Confidence is Key

    Confidence is critical in someone’s occupational therapy journey. Mobility is very important in order for someone to perform ADL’s and occupations. There is a Hierarchy of mobility skills to help restore confidence in clients. The order of these skills is: Bed Mobility, Mat Transfer, Wheelchair Transfer,
Bed Transfer, Functional ambulation for ADLs, Toilet/Tub Transfer, Car Transfer, Functional ambulation for community mobility, Community mobility and driving.

    This ordering of mobility skills was what I expected and makes complete sense to me. Every step requires a little more effort and helps the clients be a little more independent every step of the way. I think it is ordered this way so each skill can be a just right challenge for the client at the time in their recovery. As they regain strength, balance, and endurance they can move up the hierarchy and gain more independence and more confidence, which can ultimately increase the clients intrinsic motivation.

    I have worked in clinics before and observed transfers, but I have not seen enough of it to say that I have observed this hierarchy of mobility firsthand. I have seen specific transfers done for patients during that specific stage in their recovery, but I never witnessed another step in the hierarchy for that client. I mostly observed bed transfers, wheelchair transfers, and toilet/tub transfers.

    I agree with this hierarchy approach because it is like a set building blocks to success. Every step in the hierarchy requires a little bit more strength and endurance to go on to the next. Every step preps the client for a new one, so the client is not overwhelmed every time they move up. This approach is safe for practitioners and clients and helps establish trust within the therapeutic relationship.

    During the labs in school, my biggest takeaway was how much confidence you have to have in others when it comes to mobility rehabilitation. This just stressed how important trust and good relationships were in occupational therapy. My freedom was taken away and it made me feel out of control. I better understand the importance of safety precautions and how critical they are when transferring a client.  In lab, we were able to catch ourselves or help with stabilization if we felt ourselves falling but most of the time in a real therapy session the client probably won’t be able to do that. Safety precautions for both the client and practitioner are something that I will focus on a lot of before going into my fieldwork next year.