Reflections of a Capstone Student

After a wonderful 14 weeks with Moxie OT completing my doctoral capstone, I have been gifted some important lessons and things learned that I will always take with me. Dr. Zera is a compassionate, patient, and competent therapist who I was lucky to have as a mentor! Together we formed a self-management focused support group for chronic stroke survivors. The goal was to give stroke survivors the tools and skills to have more ownership and control over their own lives. In turn, we hoped it would increase their ability to follow through on home exercises, seek and maintain social support, and overall improve their quality of life!

Self-management is inherent, but not always intuitive. A quote I read stuck out to me and led me to this realization. “Unless one is totally ignorant to healthful behaviors, it is impossible not to manage one’s health” (Lorig & Holman, 2003). It’s a poignant statement that emphasizes autonomy and self-realization, rather than framing it as something to be added to one’s life. You are already managing, so why not do it right! That’s the goal of self-management education. This is just one of the many fruitful discoveries that changed my outlook on OT. My understanding of self-management shifted to become an inherent way of life, not just another one-off intervention. Something clicked into place, and I knew that this was a missing piece of my clinical competency. It felt like an underlying principle of OT that I knew would benefit my ability to shift responsibility, autonomy, and independence to my patients throughout my career. 

Among these clinical realizations, I had some personal ones as well. I asked myself, if I’m asking patients to internalize this skill, then shouldn’t I be able to do so myself? This capstone came at a time of uncertainty and instability in my life; secondary to moving states and trying to manage the transition from years in my college town, to the eventual decisions and difficulties that seem to follow in a new grad’s life. In this way, I was sort of a patient of my own. I self-managed through my loss of occupation, routine, and balance. 

As the support group’s leader, I found a refreshing ability to connect with the group members although I didn’t relate to their stroke experience specifically. Part of being a good group leader is humbling yourself to the opportunity, and choosing to lead by example with honesty, intention, and effort. Because I felt like I had my own experiences with self-management and coping, I was eager, and also felt it necessary, to create space for all group members to share their personal reflections. As a group leader, you want to be disarming, and for others to feel safe in your presence. We aren’t there to patronize or tell anyone what to do, but to listen and facilitate group members' ability to learn from each other.

I learned to ask questions that encourage active thought and reflection, rather than succumbing to my eagerness to provide immediate advice. Motivational interviewing principles guided me to the right kind of questions, and I integrated my own therapeutic use of self to tailor the questions to my group. A main piece of feedback received, and something Dr. Zera emphasized to me early on, is that group members can learn more from each other than they can from me providing education. The members overwhelmingly preferred and enjoyed getting to know each other, following each other's journey to meeting goals, sharing relatable experiences, and simply listening to one another. Seeing someone just like you succeed can act as a powerful motivator, and one that isn’t easily replicated by a therapist. Carving out time for discussion, and not rushing past it for scheduled activities was a learning curve, but an important one!

In the end, I’m grateful for the opportunities this project gave me and the growth I’ve been privileged to experience because of it. If every OTP had the foundation in self-management that I now have, I know our profession would experience growth too. OTPs have a unique opportunity to share this knowledge, and make a world of difference in the quality of life for patients and those around them. 

Guest Blogger: Lindsay Friker, OTDS