Have you ever been to a medical appointment, whether with a primary care physician, a specialist, technician or therapist, and felt genuinely listened to, cared for, affirmed, appreciated, connected or uplifted?

Perhaps it took you by surprise. Perhaps you’ve come to not expect such positivity from a medical appointment. After all, in today’s busy health care centers, most professionals now type the details into your chart while you are with them, so they rarely make eye contact with you. They nod and show signs they’re listening, but you’re never quite sure, since they’re multitasking. It’s commonplace now, partly due to payor demands for increasingly accurate and detailed documentation. And, after all, your professional needs reimbursement for services.

But we’re not talking today about those less-than-warm-and-fuzzy visits. We’re talking about the encouraging interactions, the ones where you felt—shall we dare even say—loved?

Maybe your doctor put the computer aside and looked straight at you while you told her your whole story, and then asked more questions, and affirmed your struggle with a statement like, “It must be really hard losing your husband like that, and then having difficulty at work too. Stress like that can definitely play a role in your health. . .”

Or was it the phlebotomist, who laughed and joked with you while distracting you from the blood draw, then gave you a hug on the way out, “So good to see you, Mrs. Jones, please say hi to your husband for me.”

What IS it about those caring interactions that make them so rich?

It’s all about connecting.


From the day we are born, and find ourselves disconnected, we seek and find solace in connections. Warm, tender, respectful, genuine and joyful connections turn off our stress hormones and neurotransmitters (which are so bad for our health) and instead release “feel-good chemicals” such as dopamine and serotonin.

As we know from modern science, positive hormones and neurotransmitters promote healing and prolong life! This is the very thing we seek medical treatment for, so it follows that medical care will always better succeed if it helps people feel connected, loved, and valued, and, if possible, helps people to laugh. That, added to healthy exercise and diet, is a powerful agent of neurobiological change!

As occupational therapists, we are poised to provide such care. We know the importance of establishing rapport and building therapeutic relationships with our clients. We know how to recognize and respect our clients’ inner motivations, preferences and interests as we co-design a plan of care to facilitate healthy functioning. We know there are times when it is better to lay aside what we planned for a treatment session to comfort a crying client, get them a drink of water and tissues, and be there for them as they process their emotions. We know relationships with our client’s family members are just as important as our relationships with our clients, because in supporting caregivers, we multiply service to our clients beyond the clinic. We know the essential value of fun, humor, and leisure activities in the balance of work, rest and play. We can even use our senses to quickly adapt an environment to support our clients’ recovery, whether it be something as simple as changing a fluorescent light to incandescent and introducing a calming aroma, or as complex as relocating kitchen items to safe reach, recommending home modifications and facilitating purchase, install and proper use of assistive technology. We know the simplicity of a smile, an appropriate touch, a listening ear and a positive attitude produce wonders toward achieving goals.


We have the basic training (example is a text from OT school) needed to become powerful forces of positive change in the world! Do we make use of this? Or do we get lost in the demands of our health care systems, with their ever-increasing productivity requirements, documentation challenges, equipment shortages, funding issues and sometimes even staff incompatibility struggles? Do we find ourselves falling short due to personal reasons? (Interestingly, a 2009 survey of OT’s found the need for more training in therapeutic use of self and relationships. See that here.)

Maybe we need some OT intervention for ourselves–some days, anyway!

OT Interactions is a forum for you, to help support your development as the therapeutic person you want to be, were trained to be, and can be. We will be sharing more of what you need to enhance your therapeutic use of self. You are invited to participate here. You can contribute your articles, blogs and links. You can comment and discuss. You can write for OT Interventions as a guest blogger or regular featured therapist. You can share funny stories. You can share great ideas that helped your clients. You can share research articles to support evidence-based practice. You can share OT Interactions with your peers, patients and families—as we post helpful information for clients too.

So, wherever you are, whatever time of day it is, do something that increases your sense of calm. Breathe! Smile, even if only a half-smile. Connect. You’ll find your stress chemicals dissipate and your “feel-good” chemicals release. There. You’re ready to share your goodness with the world!

Be therapeutic, OT’s!Floral


Joan T. Warren, MHS, OTR/L