OTs may use ‘MacGyver-thinking’ to assist patients

  By Cheryl Rose Jobs Correspondent

If you had a stroke that paralyzed your right arm, could you button your shirt, tighten your buckle or tie your shoe? If you couldn’t, there are patient teachers called occupational therapists (OTs) who can help you adapt and learn new ways to function.  

The rehabilitative role,

 The name of this rehabilitative therapy can cause confusion. Monique Burrage, an occupational therapist for 21 years and the owner of Houston Occupational Therapy, said when she tells people her profession they often think she does vocational job training.

 “Occupational therapy is a skilled service that teaches patients compensatory techniques to master their environment,” she said.

 Darrell Parker, an occupational therapist at Memorial Hermann Rehabilitation Hospital in Katy, recalled a day when he was shadowed by an  administrator who later said, “I didn’t know you had to be MacGyver to be an occupational therapist.” Parker took it as a high compliment.

  “OTs need to be creative and innovative to do a good job,” he said. “There’s no playbook or rulebook. Every single case is different. Every patient needs a customized program.”  

 A holistic approach,

Occupational therapy takes a holistic approach to the patient, Parker said, from diagnosis to psychology. “If a person can’t tie their shoes, what’s the cause? Is it a mechanical problem because he can’t reach the shoe, or is it a visual, sensory or fine-motor skills problem?” he said. Psychology is part of the job, too, he said, in understanding the grieving process patients may be experiencing for their physical loss.

The occupational therapist helps patients manage tasks of daily living that may have become difficult due to injury, illness or aging. An important part of that task is establishing a relationship with the patient, which can help the OT better determine the cause of a problem and find possible solutions.



Establishing relationships, showing compassion and motivational coaching are important parts of an OT’s role, Ms. Burrage said. For example,  she was called in to help an elderly patient who repeatedly fell, causing a variety of broken bones. In working with the woman and gaining her trust, Burrage discovered the reason for the falls was incontinence and attempts to rush to the toilet. Burrage put her on a bowel-and-bladder program, specific diet instructions and taught Kegel exercises. The woman stopped falling.

Growing demand,

 Demand for occupational therapists is predicted to expand by one-third in the next decade. Occupational therapy is a master’s degree program. According to Patricia Bowyer, the associate director for the School of Occupational Therapy at Texas Woman’s University in Houston, a candidate’s bachelor degree can be in any subject, but school admissions are very selective so a background in the prerequisites is beneficial. Program graduates then must be registered and licensed to practice.  

Students graduate as generalists, but many select a particular type of OT or workplace in which to specialize. “There are different aspects such as pediatric, geriatric, psychiatric, traumatic brain injury,” Burrage said.   “You learn certain basic principles for all areas, but what you choose to specialize in is what speaks to you, something that calls you.”

 Burrage said new OTs try several settings and experiences before determining   a specialty. “It’s a competitive field and there is always a need,” she said. “You have the ability in occupational therapy to decide how far you will go, what you will achieve.”