
it out once I've opened it up in October,I'll think through how many months do
(16:45):
I want to wait before I offer it again.
Carlyn (16:47):
Okay, great.
And so we'll put a link for that in theshow notes so that they can find that.
And what's it called again?
Can you remind me of the name?
the Mindful OT Mastery Program.
Okay, perfect.
That's great.
So in your mental health privatepractice, how are people finding you?
Sarah (17:05):
a couple ways.
Veterans Affairs, I do get calls.
Fair bit of referrals for VeteransAffairs and through our, our Workers
Compensation Program in Ontario.
sometimes I'm surprised areferral source that I'm not as
accustomed to will suddenly, I'llget three referrals from them.
they must, so the RCMP has beenlately having more referrals from, and
then I have private paying clients.
some people who just look for me whenthey're, Off work, I'm in Ottawa, so we've
(17:28):
got a lot of federal government employees,so I've had a good number of federal
government employees who are on leaveof absence and, needing to transition
back to work and helping them with that.
paramedics as well, seem to have gottenquite a few paramedic referrals in the
last few years and family physicians.
Actually, their organization hasreferred a number of people to me.
And it's not always return to work.
(17:50):
Sometimes it's support for mental health,while people are already working, or
they're going through a lot of caregiverstress with an aging parent, or a
child going through a difficult time.
It's a wide variety of issues.
Carlyn (18:03):
would it be the employer who's reaching out to arrange some of those more
proactive services or how's that coming?
It's the employee themselves.
They'll come play themselves.
Yeah.
Sarah (18:13):
the third party people like Veterans Affairs Canada and, the
workplace safety and insuranceboard will reach out to me.
but other people will reach out.
independently.
for instance, the family physicians,there's an organization that lists
where they can get some help ifthey're struggling with their mental
health, and I'm listed on that.
So they might see me on thelist and just reach out to me.
Great.
(18:34):
That is really good.
Yeah.
Yeah, it's a good variety.
I've always enjoyed wide variety, widevariation in the clients that I'm seeing.
Yeah.
And it lets me see differentworkplaces and getting to know what
it's really like to be a paramedicor to work for the RCMP or to, be,
be in different types of employment.
Yeah, because everyone'slife's interesting.
(18:55):
Very much I just love to see suchdifferent routines and different
jobs, different family structures.
So I do find that good variety there.
Carlyn (19:03):
I like that about It's really having that mobile practice that, you're
designed to go to the environmentswhere the people are, where they're
functioning, where they're experiencingchallenges and help, help them, be
able to fully participate or return toparticipation or improve their ability
to engage or how they're doing it.
And, that environment piece,gives us so much context, right?
(19:26):
if a client's coming to see us in aclinic, which we've done at times too,
or right now I'm doing a lot online,like I'm missing so many key things,
like even just even seeing how a personresponds to struggling to find parking
or a person messing up their coffee orderor a noisy crowded environment, gives
me so much information that I wouldn'tget if they came to my office to sit in
(19:48):
front of me and tell me about their week.
Sarah (19:50):
Absolutely.
We get to use all of ourInvestigative skills.
as soon as I walk into a house, I feellike I already know something about them.
so like you, I went down to almosteverything online for a couple of years.
unless, and it went from it usedto be the default for all my
clients was in person before COVID.
And if there was an extenuatingcircumstance, like I would say to
people, if the school buses arecanceled because of bad weather, I'm
(20:13):
not going to be driving out to youif you're far away from where I live.
So then we would go to online.
Then.
the pandemic, everything went online,unless there was a really good reason
why we needed to move in person.
And in the last six months,I've moved much more to maybe
a little longer than that.
I have new clients I was movingto, no, we're back to in person.
But then now I'm really trying to pushsome of the people I've been seeing
(20:34):
online for years to, okay, I think nowwe really can meet, assuming everyone's
okay in my household and your household.
Let's try to get you out.
Yeah.
Yeah.
Yeah.
And I'm noticing my drive to get peopleout into nature, even urban nature.
We're not going into deep forests here,it's helped people to start getting out
of their house after this time of so manylockdowns, helping people to get used to
(20:55):
being out and about in their community.
And then I'll notice people aremore likely to sign up for a pool
tournament or go out and, join a sportsleague or get out and about more.
Ciao.
Certainly, the ripple effect too.
Yeah, it's a ripple effectonce people get out.
Carlyn (21:10):
Oh, that's inspiring me because I feel like a lot of my referrals are where
they used to pay me to travel to them.
They're coming with Yeah, like whichvirtual platform are you using?
Perfect.
We'll give you this manyhours for this many sessions.
and, and so it's become the default.
And I think that it is wise to get out.
And I have a park nearby herethat's about a seven minute drive.
(21:33):
So even if I'm not gettingpaid to travel, why not have
the person come meet me there?
Sarah (21:38):
Yeah, that's it.
Because I'll pick one if I'm not, ifit's a private pay client, I try to
avoid billing people for travel timeif there's no third party involved.
But yes, I'll pick a park that'svery close to me that I can walk to.
And it's by the canal and, it's alovely spot and we can walk on a path
or we can sit on a bench, but now we'reface to face and we're out and about.
(21:59):
Yeah, so that makes abig difference, I find.
Totally.
Carlyn (22:03):
Do you find too, I've found that, even just when I started walking
more with people versus meeting them ina coffee shop, for instance, still face
to face, but actually, it's the not faceto face, like sometimes that walking
side by side with them and moving, theygot unstuck a lot more readily than
the more stagnant face to face session.
Have you experienced that?
Sarah (22:26):
Yes, I have.
I think some people reallylike the eye contact.
Yeah.
And that's fine.
So for those people, the walkingisn't that great, but I've got
all kinds of people out there.
So not everyone likes eye contactwhen they're sharing things.
So I think that's part of it too.
Just like the parenting advice,
if you need to talk to your teenagerabout something in the car, do
it while you're driving, right?
Totally.
Exactly.
Not while you're sittingat the dinner table.
(22:47):
They can't get anywhere, andthey don't need to look at you
as they're talking about it.
the same kind of thing can be true.
And then, yes, that reciprocal movementof the walking and being out in nature
has a huge impact on our nervous system,and I find it an easier way to introduce
mindfulness practices to people.
So, that idea that topractice mindfulness.
(23:09):
We need to sit in a particular way and weneed to have no distractions and we need
to be able to focus and clear your mind.
I can never clear my mind,which is a good thing, right?
I'm alive.
I've got to think in mind.
It's never going to clear.
But when we're out and about, I'mjust going to sit here and think.
You Often there's something theynotice or something I notice wow,
those flowers weren't out last week.
(23:30):
Check out the hair and then we can stopand take some time to really notice that.
And then that in itself is a mindfulnesspractice of we're stopping, we're noticing
what's in the here and now, and SometimesI'll invite people to close their eyes,
depending on what we're noticing, andbring in different senses, because we do
tend to use our visual sense a whole lot.
And as OTs, we're very aware of bringing amulti sensory kind of approach to things.
(23:54):
So I think the idea of when we'reout in nature, there's so many
ways we can engage our senses.
That's an added bonus, as well,of seeing people outdoors.
Carlyn (24:02):
I totally agree.
I've found that's been my go toas well yeah, it's almost like you
teach mindfulness before even youtell them that this is mindfulness.
It's just this natural thing we do.
And then if you explain thatwas a mindful practice, no way.
Who knew?
I didn't think I could do that.
Sarah (24:19):
Exactly.
I have some downloadable thingson my website because this
relates that OTs can download.
So I'll send you thelink for that as well.
But one of them is ways tointroduce mindfulness to your
clients, if it's a challenge.
And that is one of the ways.
Don't even tell them.
Just, Sneak it in, and labeling itmindfulness can actually cause many
people to be turned off the idea.
But yeah, just putting a practice inthere, and and seeing how it lands,
(24:43):
rather than, I think sometimes as OTs wefeel like we need to tell people all the
research, and the risks, and rewards, andmake sure they understand what they need
to do, is that before we just try it.
And, I'm all for informed consent.
If somebody has given informedconsent to walk in a park with
me, and then I'm inviting themto really notice the flowers.
(25:05):
That's part of it.
I don't need to be stopping andexplaining the research behind the
impact of nature or the impact ofmindfulness in order to do that.
So I think that kind of takes the pressureoff us as practitioners of that, I hope.
Carlyn (25:18):
Totally.
if you, overly formalize it, like youlose the plot on let's just feel this
magic moment, like it's beautiful,like just this experience of all that's
around us, this sensory experience, if weintellectualize it before presenting it.
then that kind of has the oppositeeffect of what we're trying to do.
Sarah (25:38):
Yeah.
Yeah.
I heard someone say recently,go on mindfulness until
you say it's mindfulness.
Isn't that the truth?
That was pretty funny.
That is so true.
Carlyn (25:47):
Because you talked about mindfulness meditation, and so
thinking about meditation andmindfulness meditation, how do
you explain that relationship?
Sarah (25:57):
Yeah, so I think I start with the idea of meditation, and
many, and maybe even most cultureshave some form of meditation.
And so sometimes, part of myassessment is asking people about
any spiritual practices they have.
And so that, that can sometimes revealif they already have some type of
meditation or some type of prayerin their day as part of the routine.
And then I reinforce thebenefits of keeping that up and
(26:20):
building that into your routine.
So meditation comes fromlots of different traditions.
Mindfulness is the idea ofbeing present with what is here
right now without judgment.
And That can be done while you andI are having this conversation.
I'm not trying to think of what I'mgoing to eat for dinner tonight or
(26:40):
what my client said this morningwhile I'm talking with you, ideally.
So that, that's bringing my mindfulpresence to our conversation.
Mindfulness meditation would bethen a specific type of meditation
which, Because it's a secular type ofmeditation, so it's not coming from
a particular religious background.
It's something that's been brought toNorth American or Western healthcare
(27:01):
more than other types of meditation.
and so it's the idea of focusingon using formal practice to focus
in on what's present right now.
So that could be thesounds in the background.
It could be looking at a candle.
It could be the breath.
It could be the sounds.
It could be being mindful of my thoughts.
(27:22):
So there's a whole variety ofthings that are going on right
now that we can pay attention to.
So I would call that themore formal mindfulness, is
the mindfulness meditation.
and then the more informal, Mindfulnesswould be the stuff that happens as
we're going around through the day.
for me personally, in order to bringthat more informal mindfulness to my
day, to my clients, to my family, tomyself, I need to have a daily formal
(27:45):
practice of mindfulness meditation.
So it's would be like saying, I need to goto the gym regularly so I can go on hiking
trips, which not everyone does, right?
And that's okay.
But, for me, I find if I don't dothat formal practice fairly often
through the week, I start to noticemyself getting more derailed from
(28:05):
the present moment more easily.
Carlyn (28:07):
yeah.
Yeah.
That makes sense.
I like how you framed that.
cause, I find that sometimes with myADHD brain also, there's that sense
of, I love mindfulness, the practicalversion, and I don't love meditation.
And I think I have some of those hangupsthat we often hear when people, sometimes
if we introduce mindfulness to people andthey're like, ah, that's too religious
(28:29):
or too this or too that, or I can't.
And so I think I get someof those hangups when.
I have had a really consistent meditationpractice at times, and right now I'm
out of that, but it is interestingto think about how it's for you.
It's like going to the gym so you can dothe hiking or the activities you enjoy.
That's a nice way of framing it,strengthening those neural connections
(28:51):
and habits, essentially, to beable to more easily be mindful
throughout your other activities.
Sarah (28:57):
Absolutely, and realizing that we're all different.
some people can feel like they'refit enough to go on a hike
just because they go on hikes.
every week, but other people feellike they need to do certain physio
exercises, maybe, or they need togo to the gym, or whatever they
need to do, so that they can be goodenough shape to go for hikes, right?
Yeah, it's interesting that ADHDmind, I don't have an ADHD mind,
but I live with three people who do.
(29:17):
for me, perhaps that need for thatformal practice is also a removal
from all that spinning mind thatcan go around me a fair bit.
That's fair.
That is totally fair.
Carlyn (29:31):
Yeah, that's good.
That's really good.
I'm thinking about, ACT and mindfulness.
so we both use acceptance andcommitment therapy in our work.
Also known as ACT.
And so for the listeners, I like tokind of describe ACT it's a, it's
part of a third wave of cognitive andbehavioral therapies that, that works
(29:52):
really beautifully with OT and thereare Four of six kind of core processes
in ACT are based in mindfulness,and the other two are values and
committed action, and so doing whatmatters, which is what we're all about.
And so in ACT, the goal is to supportpeople in doing what matters, and
to do so they connect with what'simportant, their values, and commit
(30:16):
to the action of doing that, and wherewe get pulled away from doing those
things, we have a bunch of tools thatare largely based in mindfulness to help
us create a bit of space between thosedifficult thoughts and feelings and
sensations that can pull us away fromdoing the things that we care about.
And unhooking skills is an partof, describing that in ACT.
(30:37):
And so the mindfulness ones are thatability to observe the situation, the
observing self, and have that abilityto see what's going on, see yourself,
having the thoughts and feelings, seeourselves engaging, see ourselves maybe
avoiding or moving toward, and thenthere's that sense of being present, being
there in the present moment, and thenthe other ones are more about, Accepting
(31:01):
the difficult inner experiences, thedifficult feelings, difficult emotions
and sensations that come up and makingroom for them, turning toward them
instead of trying to push them away.
And then with the thoughts we're tryingto like use to be able to create a bit
of space between you and the thought.
We don't have to change the thought.
We don't have to make it positive.
We just don't necessarily need to smush itall over ourselves and fully engage in the
(31:23):
world through the view of that thought.
so these.
processes help us to then be ableto do the things that matter.
And, any ways we do this, likethis is, we're really building that
capacity to have the flexibility tosurf the waves of the difficulties
of being human, all very grounded inthousands of years of mindfulness.
Sarah (31:47):
Yes, absolutely.
As soon as I started learning about Ithought, wow, this is, it's definitely
a mindfulness tool that we canuse, and it's so nicely structured.
there's so many specific,it's almost things in the ACT
toolkit that we can use as OTs.
The one I find I personally use the mostis noticing which stories are present for
me the most often, and those unhookingI'm having the thought that I know one
(32:08):
that I don't personally use as much, butI've had clients find very helpful is
that, taking that story and putting itto happy birthday or something like this,
like singing it to themselves, right?
Oh, it's the, it's all my fault story.
And they got to sing that tothemselves, that presence of that story.
So that's where the mindfulnesscomes in is I'm aware that yes,
I'm having this story's going on.
(32:29):
I'm getting pulled.
I'm getting hooked onto this story.
Now, it's dragging me through the day andchanging, perhaps, my behaviors and my
thoughts about the future and so forth.
I find it to be a fascinatingone to use on myself.
And as a provider, it puts a lot oftrust in my clients, which is lovely
because Everyone is so different, andalso it doesn't put the expectation
(32:49):
that I'm going to know what they needto do to unhook from things, or I'm,
I don't know what their values are.
I can help them figure out theirvalues, but that's up to them.
And their story, I use a lot the, oneof the tools, the ACT matrix, where they
draw in their values in one quadrant tothe things that are true, but a challenge
in their lives and another, and what itlooks like, in their lives when they're
really getting pulled by those challenges,and then what it looks like when they're
(33:12):
actually living out those values.
And it's fascinating that every singleperson has a different matrix, and it's
not up to me as the OT to tell peoplewhat it's going to look like for them
to have a good routine in the day, orin Start their day off really well for
themselves, because what's going to starttheir day off well is different than
what's going to start my day off well.
Carlyn (33:28):
that and say motivational interviewing.
I probably learned about that one first.
And as soon as I learned aboutthat, I thought, this is amazing.
I can ask people the right questionsand they can come up with the answers.
I don't need to know.
I don't need to have the solution.
Totally.
I have a worksheet of ACT basedquestions that I think I download it
from the ACT Made Simple Facebook group.
And the author is Lou Laspregado.
(33:51):
I don't even know, but he uploadeda sheet of great ACT questions.
And I was like, Oh, so I have a studentright now she's supporting actually
in the ACTivate Vitality program morethan in my mental health practice.
And, it's neat because she doesn'thave the business experience or
the OT experience of a lot of theOTs in the group coaching program.
But I'm like, you don't have toactually have the answers, right?
Like if you've got some greatquestions, this can really do it.
(34:14):
And I remember that feeling that way withmotivational interviewing too, when I
learned it and I incorporated it as well.
But the, it's neat to find those questionsthat get you like out of that spinning
thought process, that's agitating andgo, Oh, That kind of stops me in my
tracks and gets me to think about thissituation from another perspective.
Sarah (34:33):
Yeah, and being able to pull out the right questions.
That's great.
The whole list of ACT questions.
ACT questions are motivationalinterviewing questions
that you can ask people.
so what would it look like ifyou had a good morning routine?
what would that look like?
And then being able to bethat accountability person
to help them build that.
With their values.
Yeah, it's huge.
It's huge.
And for a lot of our American listeners,I'm sure you've provided these, some
(34:57):
training and stuff to American andCanadian, a lot of the questions we get.
Which are hard to answer as Canadians.
how do you bill for that?
Or how do you charge for that?
And I know for us as Canadians, it's,I just put an OT invoice in and I don't
have to justify the modality I'm using.
I don't have to explain why I didwhat, with the types of payers that
(35:18):
we're dealing with for the most part.
But How do you respond to that forsome of the people who really do
need to itemize the treatment or thecondition and that sort of thing?
Yeah.
because that does come up when peoplejoin the, the Mindful OT's Facebook group,
I ask them, what are your questions?
What, what do you hope to learn?
(35:38):
And that comes up surprisingly oftenis that one of the challenges to
integrating mindfulness into thepractice is I don't know how to
bill for it, or I can't bill for it.
So what, in speaking with some, AmericanOTs and say, it's hard for me to
understand and imagine as a Canadian OTis saying, what are you, what are you
working on introducing mindfulness for?
(35:58):
What's the occupationthat this is based on?
And there we go.
Okay.
So you're doing this aspart of pain management.
Then how would you normallybuild pain management?
You're billing it that way.
or you're doing this as partof discharge planning from an
inpatient mental health unit.
Okay.
So helping people with lifeskills when they get discharged,
what would you bill that as?
And usually people can come upwith what they would bill that as.
(36:20):
We're not doing any of this for the sakeof just Being more mindful, like it's
exactly, it's always an interventionto facilitate occupational engagement
in some way, form or another, right?
Exactly.
And I'm only interested inbringing mindfulness to my clients
if it's going to help them withtheir occupational engagement.
Yeah.
So if their minds are totally woundup and they can't settle to go to
(36:40):
sleep, well, then can we find somekind of evening activities that
are going to help them settle?
And maybe that would include amore formal mindfulness meditation.
Or maybe it would include awalk or eating meditation.
nothing to eat right before bed but, acup of tea, but then it becomes, okay, so
this is part of an intervention on sleep.
you know what?
What are we trying to accomplish?
And that's what it gets down to.
(37:01):
Sometimes people think, oh, if I'm doingmindfulness, it's got to be just for the
sake of training someone in mindfulness.
And that's not a, there'sno treatment code there.
So that's, that matters.
And for some of them too, theyshare that their insurance.
isn't acknowledging OT asa mental health service.
So they're seeing that connection that,this is a mental health intervention,
(37:21):
but OT is an intervention for, andthat's a whole other argument, like
it's fully in our scope, but, insurancechallenges, but ultimately we're
still always working on an occupation.
What's the thing thatthey're trying to do?
The thing that they're not doingis why we're addressing this.
And these are the, this the toolsthat we use to help address it so
they can do the stuff that theywant to do with the occupations.
(37:43):
Yeah, that's beautiful.
Exactly.
They've got to be able to do something.
And whether, sometimes I think it'sthought that, mindfulness is a mental
health intervention, and it can beperhaps, but it doesn't need to be.
It can be, Something to help with anyoccupation that a child does, that an
adult does, that a parent who's in theneonatal intensive care unit is using.
(38:03):
All right, so there can be allkinds of every age can be using
it to engage in some occupation.
Yes, that is key.
That is so key.
Some of the other concerns peoplehave about bringing mindfulness to
the clients is just team members won'tthink this is appropriate for OTs.
So that same explanation can be helpful.
this is the intervention I'musing to help this person engage
(38:26):
in such and such occupation.
Because sometimes people will beon teams and still know that the
psychologist does mindfulness.
Okay, and that's fine.
But the psychologist isn'tnecessarily helping them engage
with a particular occupation.
So they can already have learnedsome stuff from the psychologist.
They can already have taken aneight week mindfulness based
stress reduction program.
That's great.
That's just getting,making your job easier.
(38:49):
But now, can you help them apply itto doing whatever they need to do?
Or whatever role they need to be able toembrace that they're not able to embrace.
And that's exactly the juncturewhere I often get referrals is
where they've been taught all thethings in a clinical setting or,
in, in counseling or something, butthey're not doing anything with them.
(39:11):
And the referral source is oftenidentifying that they haven't engaged
in changing the way they'reapproaching anything.
They've got the knowledge,but they're not using it.
And OT is great for that.
We can teach it too.
but it's often that, spot where I getthe referrals from those third parties.
Exactly.
Exactly.
So that's a good one.
And then we've already addressedthe third thing that I think
really stops OTs is that theythink, Oh, no, clients won't do it.
(39:33):
no, my clients aren't toointo the hippie to be stuff.
People will say that.
So the majority of my clients are young,Canadian military veterans or paramedics.
They are strong, not hippie dippiepeople that I am working with.
and, When it's introduced to themin a way that actually seems to
make sense and fit their lives,many of them find it really helpful.
(39:57):
And I don't show up at my first one on oneappointment with people and say, okay, now
we're going to learn mindfulness at all.
It's more chill.
Let's get out the candleand the essential oils.
No,
but as we're doing thingslike, okay, we need to get back
into paramedic headquarters.
We're standing in the Parkette rightoutside Ottawa paramedic headquarters.
I'm You know, say, let's justsit here on this bench and just
(40:17):
feel our feet on the floor, onthe grass, rather, not the floor.
Let's just take in this place.
what do we see in this park hat?
Let's just bring this in.
So suddenly I'm introducingthem to mindfulness.
without it being a formal thing.
Now, people do sometimes come to mespecifically because their doctor or their
physio or somebody said mindfulness wouldbe really helpful to you, in which case
I am diving right in the first session.
I'm like, okay, let's do this.
(40:38):
Or they're coming to, one ofmy client facing programs.
That's different.
But, not all of my clients are goingto do formal mindfulness practice.
But in some ways, that is anessential part of what all of them
are doing is finding ways to bepresent with whatever they need
to be doing to occupy their time.
Yeah.
I have, I know all the bestspots for doing just that
(40:58):
outside of all the hospitals.
I seem to have a lot of healthcare workerswhere I've needed to do exposure to
the workplace in advance of like, oftenthey're driving whole other routes, so
they never see the hospital they workat and then building that gradual and
we sit and we observe and we feel allthe feels and we sit in that and or we
(41:18):
move to another spot and often it is,yeah, in the car or on a park bench or,
at the grocery store across the street.
Yeah, exactly.
Yeah.
And that's bringing some mindfulexperiencing to that environment
and approaching it at a human speed.
And in order to do exposure therapy, youneed to become mindful of your physical
sensations or else you're just going to berushing into the building and then hitting
(41:41):
panic and not even, thinking you went fromzero to a hundred in terms of anxiety,
when the reality is probably just was aspace that you weren't able to notice that
you were going from zero to a hundred.
We went too quickly and we didn't spendenough time noticing what was going on.
Brilliant.
Oh, this is so fun to talk tosomebody else who, yeah, we
share a lot of those things.
I really appreciate that.
(42:01):
Yes, this has been wonderful.
Yes.
I have a couple questions I askeverybody who comes on the podcast.
Are you open to answering those?
I am indeed.
Okay.
What does being brave mean to you?
I think being brave means pushing yourselfa little bit outside your comfort zone.
And knowing that you're stillsafe, but It's a little further
(42:23):
than you're comfortable.
And doing it anyway.
Yeah.
and that's different, right?
It's different than running,just like you said, running
past that threshold into panic.
it's that stretch and being aware of thestretch and stretching anyway, right?
Yeah.
Yeah.
To me, starting a business 10years ago was a huge one for me.
Totally.
(42:44):
Very huge.
What's something recent that you've donethat's brave that you would say is brave?
Ah, that's a great question.
I probably don't acknowledge as muchwhen I do things that are brave.
To myself.
So that's a curious thing to observe.
That is a curious thing.
I noticed when my kids do brave things, Ipointed out, I can look back historically
and say, wow, I did those brave things.
(43:05):
But yeah, something recent.
Okay, here's one in thelast couple summers.
I've been learning to sail.
And I've gone to this introductorysailing course, but a couple weeks ago,
I took a sailboat out by myself, notduring the class and just went out.
So that felt brave and it went well.
Ooh, that would be very brave.
Oh, was that on a lake nearby?
(43:27):
It's in the Gatineau River.
So very wide river.
Looks very lake like.
yeah.
Cool.
Really cool.
So that's pushing my comfort zone a bit.
Totally.
What would you like to see OTsget a little bit more brave about?
I'd like to see OTs get a littlemore brave about, pointing out
how essential our services are.
I know it's different in differentcountries, but in Canada, we talk
(43:48):
about having universal healthcare,but we actually have universal
hospital and doctor care, right.
And occupational therapy for mostpeople isn't covered very much under
their extended health benefits, whichin Canada is what we use if we need
to pay out of pocket for things.
I think that we need to get braver on,as a profession at advocating for the
fact that we do provide mental healthservices, so that might be true for
(44:10):
some of our colleagues in differentcountries, and that we do provide,
cost effective ways for people to Getback to living their lives, and I think
it's an underappreciated profession.
Yeah, for sure.
This would be a good place to dropthe whole, Ask for OT campaign too.
Maybe I'll put some links inthe show notes for Canadian OTs.
(44:31):
There's an Ask for OT movement, and I knowsomething nationally, and each province
has a version of that, where we'retrying to get on more extended health.
benefits plans and it's working.
I think there, the needle ismoving, but it's, it's amazing
that you can, get coverage.
I'm, I've seen some plans where evena nutritionist, not even a dietician.
(44:51):
could be covered, yet we're aregulated health profession.
and not some people don't haveOT on their health benefits.
They could get acupuncture or Chinesemedicine or naturopathy or, some of these
other things and not OT and it's, Thisadvocacy movement is really important.
Absolutely.
Yes.
I saw that, signed up for it, put iton my website, but my Facebook page.
but yeah, in Ottawa, because so manypeople are federal government employees,
(45:15):
it definitely, the needle moved, but everypeople get 300 a year for occupational
therapy, which is not nothing.
It'll get you two sessions.
Yeah.
They get 5, 000 a yearfor psychology per person.
Yeah.
Now, sometimes mental health OTcan be put on, it's not psychology,
if psychology in that senseunderneath or other psychotherapy.
So sometimes mental health OT,sometimes they'll let that go
(45:37):
under there, but not always.
So, yeah, 300 a year is not really,it's enough for people to come
and do a couple sessions with me,get a sense of where we're going.
But then I find it.
People will do maybe four or fivesessions and then they start to feel
like, okay, I've made some progressand then they're done because they
now need to pay out of pocket.
As you say, it covers two sessions.
Yeah.
(45:57):
Oh boy.
we need more than justgetting on the benefits plan.
And that's a start.
how would you like peopleto reach out to you?
what's that sort of call to action thatyou want people to take to reach out?
Yeah, excellent question.
So if they're wanting to just learnmore about this and learn more
about mindfulness and have somemore tools as an OT, I'd recommend
they go to my free resources.
(46:17):
That's probably a good spot to start.
people are welcome to email me.
So you can put my emaildown there as well.
and I do write back topeople who write to me.
they can DM me or messageme on social media.
I cannot guarantee a prompt response.
I'm not that great at checking those.
I'm not checking those every day or two,but if they do have a question, email
(46:39):
or if they download one of the itemsfrom the, free resources, they'll be
added to my mailing list, which theycan unsubscribe from if they would
like, but it gives a couple littleemails where they'll get some blurbs on
what's going on and what's happening.
And then about once a month,I send out an email on it.
That's great.
And I'll ensure that I include a linkto the Mindful OT Mastery Program.
(47:01):
Excellent.
Thank you.
That would be great.
Yes.
Good.
Oh, thank you so much.
It's such a delight.
And I feel excited and inspiredand truly love this work.
people often talk about, when they're ina state of burnout, wanting to get out
of OT and, Build something that's, moreleverageable or that they can serve many.
And I like that side, but Idon't want to stop doing this
(47:24):
stuff that we've talked about.
I really love doing this client work.
I can't imagine not doing it.
No, me too.
I love the client work.
I love seeing people's livessometimes change direction or
sometimes go back to what theythought they couldn't get back to.
it's amazing.
Yeah.
So rewarding.
Yeah.
We just need to find ways to workthat are sustainable for our lives.
Exactly.
(47:44):
I think part of that is runningour own businesses sometimes as
long as you can do that within,maintaining your own boundaries.
Otherwise it becomes the flip side ofthat, which is a recipe for burnout.
So true.
Good reminders.
Thank you, Sarah.
thank you very much for having me.
It's been a pleasure.
My pleasure as well.
Carlyn (48:04):
I really hope this conversation with Sarah Good, inspired you to
think about how you are showing upas a therapist, how you're working
and how you'd like to be working.
Sarah's mindful OT mastery programis going to open very soon.
If you're listening to this podcastat launch time It'll be open for
enrollment November 18th to 21, 20 24.
(48:24):
And there's a link to theregistration page in the show notes.
At this point, I think you cansign up to be notified When
it opens for registration.
The program is for occupationaltherapists and is designed to
help you incorporate mindfulness
Into your occupational therapypractice and into your personal life.
Sarah's brave move into providing a uniqueand much needed service that felt aligned
(48:48):
with her values and life experiences isexactly why I developed ACTivate Vitality.
We've recently switched from alwaysaccepting new participants to only
opening the doors three to four times peryear for the ACTivate Vitality program.
I invite you to visit my program page,linked in the show notes To book a time
with me, if you'd like to have a quickchat or be notified of the next time
(49:10):
we are accepting OT business ownerswho want to thrive without the hustle.
Thanks again for listening.
And please send this episode toa friend who needs to hear it.
As always be brave OTs.
We're not doing any of this for the sake of just Being more mindful, like
(00:04):
it's exactly, it's always an interventionto facilitate occupational engagement
in some way, form or another, right?
Exactly.
And I'm only interested inbringing mindfulness to my clients
if it's going to help them withtheir occupational engagement.
you know what?
What are we trying to accomplish?
And that's what it gets down to.
Sometimes people think, oh, if I'm doingmindfulness, it's got to be just for the
sake of training someone in mindfulness.
Carlyn (00:25):
you're listening to the Brave OT Podcast with me, Carlyn Neek.
This podcast is all about empoweringoccupational therapists to step up,
level up, blaze some trails, and maybeengage in a little conscious rebellion.
In service of our profession, ourclients, our work, our businesses,
and living our mission wholeheartedly.
We are all about keepingit real, doing hard things.
(00:47):
Things unhustling, being curious,exploring, growing through our
challenges, and finding joy,fulfillment, and vitality as we do so.
Really, we're OT ingourselves, and each other.
I hope you love this episode!
I just want to take a moment to saythat I really appreciate you as a
listener to The BRAVE OT Podcast.
(01:08):
I enjoy having these conversations,as you can probably tell.
And it was really rewardingto hear how they impact you.
So I welcome a message from you onFacebook or Instagram, I'll make sure
to put those links in the show notes.
Or you could even share a postabout this podcast and tag me in it.
It helps the message, reach thepeople who really need to hear it.
(01:29):
Today we are diving into all thingsmindfulness in occupational therapy.
Our guest today is a fellow CanadianOT who works in mental health.
Sarah Good.
I know we have an international audienceand our American colleagues will
certainly notice our Canadian accents.
Since we both see clients in thecommunity, you'll notice us saying "out
(01:50):
and about" a lot in this conversation.
And it made me giggle when Ilistened back to it, because
Americans like to tease usfor how we say that phrase.
the American accent is alittle bit more out and about.
Whereas Canadians tendto say out and about.
but it's exaggerated and we'recriticized for saying, "Oot and aboot."
See, if you can notice the differenceas you listen to this, but I wanted to
(02:13):
make sure to give a shout out to my palWalker in North Carolina on this one.
We've had some goodconversations about it.
And so I thought I would make referenceto out and about in the title.
in addition to talking about being outand about, we will explore how mindfulness
can be used as a powerful interventionto enhance occupational engagement
And not just an end in itself.
(02:34):
Sarah shares her unique approach toseeing clients in their homes and
outdoor settings And integratingnature into therapy to help her clients
reintegrate socially post pandemic.
We also discuss how our clients findus and are funded for occupational
therapy, with a mental health focusand the flexibility of working
online versus in-person at times.
(02:55):
Alongside practical insights,Sarah and I delve into the profound
impacts of using mindfulness andacceptance and commitment therapy or
ACT, offering real life strategiesfor therapists and clients alike.
I hope you find it impactful.
Today's episode is sponsored byJane, a clinic management software
and EMR that helps you handle yourclinic's daily admin tasks so you can
(03:19):
free up your evenings and weekends.
The JANE team understands how preciousyour time is and recognizes that
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To see how Jane can help you spendmore time doing what you love,
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(04:01):
time of signup for a one month graceperiod applied to your new account.
Sarah.
Thank you so much for joiningme on The BRAVE OT Podcast.
Sarah (04:10):
thank you.
I'm excited to be here.
I've enjoyed listening to your episodesbefore and reading stuff you post
different places and definitely feela connection to the work you do.
So I'm happy to be here.
Carlyn (04:20):
I think we do have a lot of overlap, not only in the cities we've
lived, but the ways we've practiced.
And, I think one of the things I loved yousaid when you filled out the form to book
this is that, You often want to jump in onthe conversations when you're listening.
And I find that too, sometimes whenit's like a podcast that it's like, Oh,
this is, I have something to contribute.
(04:42):
You just, why don't they hearme talking at them in the car?
Sarah (04:46):
Indeed, yes, you get a lot of interesting people on here and
I sometimes have other questions Ithink, Oh, that'd be interesting.
Yeah.
Please tell us a littlebit about what you do.
So I'm an Occupational Therapist inOttawa, Canada, and, I see people in the
community, primarily people who are livingwith mental health issues, particularly
mood issues, and, so often post traumaticstress disorder, depression, anxiety,
(05:10):
and often, as well, persistent pain.
So those, often an overlap, butsometimes those are the two main areas.
And, I work with adults, so I get tobe out and about through our beautiful
city a fair bit, which is good.
I try to see clients in their homesor outdoors as much as possible.
And, Outside of that, I'm a motherand a spouse and I spend a lot
(05:31):
of my free time outdoors as well.
I like cross country skiing andswimming in the lakes around here
and paddling and cycling and walking.
love to do that.
And I also find mindfulness meditationhas been a big part of my own, big
resource for my, for me over the last, alittle more than 20 years of being an OT.
(05:52):
It's been a big resource.
for my own personal well beingand professionally as well.
So that's another part of me and youteach these skills to OTs also, don't you?
I do.
Yes.
Yes.
I run a program for occupationaltherapists who want to learn mindfulness
for their own well being, but also,really a ways to bring it to whatever
(06:12):
their occupational therapy practices.
I've had people who work with kidsand seniors and everything in between
in hospitals and private practice.
Yeah.
So I've really enjoyedgetting to know OTs.
Throughout the world, but doing that.
I feel like if there was a Venndiagram of all the things we do,
we're almost Almost, except I'm inCalgary, but I did live in Ottawa.
(06:34):
And so it's, I love the journey too,because, I really relate to that
element of teaching, using a skill thatmakes a really big difference for my
clients, but that when I learned it,I integrated it into my own life, and
that was game changing, and I couldn'tnot share that with other therapists
for their well being too, right?
(06:55):
So I'm also teaching therapists stuffthat is for them, and I'm focusing a
lot more on acceptance and commitmenttherapy, which I know you use as
well, and, But that's the frameworkthat I'm using to, support my mental
health clients in the community andteaching OTs for their well being, but
also for that skill of, like, how theycould apply that in their practices.
(07:15):
yeah, this is very exciting.
Absolutely.
And your own well being, right?
You're probably using ACT, yourself.
Yeah.
Yes, exactly.
that's, I think, my favorite thingabout being an occupational therapist
is I get to learn these differentthings that just help me as a human.
Yeah.
And then offer them to other humans.
it's a really privileged spacethat we get to be in to be able
to dive into these things as well.
(07:36):
And BRAVE, right?
When you think about that bridge, likethat, it's easy for us, like that path
of, okay, I'm doing this type of work.
I need to learn this skill to helpmy clients and then to go, maybe
teach other people some of thisoutside of a clinical practice.
that's a big leap to make.
How did that come about for you?
(07:58):
Yeah, that was a big leap, for meand I think, probably for lots of us.
so I trained, I used mindfulness myself,start with that as, when I was, A new
graduate, I actually started doingmindfulness meditation, in using, I
got, I signed CDs out of, the hospitalwellness center, and I went to take
them to, the hospital I worked in atthe time, had this lovely interfaith
(08:20):
chapel, so I used to just Go in therefor 10 or 20 minutes at lunchtime and,
turn my pager off and listen to the CDs.
So that was the way I sort ofintroduced it to myself and thought,
okay, this is helpful to just havea few minutes every day at lunch
to start practicing this myself andthen I started reading more books.
And so I was very much self taughtand in there, I had kids and so forth.
(08:42):
And then, 10 years ago, I then decidedto train as a mindfulness meditation
teacher, which was definitely a gamechanger for me, because as I've been
self taught, I was doing the mindfulnesspractice for 10, 20 minutes a day, but
I hadn't thought of ways that couldactually impact my time, that I wasn't
sitting and doing the meditation.
(09:02):
So bringing mindfulness more to myinteractions with other people, clients,
family members, my time walking in nature.
Eating, whatever else.
I sort of hadn't self taughtmyself of that so much.
So, when I trained to be a teacher,that was really, the game changer
of, wow, there's a lot of ways I canbring this into my day to day life.
And it really encapsulates, theidea of occupational therapy.
(09:24):
I mean, everything that we do thatoccupies our time, we can bring, you
know, mindfulness attitude to it.
So I trained as a mindfulnessmeditation teacher at the Ottawa
Mindfulness Clinic and started teachingthere the program they have for
people living with persistent pain.
And then when COVID started, I gotmore, connected with OTs online as a
(09:45):
way to, as I run a private practice,it's just me, myself, and I, so it
was nice to be able to connect withcolleagues throughout the world.
And, and I started exploring more.
people interested inlearning more about this.
So I put out there, you know,would people be interested in that?
If I put together a video onjust introducing people to what
mindfulness is, and I had hundredsof people sign up to see this video.
So that, okay, we'retaking it to the next step.
(10:07):
So proof of concept right there.
That was like just a little tester.
Carlyn (10:11):
Let's see.
Is maybe anybody, hopefully acouple of people who are interested.
Oh, hundreds, hundreds.
Okay.
I'll make the video.
Okay.
So maybe video shared the link and then Ioffered it as a program, which I designed
to be an eight week program startingin the fall of 2020, with the idea of
there being some asynchronous stuff wherepeople can watch videos, read things,
(10:31):
do meditation practice on their own, andthen also have group calls where we come
together and can share what we're doing.
What's hard or what questions peoplehave, or how do I really apply it
to this particular area of practice?
so that's been continuing.
So there was that, the bridge for you wastaking that training to be the trainer.
(10:52):
then you started to see where you hadthat potential to be able to deliver that.
As a service, but it was first integrated,not as a clinical skill for you as
it was as a personal thing to do.
And then it expanded from there.
Yeah.
Yeah.
Really neat.
Yeah.
When did you start your program for OTs?
(11:13):
Around the same time.
So I had taken a course to learn how tocreate a course in 2019, or I signed up
for one at the kind of October, 2019, andthen was just too busy in my practice.
So my practice is similar toyours in that it's a mental health
private practice for adults.
It's typically beencommunity based where I go.
(11:34):
And.
Funded by third party referrals.
So I'm getting the referralsfrom mostly long term disability.
Actually, I used to do more veteransaffairs, but right now it's mostly
been long term disability orpeople, paying privately and, so
meeting them out and about now it'stransitioned to a little bit more.
mostly online and I miss going outactually and meeting people in class.
(11:54):
So I get excited when I havethat opportunity again, but I was
just so busy with that practice.
There was so many referrals comingin that I really didn't apply
what I learned in that course.
And so when the pandemic hit in 2020.
It was time.
And similar to you, I'm reachingout online to connect with other
OTs and going, okay, well, I guessthere's no time better than now
(12:16):
to reach out for connections.
So I threw out like my first littlelead magnet as a email list builder.
Right.
And it was about Just basic buildingroutine and structure, because as you
and I both know, when people have beenout of the workplace for a long time,
then that starts to be limiting andnegatively impacting their mental health.
(12:39):
go off work because of their mentalhealth, but then that actually
starts to perpetuate it a little bitbecause they've lost that structure
and routine and occupation andreward and socialization and stuff.
And so I decided to put togethera little kind of like, how do
we maintain some basic structurein our kind of quarantine times?
And that sort of started the ballrolling and then threw out like anybody
(13:02):
interested in learning more about ACTand all sorts of people and then turned
that into ACTivate Vitality, whichis my program that I offer for OTs.
And OT business owners aretechnically my niche at this point.
You don't have to havea business to benefit.
It just tends to be the group that tendsto want to sign up for the program.
(13:24):
And then my ACTivate Vitality planner.
So it grew and evolved.
You have one?
I have one.
I see it's been nicely used too.
It looks, lived in.
Yeah, so I'm a Fountain pen user.
So then it gets a little leaked onthe front here, but that's okay.
It's been a while.
I love that.
Yes, I find some people don't wantto write in it because they're
afraid of not doing it perfectly.
(13:44):
I'm like, no, that's I wrote inthere like get coffee stains on it.
give it a lived in used feel.
But yes, it's been similar to you.
I throw things out and tryand are people interested?
And this year I ran an ACT,Practical ACT for OTs course,
which people really liked that.
So I think I'll get some feedback, dosome revisions and offer that again, I
recorded it all, but sort of figuringout what people want and figuring out
(14:08):
how to deliver it, do it kind of low key.
And then see if you wantto fine tune, right?
Absolutely.
Yeah.
that is similar.
experience for me.
I've, put things out there, and then Ithink, okay, for instance, I said it was
an eight week course to start, becauseI thought I'll release one asynchronous
unit a week, and then we'll have one call.
And then I started, then peoplestarted showing up and feeling bad.
(14:30):
Oh, I'm way behind.
I haven't, I thought,we can do my homework.
Yes.
To be, you know, there's no rush to this.
then changed it to just giving peopleaccess to the material without calling
it week one, week two, and saying, Workthrough it at the pace that works for you.
I do have it, structured so people can'tget access to all the material at once.
There's no binge watching of videos.
But other than that, people goas slowly as they want through
(14:52):
it and then come to the calls.
I love that.
And so did you find that givingsome flexibility around that, helped
them actually go at their own pace?
Yeah, I think so.
And then what's come out of that as wellis some people wanted to stick around
for to be able to move through it longer.
So then I've offered, extensionsfor not, if people sign up for the
(15:14):
program, they get the asynchronousstuff for, as long as I'm running it.
So there's no deadline to that.
But the group calls, I've nowgot people who have graduated.
We have a group as well,a membership program.
So people can stick around with that,and they're not in the same calls as
people who are just starting on week one.
So some of the people who are in thathave been coming for 2 years to the
(15:34):
membership, a couple times a monthof just checking in and so it offers
a different level of support just.
Yeah, finish the program, and it cangive them accountability and give me
accountability to keep up with ourown practice and as people switch
jobs or have started training in someother things, how they integrate it.
So that's been helpfulto see the longer term.
(15:56):
Yeah, application of it.
I like that too.
I've also had people around for a coupleof years and I thought, oh, wow, I wasn't
sure that's what people would want.
But that's it.
if you're paying attention and responsiveand finding ways to meet the needs in
a way that works for you, then why not?
Yeah.
so this program that you're talkingabout with the mindfulness for the
(16:17):
OTs, is that something that peoplecan sign up for at any time, or
do you launch it periodically?
Sarah (16:24):
I launch it periodically just so that then I can offer the calls, sequence
we do twice a month for a few months.
so I'll be offering it in October2024 is the next offering of it.
and if people are interested in it atother times, then people can send me an
email and I'll let them know when the nextoffering will be, because I tend to plan
it out once I've opened it up in October,I'll think through how many months do
(16:45):
I want to wait before I offer it again.
Carlyn (16:47):
Okay, great.
And so we'll put a link for that in theshow notes so that they can find that.
And what's it called again?
Can you remind me of the name?
the Mindful OT Mastery Program.
Okay, perfect.
That's great.
So in your mental health privatepractice, how are people finding you?
Sarah (17:05):
a couple ways.
Veterans Affairs, I do get calls.
Fair bit of referrals for VeteransAffairs and through our, our Workers
Compensation Program in Ontario.
sometimes I'm surprised areferral source that I'm not as
accustomed to will suddenly, I'llget three referrals from them.
they must, so the RCMP has beenlately having more referrals from, and
then I have private paying clients.
some people who just look for me whenthey're, Off work, I'm in Ottawa, so we've
(17:28):
got a lot of federal government employees,so I've had a good number of federal
government employees who are on leaveof absence and, needing to transition
back to work and helping them with that.
paramedics as well, seem to have gottenquite a few paramedic referrals in the
last few years and family physicians.
Actually, their organization hasreferred a number of people to me.
And it's not always return to work.
(17:50):
Sometimes it's support for mental health,while people are already working, or
they're going through a lot of caregiverstress with an aging parent, or a
child going through a difficult time.
It's a wide variety of issues.
Carlyn (18:03):
would it be the employer who's reaching out to arrange some of those more
proactive services or how's that coming?
It's the employee themselves.
They'll come play themselves.
Yeah.
Sarah (18:13):
the third party people like Veterans Affairs Canada and, the
workplace safety and insuranceboard will reach out to me.
but other people will reach out.
independently.
for instance, the family physicians,there's an organization that lists
where they can get some help ifthey're struggling with their mental
health, and I'm listed on that.
So they might see me on thelist and just reach out to me.
Great.
(18:34):
That is really good.
Yeah.
Yeah, it's a good variety.
I've always enjoyed wide variety, widevariation in the clients that I'm seeing.
Yeah.
And it lets me see differentworkplaces and getting to know what
it's really like to be a paramedicor to work for the RCMP or to, be,
be in different types of employment.
Yeah, because everyone'slife's interesting.
(18:55):
Very much I just love to see suchdifferent routines and different
jobs, different family structures.
So I do find that good variety there.
Carlyn (19:03):
I like that about It's really having that mobile practice that, you're
designed to go to the environmentswhere the people are, where they're
functioning, where they're experiencingchallenges and help, help them, be
able to fully participate or return toparticipation or improve their ability
to engage or how they're doing it.
And, that environment piece,gives us so much context, right?
(19:26):
if a client's coming to see us in aclinic, which we've done at times too,
or right now I'm doing a lot online,like I'm missing so many key things,
like even just even seeing how a personresponds to struggling to find parking
or a person messing up their coffee orderor a noisy crowded environment, gives
me so much information that I wouldn'tget if they came to my office to sit in
(19:48):
front of me and tell me about their week.
Sarah (19:50):
Absolutely.
We get to use all of ourInvestigative skills.
as soon as I walk into a house, I feellike I already know something about them.
so like you, I went down to almosteverything online for a couple of years.
unless, and it went from it usedto be the default for all my
clients was in person before COVID.
And if there was an extenuatingcircumstance, like I would say to
people, if the school buses arecanceled because of bad weather, I'm
(20:13):
not going to be driving out to youif you're far away from where I live.
So then we would go to online.
Then.
the pandemic, everything went online,unless there was a really good reason
why we needed to move in person.
And in the last six months,I've moved much more to maybe
a little longer than that.
I have new clients I was movingto, no, we're back to in person.
But then now I'm really trying to pushsome of the people I've been seeing
(20:34):
online for years to, okay, I think nowwe really can meet, assuming everyone's
okay in my household and your household.
Let's try to get you out.
Yeah.
Yeah.
Yeah.
And I'm noticing my drive to get peopleout into nature, even urban nature.
We're not going into deep forests here,it's helped people to start getting out
of their house after this time of so manylockdowns, helping people to get used to
(20:55):
being out and about in their community.
And then I'll notice people aremore likely to sign up for a pool
tournament or go out and, join a sportsleague or get out and about more.
Ciao.
Certainly, the ripple effect too.
Yeah, it's a ripple effectonce people get out.
Carlyn (21:10):
Oh, that's inspiring me because I feel like a lot of my referrals are where
they used to pay me to travel to them.
They're coming with Yeah, like whichvirtual platform are you using?
Perfect.
We'll give you this manyhours for this many sessions.
and, and so it's become the default.
And I think that it is wise to get out.
And I have a park nearby herethat's about a seven minute drive.
(21:33):
So even if I'm not gettingpaid to travel, why not have
the person come meet me there?
Sarah (21:38):
Yeah, that's it.
Because I'll pick one if I'm not, ifit's a private pay client, I try to
avoid billing people for travel timeif there's no third party involved.
But yes, I'll pick a park that'svery close to me that I can walk to.
And it's by the canal and, it's alovely spot and we can walk on a path
or we can sit on a bench, but now we'reface to face and we're out and about.
(21:59):
Yeah, so that makes abig difference, I find.
Totally.
Carlyn (22:03):
Do you find too, I've found that, even just when I started walking
more with people versus meeting them ina coffee shop, for instance, still face
to face, but actually, it's the not faceto face, like sometimes that walking
side by side with them and moving, theygot unstuck a lot more readily than
the more stagnant face to face session.
Have you experienced that?
Sarah (22:26):
Yes, I have.
I think some people reallylike the eye contact.
Yeah.
And that's fine.
So for those people, the walkingisn't that great, but I've got
all kinds of people out there.
So not everyone likes eye contactwhen they're sharing things.
So I think that's part of it too.
Just like the parenting advice,
if you need to talk to your teenagerabout something in the car, do
it while you're driving, right?
Totally.
Exactly.
Not while you're sittingat the dinner table.
(22:47):
They can't get anywhere, andthey don't need to look at you
as they're talking about it.
the same kind of thing can be true.
And then, yes, that reciprocal movementof the walking and being out in nature
has a huge impact on our nervous system,and I find it an easier way to introduce
mindfulness practices to people.
So, that idea that topractice mindfulness.
(23:09):
We need to sit in a particular way and weneed to have no distractions and we need
to be able to focus and clear your mind.
I can never clear my mind,which is a good thing, right?
I'm alive.
I've got to think in mind.
It's never going to clear.
But when we're out and about, I'mjust going to sit here and think.
You Often there's something theynotice or something I notice wow,
those flowers weren't out last week.
(23:30):
Check out the hair and then we can stopand take some time to really notice that.
And then that in itself is a mindfulnesspractice of we're stopping, we're noticing
what's in the here and now, and SometimesI'll invite people to close their eyes,
depending on what we're noticing, andbring in different senses, because we do
tend to use our visual sense a whole lot.
And as OTs, we're very aware of bringing amulti sensory kind of approach to things.
(23:54):
So I think the idea of when we'reout in nature, there's so many
ways we can engage our senses.
That's an added bonus, as well,of seeing people outdoors.
Carlyn (24:02):
I totally agree.
I've found that's been my go toas well yeah, it's almost like you
teach mindfulness before even youtell them that this is mindfulness.
It's just this natural thing we do.
And then if you explain thatwas a mindful practice, no way.
Who knew?
I didn't think I could do that.
Sarah (24:19):
Exactly.
I have some downloadable thingson my website because this
relates that OTs can download.
So I'll send you thelink for that as well.
But one of them is ways tointroduce mindfulness to your
clients, if it's a challenge.
And that is one of the ways.
Don't even tell them.
Just, Sneak it in, and labeling itmindfulness can actually cause many
people to be turned off the idea.
But yeah, just putting a practice inthere, and and seeing how it lands,
(24:43):
rather than, I think sometimes as OTs wefeel like we need to tell people all the
research, and the risks, and rewards, andmake sure they understand what they need
to do, is that before we just try it.
And, I'm all for informed consent.
If somebody has given informedconsent to walk in a park with
me, and then I'm inviting themto really notice the flowers.
(25:05):
That's part of it.
I don't need to be stopping andexplaining the research behind the
impact of nature or the impact ofmindfulness in order to do that.
So I think that kind of takes the pressureoff us as practitioners of that, I hope.
Carlyn (25:18):
Totally.
if you, overly formalize it, like youlose the plot on let's just feel this
magic moment, like it's beautiful,like just this experience of all that's
around us, this sensory experience, if weintellectualize it before presenting it.
then that kind of has the oppositeeffect of what we're trying to do.
Sarah (25:38):
Yeah.
Yeah.
I heard someone say recently,go on mindfulness until
you say it's mindfulness.
Isn't that the truth?
That was pretty funny.
That is so true.
Carlyn (25:47):
Because you talked about mindfulness meditation, and so
thinking about meditation andmindfulness meditation, how do
you explain that relationship?
Sarah (25:57):
Yeah, so I think I start with the idea of meditation, and
many, and maybe even most cultureshave some form of meditation.
And so sometimes, part of myassessment is asking people about
any spiritual practices they have.
And so that, that can sometimes revealif they already have some type of
meditation or some type of prayerin their day as part of the routine.
And then I reinforce thebenefits of keeping that up and
(26:20):
building that into your routine.
So meditation comes fromlots of different traditions.
Mindfulness is the idea ofbeing present with what is here
right now without judgment.
And That can be done while you andI are having this conversation.
I'm not trying to think of what I'mgoing to eat for dinner tonight or
(26:40):
what my client said this morningwhile I'm talking with you, ideally.
So that, that's bringing my mindfulpresence to our conversation.
Mindfulness meditation would bethen a specific type of meditation
which, Because it's a secular type ofmeditation, so it's not coming from
a particular religious background.
It's something that's been brought toNorth American or Western healthcare
(27:01):
more than other types of meditation.
and so it's the idea of focusingon using formal practice to focus
in on what's present right now.
So that could be thesounds in the background.
It could be looking at a candle.
It could be the breath.
It could be the sounds.
It could be being mindful of my thoughts.
(27:22):
So there's a whole variety ofthings that are going on right
now that we can pay attention to.
So I would call that themore formal mindfulness, is
the mindfulness meditation.
and then the more informal, Mindfulnesswould be the stuff that happens as
we're going around through the day.
for me personally, in order to bringthat more informal mindfulness to my
day, to my clients, to my family, tomyself, I need to have a daily formal
(27:45):
practice of mindfulness meditation.
So it's would be like saying, I need to goto the gym regularly so I can go on hiking
trips, which not everyone does, right?
And that's okay.
But, for me, I find if I don't dothat formal practice fairly often
through the week, I start to noticemyself getting more derailed from
(28:05):
the present moment more easily.
Carlyn (28:07):
yeah.
Yeah.
That makes sense.
I like how you framed that.
cause, I find that sometimes with myADHD brain also, there's that sense
of, I love mindfulness, the practicalversion, and I don't love meditation.
And I think I have some of those hangupsthat we often hear when people, sometimes
if we introduce mindfulness to people andthey're like, ah, that's too religious
(28:29):
or too this or too that, or I can't.
And so I think I get someof those hangups when.
I have had a really consistent meditationpractice at times, and right now I'm
out of that, but it is interestingto think about how it's for you.
It's like going to the gym so you can dothe hiking or the activities you enjoy.
That's a nice way of framing it,strengthening those neural connections
(28:51):
and habits, essentially, to beable to more easily be mindful
throughout your other activities.
Sarah (28:57):
Absolutely, and realizing that we're all different.
some people can feel like they'refit enough to go on a hike
just because they go on hikes.
every week, but other people feellike they need to do certain physio
exercises, maybe, or they need togo to the gym, or whatever they
need to do, so that they can be goodenough shape to go for hikes, right?
Yeah, it's interesting that ADHDmind, I don't have an ADHD mind,
but I live with three people who do.
(29:17):
for me, perhaps that need for thatformal practice is also a removal
from all that spinning mind thatcan go around me a fair bit.
That's fair.
That is totally fair.
Carlyn (29:31):
Yeah, that's good.
That's really good.
I'm thinking about, ACT and mindfulness.
so we both use acceptance andcommitment therapy in our work.
Also known as ACT.
And so for the listeners, I like tokind of describe ACT it's a, it's
part of a third wave of cognitive andbehavioral therapies that, that works
(29:52):
really beautifully with OT and thereare Four of six kind of core processes
in ACT are based in mindfulness,and the other two are values and
committed action, and so doing whatmatters, which is what we're all about.
And so in ACT, the goal is to supportpeople in doing what matters, and
to do so they connect with what'simportant, their values, and commit
(30:16):
to the action of doing that, and wherewe get pulled away from doing those
things, we have a bunch of tools thatare largely based in mindfulness to help
us create a bit of space between thosedifficult thoughts and feelings and
sensations that can pull us away fromdoing the things that we care about.
And unhooking skills is an partof, describing that in ACT.
(30:37):
And so the mindfulness ones are thatability to observe the situation, the
observing self, and have that abilityto see what's going on, see yourself,
having the thoughts and feelings, seeourselves engaging, see ourselves maybe
avoiding or moving toward, and thenthere's that sense of being present, being
there in the present moment, and thenthe other ones are more about, Accepting
(31:01):
the difficult inner experiences, thedifficult feelings, difficult emotions
and sensations that come up and makingroom for them, turning toward them
instead of trying to push them away.
And then with the thoughts we're tryingto like use to be able to create a bit
of space between you and the thought.
We don't have to change the thought.
We don't have to make it positive.
We just don't necessarily need to smush itall over ourselves and fully engage in the
(31:23):
world through the view of that thought.
so these.
processes help us to then be ableto do the things that matter.
And, any ways we do this, likethis is, we're really building that
capacity to have the flexibility tosurf the waves of the difficulties
of being human, all very grounded inthousands of years of mindfulness.
Sarah (31:47):
Yes, absolutely.
As soon as I started learning about Ithought, wow, this is, it's definitely
a mindfulness tool that we canuse, and it's so nicely structured.
there's so many specific,it's almost things in the ACT
toolkit that we can use as OTs.
The one I find I personally use the mostis noticing which stories are present for
me the most often, and those unhookingI'm having the thought that I know one
(32:08):
that I don't personally use as much, butI've had clients find very helpful is
that, taking that story and putting itto happy birthday or something like this,
like singing it to themselves, right?
Oh, it's the, it's all my fault story.
And they got to sing that tothemselves, that presence of that story.
So that's where the mindfulnesscomes in is I'm aware that yes,
I'm having this story's going on.
(32:29):
I'm getting pulled.
I'm getting hooked onto this story.
Now, it's dragging me through the day andchanging, perhaps, my behaviors and my
thoughts about the future and so forth.
I find it to be a fascinatingone to use on myself.
And as a provider, it puts a lot oftrust in my clients, which is lovely
because Everyone is so different, andalso it doesn't put the expectation
(32:49):
that I'm going to know what they needto do to unhook from things, or I'm,
I don't know what their values are.
I can help them figure out theirvalues, but that's up to them.
And their story, I use a lot the, oneof the tools, the ACT matrix, where they
draw in their values in one quadrant tothe things that are true, but a challenge
in their lives and another, and what itlooks like, in their lives when they're
really getting pulled by those challenges,and then what it looks like when they're
(33:12):
actually living out those values.
And it's fascinating that every singleperson has a different matrix, and it's
not up to me as the OT to tell peoplewhat it's going to look like for them
to have a good routine in the day, orin Start their day off really well for
themselves, because what's going to starttheir day off well is different than
what's going to start my day off well.
Carlyn (33:28):
that and say motivational interviewing.
I probably learned about that one first.
And as soon as I learned aboutthat, I thought, this is amazing.
I can ask people the right questionsand they can come up with the answers.
I don't need to know.
I don't need to have the solution.
Totally.
I have a worksheet of ACT basedquestions that I think I download it
from the ACT Made Simple Facebook group.
And the author is Lou Laspregado.
(33:51):
I don't even know, but he uploadeda sheet of great ACT questions.
And I was like, Oh, so I have a studentright now she's supporting actually
in the ACTivate Vitality program morethan in my mental health practice.
And, it's neat because she doesn'thave the business experience or
the OT experience of a lot of theOTs in the group coaching program.
But I'm like, you don't have toactually have the answers, right?
Like if you've got some greatquestions, this can really do it.
(34:14):
And I remember that feeling that way withmotivational interviewing too, when I
learned it and I incorporated it as well.
But the, it's neat to find those questionsthat get you like out of that spinning
thought process, that's agitating andgo, Oh, That kind of stops me in my
tracks and gets me to think about thissituation from another perspective.
Sarah (34:33):
Yeah, and being able to pull out the right questions.
That's great.
The whole list of ACT questions.
ACT questions are motivationalinterviewing questions
that you can ask people.
so what would it look like ifyou had a good morning routine?
what would that look like?
And then being able to bethat accountability person
to help them build that.
With their values.
Yeah, it's huge.
It's huge.
And for a lot of our American listeners,I'm sure you've provided these, some
(34:57):
training and stuff to American andCanadian, a lot of the questions we get.
Which are hard to answer as Canadians.
how do you bill for that?
Or how do you charge for that?
And I know for us as Canadians, it's,I just put an OT invoice in and I don't
have to justify the modality I'm using.
I don't have to explain why I didwhat, with the types of payers that
(35:18):
we're dealing with for the most part.
But How do you respond to that forsome of the people who really do
need to itemize the treatment or thecondition and that sort of thing?
Yeah.
because that does come up when peoplejoin the, the Mindful OT's Facebook group,
I ask them, what are your questions?
What, what do you hope to learn?
(35:38):
And that comes up surprisingly oftenis that one of the challenges to
integrating mindfulness into thepractice is I don't know how to
bill for it, or I can't bill for it.
So what, in speaking with some, AmericanOTs and say, it's hard for me to
understand and imagine as a Canadian OTis saying, what are you, what are you
working on introducing mindfulness for?
(35:58):
What's the occupationthat this is based on?
And there we go.
Okay.
So you're doing this aspart of pain management.
Then how would you normallybuild pain management?
You're billing it that way.
or you're doing this as partof discharge planning from an
inpatient mental health unit.
Okay.
So helping people with lifeskills when they get discharged,
what would you bill that as?
And usually people can come upwith what they would bill that as.
(36:20):
We're not doing any of this for the sakeof just Being more mindful, like it's
exactly, it's always an interventionto facilitate occupational engagement
in some way, form or another, right?
Exactly.
And I'm only interested inbringing mindfulness to my clients
if it's going to help them withtheir occupational engagement.
Yeah.
So if their minds are totally woundup and they can't settle to go to
(36:40):
sleep, well, then can we find somekind of evening activities that
are going to help them settle?
And maybe that would include amore formal mindfulness meditation.
Or maybe it would include awalk or eating meditation.
nothing to eat right before bed but, acup of tea, but then it becomes, okay, so
this is part of an intervention on sleep.
you know what?
What are we trying to accomplish?
And that's what it gets down to.
(37:01):
Sometimes people think, oh, if I'm doingmindfulness, it's got to be just for the
sake of training someone in mindfulness.
And that's not a, there'sno treatment code there.
So that's, that matters.
And for some of them too, theyshare that their insurance.
isn't acknowledging OT asa mental health service.
So they're seeing that connection that,this is a mental health intervention,
(37:21):
but OT is an intervention for, andthat's a whole other argument, like
it's fully in our scope, but, insurancechallenges, but ultimately we're
still always working on an occupation.
What's the thing thatthey're trying to do?
The thing that they're not doingis why we're addressing this.
And these are the, this the toolsthat we use to help address it so
they can do the stuff that theywant to do with the occupations.
(37:43):
Yeah, that's beautiful.
Exactly.
They've got to be able to do something.
And whether, sometimes I think it'sthought that, mindfulness is a mental
health intervention, and it can beperhaps, but it doesn't need to be.
It can be, Something to help with anyoccupation that a child does, that an
adult does, that a parent who's in theneonatal intensive care unit is using.
(38:03):
All right, so there can be allkinds of every age can be using
it to engage in some occupation.
Yes, that is key.
That is so key.
Some of the other concerns peoplehave about bringing mindfulness to
the clients is just team members won'tthink this is appropriate for OTs.
So that same explanation can be helpful.
this is the intervention I'musing to help this person engage
(38:26):
in such and such occupation.
Because sometimes people will beon teams and still know that the
psychologist does mindfulness.
Okay, and that's fine.
But the psychologist isn'tnecessarily helping them engage
with a particular occupation.
So they can already have learnedsome stuff from the psychologist.
They can already have taken aneight week mindfulness based
stress reduction program.
That's great.
That's just getting,making your job easier.
(38:49):
But now, can you help them apply itto doing whatever they need to do?
Or whatever role they need to be able toembrace that they're not able to embrace.
And that's exactly the juncturewhere I often get referrals is
where they've been taught all thethings in a clinical setting or,
in, in counseling or something, butthey're not doing anything with them.
(39:11):
And the referral source is oftenidentifying that they haven't engaged
in changing the way they'reapproaching anything.
They've got the knowledge,but they're not using it.
And OT is great for that.
We can teach it too.
but it's often that, spot where I getthe referrals from those third parties.
Exactly.
Exactly.
So that's a good one.
And then we've already addressedthe third thing that I think
really stops OTs is that theythink, Oh, no, clients won't do it.
(39:33):
no, my clients aren't toointo the hippie to be stuff.
People will say that.
So the majority of my clients are young,Canadian military veterans or paramedics.
They are strong, not hippie dippiepeople that I am working with.
and, When it's introduced to themin a way that actually seems to
make sense and fit their lives,many of them find it really helpful.
(39:57):
And I don't show up at my first one on oneappointment with people and say, okay, now
we're going to learn mindfulness at all.
It's more chill.
Let's get out the candleand the essential oils.
No,
but as we're doing thingslike, okay, we need to get back
into paramedic headquarters.
We're standing in the Parkette rightoutside Ottawa paramedic headquarters.
I'm You know, say, let's justsit here on this bench and just
(40:17):
feel our feet on the floor, onthe grass, rather, not the floor.
Let's just take in this place.
what do we see in this park hat?
Let's just bring this in.
So suddenly I'm introducingthem to mindfulness.
without it being a formal thing.
Now, people do sometimes come to mespecifically because their doctor or their
physio or somebody said mindfulness wouldbe really helpful to you, in which case
I am diving right in the first session.
I'm like, okay, let's do this.
(40:38):
Or they're coming to, one ofmy client facing programs.
That's different.
But, not all of my clients are goingto do formal mindfulness practice.
But in some ways, that is anessential part of what all of them
are doing is finding ways to bepresent with whatever they need
to be doing to occupy their time.
Yeah.
I have, I know all the bestspots for doing just that
(40:58):
outside of all the hospitals.
I seem to have a lot of healthcare workerswhere I've needed to do exposure to
the workplace in advance of like, oftenthey're driving whole other routes, so
they never see the hospital they workat and then building that gradual and
we sit and we observe and we feel allthe feels and we sit in that and or we
(41:18):
move to another spot and often it is,yeah, in the car or on a park bench or,
at the grocery store across the street.
Yeah, exactly.
Yeah.
And that's bringing some mindfulexperiencing to that environment
and approaching it at a human speed.
And in order to do exposure therapy, youneed to become mindful of your physical
sensations or else you're just going to berushing into the building and then hitting
(41:41):
panic and not even, thinking you went fromzero to a hundred in terms of anxiety,
when the reality is probably just was aspace that you weren't able to notice that
you were going from zero to a hundred.
We went too quickly and we didn't spendenough time noticing what was going on.
Brilliant.
Oh, this is so fun to talk tosomebody else who, yeah, we
share a lot of those things.
I really appreciate that.
(42:01):
Yes, this has been wonderful.
Yes.
I have a couple questions I askeverybody who comes on the podcast.
Are you open to answering those?
I am indeed.
Okay.
What does being brave mean to you?
I think being brave means pushing yourselfa little bit outside your comfort zone.
And knowing that you're stillsafe, but It's a little further
(42:23):
than you're comfortable.
And doing it anyway.
Yeah.
and that's different, right?
It's different than running,just like you said, running
past that threshold into panic.
it's that stretch and being aware of thestretch and stretching anyway, right?
Yeah.
Yeah.
To me, starting a business 10years ago was a huge one for me.
Totally.
(42:44):
Very huge.
What's something recent that you've donethat's brave that you would say is brave?
Ah, that's a great question.
I probably don't acknowledge as muchwhen I do things that are brave.
To myself.
So that's a curious thing to observe.
That is a curious thing.
I noticed when my kids do brave things, Ipointed out, I can look back historically
and say, wow, I did those brave things.
(43:05):
But yeah, something recent.
Okay, here's one in thelast couple summers.
I've been learning to sail.
And I've gone to this introductorysailing course, but a couple weeks ago,
I took a sailboat out by myself, notduring the class and just went out.
So that felt brave and it went well.
Ooh, that would be very brave.
Oh, was that on a lake nearby?
(43:27):
It's in the Gatineau River.
So very wide river.
Looks very lake like.
yeah.
Cool.
Really cool.
So that's pushing my comfort zone a bit.
Totally.
What would you like to see OTsget a little bit more brave about?
I'd like to see OTs get a littlemore brave about, pointing out
how essential our services are.
I know it's different in differentcountries, but in Canada, we talk
(43:48):
about having universal healthcare,but we actually have universal
hospital and doctor care, right.
And occupational therapy for mostpeople isn't covered very much under
their extended health benefits, whichin Canada is what we use if we need
to pay out of pocket for things.
I think that we need to get braver on,as a profession at advocating for the
fact that we do provide mental healthservices, so that might be true for
(44:10):
some of our colleagues in differentcountries, and that we do provide,
cost effective ways for people to Getback to living their lives, and I think
it's an underappreciated profession.
Yeah, for sure.
This would be a good place to dropthe whole, Ask for OT campaign too.
Maybe I'll put some links inthe show notes for Canadian OTs.
(44:31):
There's an Ask for OT movement, and I knowsomething nationally, and each province
has a version of that, where we'retrying to get on more extended health.
benefits plans and it's working.
I think there, the needle ismoving, but it's, it's amazing
that you can, get coverage.
I'm, I've seen some plans where evena nutritionist, not even a dietician.
(44:51):
could be covered, yet we're aregulated health profession.
and not some people don't haveOT on their health benefits.
They could get acupuncture or Chinesemedicine or naturopathy or, some of these
other things and not OT and it's, Thisadvocacy movement is really important.
Absolutely.
Yes.
I saw that, signed up for it, put iton my website, but my Facebook page.
but yeah, in Ottawa, because so manypeople are federal government employees,
(45:15):
it definitely, the needle moved, but everypeople get 300 a year for occupational
therapy, which is not nothing.
It'll get you two sessions.
Yeah.
They get 5, 000 a yearfor psychology per person.
Yeah.
Now, sometimes mental health OTcan be put on, it's not psychology,
if psychology in that senseunderneath or other psychotherapy.
So sometimes mental health OT,sometimes they'll let that go
(45:37):
under there, but not always.
So, yeah, 300 a year is not really,it's enough for people to come
and do a couple sessions with me,get a sense of where we're going.
But then I find it.
People will do maybe four or fivesessions and then they start to feel
like, okay, I've made some progressand then they're done because they
now need to pay out of pocket.
As you say, it covers two sessions.
Yeah.
(45:57):
Oh boy.
we need more than justgetting on the benefits plan.
And that's a start.
how would you like peopleto reach out to you?
what's that sort of call to action thatyou want people to take to reach out?
Yeah, excellent question.
So if they're wanting to just learnmore about this and learn more
about mindfulness and have somemore tools as an OT, I'd recommend
they go to my free resources.
(46:17):
That's probably a good spot to start.
people are welcome to email me.
So you can put my emaildown there as well.
and I do write back topeople who write to me.
they can DM me or messageme on social media.
I cannot guarantee a prompt response.
I'm not that great at checking those.
I'm not checking those every day or two,but if they do have a question, email
(46:39):
or if they download one of the itemsfrom the, free resources, they'll be
added to my mailing list, which theycan unsubscribe from if they would
like, but it gives a couple littleemails where they'll get some blurbs on
what's going on and what's happening.
And then about once a month,I send out an email on it.
That's great.
And I'll ensure that I include a linkto the Mindful OT Mastery Program.
(47:01):
Excellent.
Thank you.
That would be great.
Yes.
Good.
Oh, thank you so much.
It's such a delight.
And I feel excited and inspiredand truly love this work.
people often talk about, when they're ina state of burnout, wanting to get out
of OT and, Build something that's, moreleverageable or that they can serve many.
And I like that side, but Idon't want to stop doing this
(47:24):
stuff that we've talked about.
I really love doing this client work.
I can't imagine not doing it.
No, me too.
I love the client work.
I love seeing people's livessometimes change direction or
sometimes go back to what theythought they couldn't get back to.
it's amazing.
Yeah.
So rewarding.
Yeah.
We just need to find ways to workthat are sustainable for our lives.
Exactly.
(47:44):
I think part of that is runningour own businesses sometimes as
long as you can do that within,maintaining your own boundaries.
Otherwise it becomes the flip side ofthat, which is a recipe for burnout.
So true.
Good reminders.
Thank you, Sarah.
thank you very much for having me.
It's been a pleasure.
My pleasure as well.
Carlyn (48:04):
I really hope this conversation with Sarah Good, inspired you to
think about how you are showing upas a therapist, how you're working
and how you'd like to be working.
Sarah's mindful OT mastery programis going to open very soon.
If you're listening to this podcastat launch time It'll be open for
enrollment November 18th to 21, 20 24.
(48:24):
And there's a link to theregistration page in the show notes.
At this point, I think you cansign up to be notified When
it opens for registration.
The program is for occupationaltherapists and is designed to
help you incorporate mindfulness
Into your occupational therapypractice and into your personal life.
Sarah's brave move into providing a uniqueand much needed service that felt aligned
(48:48):
with her values and life experiences isexactly why I developed ACTivate Vitality.
We've recently switched from alwaysaccepting new participants to only
opening the doors three to four times peryear for the ACTivate Vitality program.
I invite you to visit my program page,linked in the show notes To book a time
with me, if you'd like to have a quickchat or be notified of the next time
(49:10):
we are accepting OT business ownerswho want to thrive without the hustle.
Thanks again for listening.
And please send this episode toa friend who needs to hear it.
As always be brave OTs.
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