1. Our Stories and Why We’re Here.

Our first episode, and our reason for embarking on this journey.

List of books/resources mentioned:

1. Gilfoyle. E., Grady, A. & Moore, J. 1981. Children Adapt.

2. Mattingly, C. & Flemming, MH. 1994. Clinical Reasoning: Forms of Inquiry in a Therapeutic Practice.

3. Stackhouse, T.M., Trunnel, S.L. & Wilbarger, J.L. 1997. STEP-SI: A Clinical Reasoning Tool.

4. Stackhouse, T.M The SpIRiT Of Paediatric OT. A Sensory Processing / Integration Reasoning Integration Tool.

Tracy’s Honourable Mentions:

• Elnora Gilfoyle

• William T. Greenough (Bill Greenough)

Listener Reflection Sheet (CPD record):

Spirited_Conversations_Ep1_Reflection_Worksheet.pdf

Download PDF • 394KB

TRANSCIRPT:

Michelle: Welcome episode one, series one of our podcast. We are. Michelle Maunder, Cory Johnston from Seed Paediatric Services, a small private practice here in Orange, new South Wales, Australia. , we're happy to be here. Yes, how exciting. So happy. We are joined by Tracy Stackhouse.

[00:00:24] Cory: Tracy is. An absolute legend in my mind, , but she's also a pediatric occupational therapist, , based in Denver, Colorado, in the, in the United States. And she's the co-founder and executive director of Developmental fx, which is a non-for-profit organization and they specialize in children with fragile X, but also all children with developmental neuro development.

Yeah. And neurodevelopmental differences and challenges. So, yeah. Do you, I wanna add anything. Tracy, welcome Tracy. Yeah, welcome. We're so excited to have you.

[00:01:01] Tracy: Well, I'm so excited to to be with you and I love this technology that allows me to be in Denver and you all to be in orange. And somehow together we're gonna have these amazing conversations.

And, you know, I'm representing my team here at DFX. We have a multi-disciplinary team of extraordinarily talented and dedicated folks, who are doing the really hard work of taking care of complicated kids and seeing them move forward in their lives. So you all are doing that as well. And I think that the people who will listen to this podcasts are, are occupational therapists, but all different kinds of disciplines.

We really welcome people in to listen to our conversations and to deepen your passion and your commitment and fend off burnout and have a blast with us as we have these conversations, spirited conversations. Is really titled after this clinical reasoning tool that I developed, in collaboration with my team here in Denver and in collaboration with people at Camp Jabiru.

So the spirit model, we aren't gonna talk all the time about the spirit model, but the spirited conversations are drawn from the spirit model. So we will, we're all in spirit here together in the spirit of thinking, in the spirit of collaboration, and, it's gonna be a great podcast.

[00:02:25] Cory: Yay.

[00:02:25] Michelle: We can't wait.

We should shout out to our, director, Sarah. McInnes

Flemming Flemming, Sarah just got married. So it's Sarah Flemming now who is the

director of SEED Pediatric Services, who has certainly encouraged and, endorsed us doing this. She's also is with the team of other therapists and Tony, our support as well, uh, working yeah.

With kids right now as we do this. So thank

[00:02:56] Cory: you.

Go seed. Go Dfx.

[00:02:58] Tracy: Mm-hmm. . . Love it.

[00:03:00] Cory: First episode.

First episode.

Wow. I can't believe we're actually here and recording this. This is really cool. So I guess today's episode is more just about us kind of getting a chance to let everybody know us a little bit.

How we, how we came to decide to do a podcast together. I guess how we came to get to like, know each other and probably also how we got to be. where we are, I guess at, at the moment in each of our individual careers or journeys. So I, I, I can kick off if you want. If anyone has a desire to kick off, you can kick off.

[00:03:43] Tracy: Yeah, that sounds great. Yeah. So, yeah, I, I love it. Go for it. Cool. So

[00:03:47] Cory: I am gonna start with how I met Tracy, and funnily enough, it's the same time that I met Michelle. So we, in 2015, I decided to do, camp Jabiru as a practicum, and I had just started working at the Sensory Gym. So, they kind of went hand in hand, because The Sensory Gym runs Camp Jabiru.

And we can talk a bit more about what camp is later, but, Tracy is she's the head, basically, well she runs the practicum…

[00:04:27] Tracy: Practicum, Yes. Colleen Hacker and Lynette Burke are the heads of Camp Jabiru. Yeah. They graciously invited me. Yeah. So I run the practicum and that's where I met both of you.

[00:04:37] Cory: Yeah. Yeah. So Tracy heads the practicum element of camp, and we, yeah, we all, well, Michelle and I and probably 14 other occupational therapists, decided we were gonna go and learn, at camp that year. And so that was a full on year at, at camp for me personally. But it basically started me on my journey of like learning really deeply about sensory integration and piecing all these pieces together.

I feel like that week gave me the foundation and I realized that week that I was like, there is a lot I need to learn, which was exciting. But I guess if I come back to how I got into occupational therapy, I like, I don't know, all of my friends who went to Uni with me didn't know what it was. And my Mum sort of said to me before I applied, I think you should try this.

You know, it lets you be creative, and you like helping people. So, have a look and see what you think. And so luckily I really enjoyed it and when I graduated I just fell into paediatrics, and realized that I really enjoyed it, but. But I also needed supervision. So I was lucky enough to be mentored by Colleen, which ultimately led me to working at the Sensory Gym about a year and a bit later.

And I genuinely loved my time at the Sensory Gym. And I, over the years that I was there, I was exposed to many, many exquisite and skilled leaders, in pediatric occupational therapy. And many of the people that I worked with at the Sensory Gym are still some of my dearest friends today. And I think the nicest thing I got out of that time that I was there was the permission to sort of treat and be myself, in sessions because you get the opportunity to watch other clinicians treat and to learn from them in their sessions.

And you sort of initially sometimes try to copy that because you're not sure how to do it and what to do in your own sessions. So I think. . Seeing that so many people came at it in a different way allowed me to, to sort of go, okay, I can find my own groove in this. and that always just feels so much nicer when you're sort of true to yourself in sessions.

But if I think about the sensory gym, I always have camp come to mind, because it's such a significant part of what the Sensory Gym does. And I guess, I guess I should probably just briefly talk about camp here because I mentioned it earlier. So, camp Jabiru was started here by Colleen Hacker and is modelled after Camp Avanti, in the US.

And so it's designed to give children with disabilities, a typical camp experience. So all these children are sort of supported by occupational therapy group leaders. And in each group you'll have two leaders, one practicum, occupational therapist, a number of occupational therapy students, many of whom come and volunteer their time for the whole week.

And, guess it's been amazing to be part of this process over the last five years for myself. And one of the things that I love is that, being part of camp as a group leader, we get access to these skilled master clinicians. And of course, one of which of those is Tracy. but these clinicians come and support us to learn, and use the treatment model through the week to help these children achieve their goals.

So CAMP is really set up to invite learning, and it's an integrated pediatric occupational therapy approach. But the biggest change that I've seen over the last few years is that they started a program evaluation, which then actually has turned into a research study, in collaboration with Dr. Shelly Lane, who was the, who was with University of Newcastle, but is now at Colorado State University. And so Tracy and Shelly Lane and the other members of the research team work together to establish a fidelity to treatment model, which is the Spirit Model that Tracy was just talking about before. And it's been amazing actually to watch this evolve, over the years that I've been at camp.

And I'm a little bit devastated not to be at camp this year because it's been such a consistent part of my life for so many years. And, funnily enough, actually it's also been a significant part of my fiance's life who I met when I was working in Sydney. And he grew up in Bathurst, which is about 45 minutes from Orange, in rural New South Wales, if you are not in Australia.

But we really wanted to get back to the country, which is why I ended up living in Orange. So when I got here, I worked in the child and adolescent mental health inpatient unit, and in a local public primary school. And then I joined the beautiful team at Seed and I absolutely love it. And I can't wait for what my future brings here at Seed.

But, what about you, Michelle? You wanna go next?

[00:09:52] Michelle: I'm happy to go next. My name's Michelle Maunder. I'm an occupational therapist. I'm gonna start my journey way earlier than you, Cory, only because it is, it illuminates how I landed where I am now. So I was raised and spent my childhood in a small country town, a farming community called Trundel, six hours from Sydney in Australia.

So I grew up really connected to the landscape, to nature, really connected to family and, to a really small community. We, as farmers, I guess, grew up, in harsh environments. And so there was a physicality required in that environment. So I saw that we needed to have strength and endurance and agility physically to maneuver, you know, stock and machinery.

I also saw that we are at the whim of the seasons, which, meant that you know, myself, my family, the community face, drought and floods and you know, everything in between at random times, which had just such a massive impact on my life, my family's life and the community around me. And so that really, started my observing of people of their different strengths and interests and, how they managed in really adverse conditions and also how they managed when they were thriving, when it was boom times in that community.

And people did it really differently. And so that kind of planted the seed for my interest in body, mind and spirit connection. People really engaged with the land and or farming, and so that kept them there. Even in the harshest of times, we had some really harsh droughts at the time and, and the environment, I guess, reflected a little bit about where we are in the world today with, you know, fires, dust storms, floods.

So a lot was thrown at that. So I just kept kind of wondering about, wow, people did it differently. We were all in it together, but we all did it differently. And my cousin from the metro area came and introduced this idea of occupational therapy, which was, you know, in a town of 500 people, we didn't get exposure to different professions.

So that sparked a little, curiosity in me because it seemed, really broad, really diverse. I love change. So I thought, you know what, this small country down girl is going to be able to, go around the world doing lots of different jobs and, yeah, just observe more people thriving through adversity.

In, in environments and in jobs, that, is really meaningful for them, I guess ideally to see us all thrive. So that took me to OT to Sydney where I studied. Again, I kind of continued this journey with observing people. So my interest was certainly in supporting people clinically in, the, all the different roles I had, but also supporting OTs to thrive.

So I did a Master's of adult education with an interest to see how I could support professionals. How could other OTs who found their work really meaningful thrive because we are often in the face of really difficult times ourselves in our professional lives. So that took me to adult education.

I then found myself and our kiddie, my family moved from Sydney, to Orange. I, by then had a gap in my career while I loved my own little children, went to preschool to watch this OT, Sarah McInnes , deliver this presentation on children and, development. And it just blew my mind because it was not what I had had presented, certainly through uni.

So I just wanted more of that. So I rang Sarah and said, Sarah, Sarah Sarah McIness. Seed Paediatric services. I wanna work with you. I want more of that. Yeah, so that's how we started many moons ago. I came to paediatric Occupational Therapy in my forties. So I, am a late starter, but I definitely have found this to be the most rewarding area of practice.

And I love working at Seed and I've found that from that moment forward, I really have, gathered people around me or I've gathered around them, to support me, to learn as much as I could, as fast as I could. I eagerly attended as much professional development as I could in whoever came to Sydney, really to Australia.

I showed up, so we were treated to the likes of Sheila Frick and Jullie, Patty Wilbarger, Shelly Lane, Beth Osten. We even pulled a few nighters to join some live online courses, mostly with Sheila Frick. Yeah, I also went to camp, as practicum, which is where I was lucky enough to meet you beautiful ladies and Tracy started. I fell in love with Tracy there actually, when I saw her work and heard her wealth of knowledge. And, Tracy started mentoring us at our clinic shortly after that, back in 2015. We were also mentored by Beth Osten in DIR floor time for a while, and Kim Barthel in Trauma and Seed hosted Kim to actually come to Australia and, come and co-treat in our clinics.

So that was just amazing experience. So while sometimes we attend courses that are just available, so whoever comes to Australia mostly, we are really driven at Seed. And I guess, I'm just driven to learn as much as I can to solve the child in front of me’s problem. And that's what's really quite organically led me on this, you know, really wild and wide range of, topics and seek out people across the globe really.

And that is really what this lifelong journey is about for me and us. I think at Seed and you know, Tracy, you obviously as well is really, solving challenges for kids and their families, here, in regional Australia so that they get access to, you know, international standard occupational therapy treatment.

[00:16:58] Cory: Yeah. I guess to add to that is, we're lucky enough I, at Seed, Michelle and I, and the team at Seeds, Sarah and Kylie and Tegan, we are all lucky enough to have mentoring with Tracy and so. That's just, it's just such a pot of knowledge and this enthusiasm and passion that we all bring and kind of collectively work on together as a team.

So it's, it's super awesome to have people around you that are passionate about the same things that you are, and you can go and ask about these super geeky questions. Like, oh, like when we tip your head back and you get this reflex, and the eyes go like this, like, what's happening there? Why is that happening?

And, and people actually, don't look at you like you're a bit odd. So it's very, very, very cool to have a little team where you can jive like that with them. Yeah. So, yeah, absolutely. Yeah. What about you, Tracy?

[00:17:59] Tracy: Wow, this is so, this is already so fun. The three of us are having a blast, and I hope everybody else is too.

And I think part of it is, you know, the journey that we're on as pediatric occupational therapists is such a surprising journey because there's so much to know. And at the end of the day, it's always about the children thriving. It's always about what can we bring to that situation? And we're gonna talk a lot in this whole series about kids who struggle, but what we bring to it as OTs is so rich and deeply meaningful. And I think both of you, you know, when I first met you as your sort of mentor, there's a special spark and a special quality that both of you have. That I think makes our mentoring sessions so fun and so captivating. So, that's what we really felt like that was worth sharing. And I think seeing that spark, seeing that kind of passion and that urge to know and to dive deeper and to really come to a deeper level of understanding is what we want to do in this podcast, right?

It's to educate, it's to elevate, and engage people. So we're saying engaging and elevating pediatric OTs. I think I've been on the journey of engaging and elevating pediatric OTs for quite a long time. Um, so, you know, I became an ot. My father, uh, told me about occupational therapy. Uh, I thought I wanted to be a psychologist and.

He, he kind of felt like there, he knew me better, you know, at that young age when you're become, you know, you're not quite an adult yet. And he, he kind of knew that, that I was connected to the wholeness in a way that I might feel a little frustrated in, in a different field. And he knew a bit about OT fortunately.

So he, he kind of suggested to me that I become an occupational therapist and I, took the intro course in college, not really knowing anything about it. And in our pediatric world of occupational therapy, one of the leading theorists that continues to guide my thoughts every, all, every day. Really.

There are two of, well, three of them actually, they wrote a book together called Children Adapt. So that's Eleanor Gilfoyle and Anne Grady and Josephine Moore. And Ellie Gilfoyle happened to teach the intro course that I took, and Ellie, became a mentor that I still to this day cherish. And partly because I'm a, I'm a tall person and she's a very tall person,

And she's also a person who really understood that understanding the shifting story of development was what kind of is the underpinning of really doing excellent pediatric practice. And so their theory of spatial temporal adaptation is a pivotal theory in my own mind, but I think also, it underlies a lot of, of the processes that we end up looking at.

And so I had a chance to just learn it from, from the very best people. Anne Grady later was my boss at Children's Hospital and Jo Moore used to teach neuroscience classes to us, a couple of times a year. And I fell deeply in love with trying to understand the brain. So that, led me to, getting a degree in neuroscience and really, trying to understand more about development and the brain and what's happening that creates roadblocks for kids in their journey. And then what might we best do to unblock those roadblocks? So in my kind of own, you know, “need to know”, I quickly kind of became a supervisor person at the Children's Hospital in Denver and started to supervise a lot of therapists.

And the common thing that I saw was that therapists would either identify lots of approaches and they would kind of live in the treatment approach and let that guide them. And that's, that serves a really critical purpose very often. And then other times they would get kind of overwhelmed by how much there is to know.

And sometimes in that, in that journey, they would kind of forget that it's the light of themselves that they have to bring to bear in the situation. So you have to know a lot, but you have to be fully present to do this work, to connect with children and to be an effective, person that is a co-occupant of their developmental space.

And so in that journey, I think I found that I had to really help people be able to shift gears between the thinking part of the work and the doing part of the work, and sort of look and understand children deeply, but also always stay present. And that's, that's kind of a, a beautiful thing to have to move between those levels of thinking.

So in that work, I sort of started to really get interested in the clinical reasoning process in the middle 1990s. Mattingly and Fleming wrote some books for occupational therapists, not just pediatrics, but about the clinical reasoning process. And so I studied that a bit. And then we also were involved at that time at Children's Hospital with our team, in doing some research on what are sensory modulation disorders, we called them disorders at that time.

We don't really call it that anymore. But, we were studying that and we had to develop a fidelity to treatment process as a part of that research study. So Lucy Miller was the principal investigator of that study. Julie Wilbarger, Sharon Trenell, and I separate from Dr. Miller, we developed this tool that we call the STEPPSI that is, it was the first fidelity tool in pediatric occupational therapy.

And that's kind of an amazing thing. So what happened was I had to learn how to think in that more scientific way, but also always keep it grounded around who are these kids and what is it that we're trying to help them to do, and who are these children and these families? And so I kind of entered into that space of, of clinical reasoning and, and distilling knowledge in a way that's really accessible to therapists.

So I've kind of been involved in that in different ways for years, kind of coincidental to all of that work. Or not coincidental, what's the word? But anyway, kind of in tandem, I was also really involved in the world of fragile X syndrome. So, I was an OT on the clinical team, the very first clinical team in the world that was really dedicated to Fragile X and I had a chance to work with extraordinary mentors, Rondy Homberman in particular, but with a team and a real multidisciplinary team.

trying to understand really complex kids, but in that field, um, I had a chance to, to have to go to these science meetings all the time. And one of the scientists who's passed away now, but his name is Bill Greeno, um, he's kind of the super guru of neuroplasticity. He's one of the people who did the, the really pivotal studies around how experience ends up being the marker of how brains shift and grow and change and how dependent our brains are on experience, but also how experience influences us.

And in that he was really eager to help the world understand that that's all experience. In all processing, not just cognitive processing. So as OTs, we're often kind of in a place where people don't quite understand how some of the sensory and affective and motor and body-based work we're doing is so critically important.

And yet here I had this chance to talk to like one of the top scientists literally in the whole world, and he said to me, you know, you have the audacity to believe that the work you do changes the brain, and you should think that that is what you're doing.

[00:27:22] Michelle: As an occupational therapist, Tracy, or as you Tracy Stackhouse

[00:27:25] Tracy: No, as an occupational therapist. Yeah, maybe a bit of both. But he really, he was very like, very impactful in my life. And I think that I felt like really emboldened. Like, no, come on OTs, we are doing something remarkable and spectacular, and we should be able to talk about it to each other and we should all be working at a very deep level.

And so that's just been my commitment, I think since then because I see what happens when you light that fire of passion and knowledge and skill and bring your whole self to the work. So that's what it's all about for me. And it's like amazing. So I've had a chance to like mentor all kinds of people all over the world.

And I have a special connection with Australia because of Camp Jabiru. And I have a special connection with Seed because your team caught the fever. You caught the fever of clinical reasoning, and you, you're so committed to it. And so it's super fun and the work that you all are doing is so deepened and enriched by the conversations that we have, and we felt like we should share those conversations.

[00:28:49] Cory: Just listening to you just then, Tracy, it was like this fascinating experience for me because just to hear how people have influenced you and shown you the potential to create change and to support development and all of that, all of that amazing stuff that we get to do to then be like, that's exactly what you do for us and for me, and, you know.

Yeah. It's, I guess that was the biggest drive for me in wanting to do this together, this podcast, because I kept thinking, what if more people had access to this conversation? What, like, if they were able to join in on this and catch the fever, I would love to have a hundred percent faith and, I wanna, I guess refer to other occupational therapists knowing that they can, go to this place with these kids as well.

Mm-hmm. you know, each of us can only treat so many children or work with so many families and support so many people. So the more of us that engage, I guess, and elevate our own practice, to be a bit corny, the better. And so I, this, this was the biggest drive for me and just hearing that I, some of that stuff, we've now known Tracy for like over five years, I guess.

And I'm just hearing some of that stuff from you for the first time. So I'm loving that we are doing this.

[00:30:37] Michelle: I am too and I'm loving that we did serendipitously, is that the word? Yeah, yeah. Yeah. Found, find each other. Yeah. And that, when I look back on my career and perhaps. Yours to Cory and Tracy is that we've bumped into people, who offered us some ideas and we moved towards that.

And sometimes that took a leap of faith to do like doing a podcast .

Uh, but that if you can harness the energy and contain the excitement of nervousness and move in the direction that you are compelled to move in, that you are driven to move in, things can unfold for you. And that can be as little as, or as important as your dad saying, Hey, Tracy, because I was too interested in psychology as well, and my dad cautioned me away from that and from teaching, I must say.

So I had to land on something and, I'm so grateful I landed on OT. But we moved in the direction, I guess pretty organically and with a leap of faith. And we've found ourselves here at different ages and stages of our career. We've landed on it. And we didn't plan this, this. Really even the podcast idea happened from Tracy and, I guess, us separately saying: “Hey, this is precious. This is, wonderful what we are doing here. I wish I had this to listen to, when I was first at starting out in Paeds” but also I guess to have the Audacity which is what it feels like for me to be brave enough to, at a conference or at Camp Jabiru or wherever you are in the world, if you see somebody or hear somebody speaking in a way that resonates with you, to go to them and approach them as boldly as we did to Tracy, to literally email and say, Hey. she's gonna be inundated now, so maybe not Tracy haha, but find your people and, and gather them round and find a safe group of people that you trust and value and align with to help move you, in the direction that you are compelled to go. Because if you, you create synergy, which is what we are hopeful, I guess, that we are doing here today. Creating some synergy to give you some energy and perhaps a little bit of braveness too, to push you into the direction, for your own personal sake, for the sake of OTs, but also for all the communities with which we live in and the families, children and families that we serve.

[00:33:34] Cory: Yeah, 100 hundred percent. I mean, for me, when I first graduated, I went into a job where I was a subcontractor and I had like no supervision and it freaked me out because I hadn't had any, peads experience even through Uni. Um, I mean, I had taught little kids dancing and so I was comfortable with little kids, but I was also in the back of my head thinking, how do they know that I'm doing anything?

You know, how am I sure that I'm actually providing treatment? So because of that, that feeling of - I really need to make sure I'm doing a good job and I wanna understand “what do I actually need to do to help these kids and families?” I proactively went and sought mentoring. And so I contacted Patty Otter, and I contacted, Colleen. And Colleen must have thought at the time that I was like, so painful, because I just, I kept trying to get on the phone and chat to her.

And, you know, of course I paid for mentoring, but it was the best thing, that I could have done early on like that because I really didn't know what to do. And, having that experience of just being able to chat with, people who think and integrate knowledge quite deeply, and help guide that for me was so helpful.

And then I guess once I got to The Sensory Gym and got connected in with you, Tracy, then I had these amazing opportunities to get mentoring from amazing therapists. And so I think that that process is just.. I find mentoring invaluable. It's been, I literally, I feel like it's changed me as a clinician.

I don't think I'd be the same clinician that I am today if I hadn't had the experiences of mentoring that I've had. Hands down.

[00:35:37] Tracy: Yeah. That's so great and maybe it's sort of one of our secret goals of this podcast is that, pediatric OTs will feel brave enough to ask for mentoring because the fact is that there's so much to know.

Mm-hmm. And if you think about the theory bases that we use, the strategies and tools and techniques and methods and all of the different treatment approaches, there's a lot to know. And our field really in university, pretty universally across the world - you learn the real foundations of – “what is occupation”, which is so rich in, in and of itself. And you learn the science and methodology, but you don't learn all of the particular treatment approaches that happen in any of the ages and stages or varieties of occupational therapy practice. So when you land in the space of deciding to work in pediatric ot, wow, at first it can be really overwhelming.

So, you know, this, framework that we're gonna talk about within the series of this podcast will be really focused on an integrated pediatric approach that's really grounded in interpersonal neurobiology and the relational qualities that we bring to bear. And then it's deeply informed by Ayres Sensory integration Theory.

And that's because it's a foundational framework that we, that all of us collectively know and have studied, but it's also, one of the neuroscience frameworks that we need, to do the work that we're doing. So to learn all of that, you don't really learn that in university. You, have to acquire these skills and then all of the varieties of different, you know, methods and techniques that we use, you learn all of that in practice and you learn it in continuing education.

But where you cement that knowledge and where you bring it into you so that you are bringing it to the intervention is in mentoring. So, you know, mentoring is kind of that, it's a relationship. The best mentoring is always in, you pick somebody who you feel like you kind of can learn from, but you trust them and you can deepen your conversation and you can be vulnerable and say, gosh, I don't know what to do here.

And, and then what would you do here? And that you start to build that trust. So mentoring's also kind of a process of deepening your professional skills. Mentoring is something we should be embracing and something we should be proud of because it really is a core value. But in every discipline in the world, we learn and advance ourselves through mentoring relationships and we kind of advance our learning. So it, it's really a beautiful thing. And I think also, you know, in many of the different OT associations around the world, mentoring is regarded as central to the process of advancing practice. But sometimes in some cultures, in some places around the world, it's more or less forefront.

I feel like one of the special things that happens in pediatric OT in Australia is that there's a growing culture of mentoring and it's just beautiful to watch that happening. And maybe Camp Jabiru has helped with that a little bit because every year at Camp Jabiru we have, well, except for Covid year. Yeah. But all the other years, you know, we have, a practicum where therapists who are already practicing want to advance their practice and they come and we dive into different topics, but we're also seeing kids at camp and it's this culture of discussion and it's a culture of clinical reasoning and that's what is so compelling.

So clinical reasoning is what we're gonna be focused on cuz that's how we elevate practice. That's, and if you can engage yourself in the clinical reasoning process, it's such a gift and, and it's a bidirectional gift. Like for me as a mentor, I love these conversations and watching you guys grow and flourish, it's like a whole different way of having an impact, an impact in the world that I just super, super, super love and, it's a beautiful thing. And then equipping you guys to step into the space of being mentors for other people is also super cool. So it's like this growing swell of really advancing practice and that's what we hope the podcast is gonna help to promote.

[00:40:43] Cory: Yes find those mentors.

[00:40:46] Michelle: And collaborate. Yeah.

You know, that synergy of working together Yeah. Collaboratively just has a power to it.

[00:40:53] Cory: But it's so like, I guess when you see the results and you talk to somebody about, you're struggling with something, in your sessions or you are feeling frustrated by a certain kiddo. And it's more about the fact that you just don't understand how to shift the behaviour or how to help them, or how to create a change.

And then you go and you talk to somebody outside the situation and they can see and they can help you pull the pieces together. And then you try it in session and it's such a different feeling. It's like this significantly different, I dunno, experience of the same child and you see it and the child feels it and the parents see it and you're all just like, what is happening here? This is amazing. Like, how is this, how is this coming together? And I guess because you've tried to integrate some knowledge in a different way and you've had support in doing that and….I don't know. It keeps you coming back for more. Otherwise, why I wouldn't keep doing it , like if I wasn't feeling like it was meaningful or creating some sort of impact, then I wouldn't, I wouldn't come back I'd, I'd go and do something else.

[00:42:04] Tracy: Yeah. Absolutely. So you used the word, you know, somehow something shifts and it integrates. I think the word integration came to you not by accident, because really so much of what clinical reasoning and clinical discussion does is it allows us to get perspective so that what we're offering is truly integrative.

Yeah. You know, Dr. Ayres talked about sensory integration, but integration in and of itself is such, kind of the, it's one of the cornerstones of things that you can come to trust as a therapist, that when you weave the pieces together and, and your intention is to move toward integration, that's really gonna happen.

That sounds maybe kind of too mystical or something like that. But honestly, I think in the course of this podcast, we'll be able to really think about some concepts like the concept of integration. Where does that come from? How do we achieve that? As you integrate a system within a child, they emerge from those opportunities of integration.

They emerge in a way that, their capacity is elevated and shifted. And so when you start to move, their system forward and make those shifts, Integration allows them to really start to put different pieces together and to harness some of their skills and strengths and use them in a new way.

So it really is the essential ingredient of development integration is. And so we, we really are gonna have to figure out how to talk about that and, and think about all the different pieces. And one of the things that we do in clinical reasoning is we, we deconstruct and reconstruct, we look at the child as a whole, always.

That's always our goal, is to help the child, the whole child, to integrate forward so that they can really thrive in all of their life. and that that is sometimes thriving for one child is always different than for another. Mm-hmm. because we work with kids who have sometimes pretty significantly reduced capacities, uh, in different developmental domains.

But that doesn't mean that they aren't gonna have a thriving, amazing life. And, So I think that what we do in, in clinical reasoning is we deconstruct and then we reconstruct we, and sometimes I say we zoom in and zoom out. We kind of zoom into the things that are the sticky bits for the child, the things that are the hardest for them, or sometimes the thing that is just so.

Remarkably amazing about them. Mm. And we enhance that, and then we kind of zoom back out to like, how is this gonna help them integrate and move down the path? Mm. So the biggest picture of clinical reasoning is that kind of moving into the different elements, the different domains of development, and kind of fine tuning our thinking around each of those domains.

So our, our thought for this podcast is that we would kind of do that, that we would jump into the core areas that each pediatric OT might need to deepen their thinking around, and that we would spend an episode, on each of those different core areas and kind of do that through case studies,

[00:45:43] Cory: I guess, in this podcast. We'll, we, we'll sort of be trying to go through some of these core areas, but, both Michelle and I have gone and done. The spirit course of, clinical reasoning for pediatric occupational therapists that Tracy runs. And I, I have found that course so, so helpful in, in separating out and trying to figure out where do you start and how do we at like attack all there is to, to, to try and work with when you're working with a child and a family, or even in communities.

But, we won't specifically in here talk about the spirit course. We'll talk about obviously, the theories and all of the parts that go into it. But I mean, if you, if you yourself want to go and do that training, you can, I think is it online now Tracy?

[00:46:44] Tracy: It will be, yeah.

[00:46:45] Cory: Yeah. That's so exciting. Yeah, I'll probably go and do it for a third time.

And so I guess that framework for us, for me, in our mentoring has been really, really helpful. And it's always sitting in the back of my mind now when I'm thinking about and when I'm reasoning out what I'm doing with a kiddo. So, , we sort of almost were like, we asked Tracy, like, let's go through this, the whole like spirit course in a podcast.

And she's like, let's just ease up and like just cause it was so helpful. So, we're sort of structuring it around those core areas that are in the model, but we, we'll be trying to keep it in a way that's super accessible and hopefully around a story cuz I think that helps me mm-hmm. when it's based around a specific kiddo or, or just an experience that then resonates with an experience that I've had.

Hmm.

[00:47:47] Michelle: So how will do that through though is through, a story about a particular child, a particular family. We have all worked in multiple, places with, A million gazillion children. So we won't be bringing one child to this story, to discuss. Each week we will, build a composite case, which is really a collection of presentations from lots of kiddos we've seen from all sorts of, workplaces.

So we will use that composite case as a way, uh, for us to dive into a specific domain and then into a, uh, specific presentation of that child, and then bury into their specific age and stage as well. Uh, so that will really help in. Uh, the theory into, uh, uh, a real life story and, uh, the practical implications of that.

And so we will, uh, define terminology in there. We, our plan is to start from the very beginning so that, that we all have universal language, I guess, that, uh, that we are going to understand and use throughout the rest of the podcast. Yep. Uh, so that if this is all brand new to you, and maybe you're not even a pediatric or occupational therapy therapist, but you are gonna get excited by this, then then hopefully something for you as well.

So we are hoping to cover, eight sessions. Cory, do you wanna cover the topics that we're gonna roll through?

[00:49:28] Cory: Yeah. Well, so under Tracy's guidance, we have sort of tried to break down some of these domains into, I guess, I guess more comprehensive or accessible. To learn about because, so like, like Tracy said, sometimes the amount that you have to learn about can be super overwhelming, and some of these topics are really, dense and you could spend ages just learning about sensory modulation or, you know, a very specific part of this, this whole big picture.

So we, we decided, I guess, collaboratively to, to start with the postural system because it's, it's quite clear, you can see it in front of you. You, you can find really obvious examples of how it's working or not quite working as well as it could be. Um, and so we'll talk about the postal system in relation to a constant case that we've put together.

And then we'll link from that system to posture and how that influences your regulation or how settled you are or how able you are to connect with others. Um, and then we'll go. regulation and co-regulation. And so we'll obviously break down all of this as we go through these sessions together. But then after we've talked, after we've sort of gone through co-regulation and how you use another person, to get settled and to get organized, then we'll sort of talk about, social relationships.

Because you use, you interact with other people, you get yourself organized so you can interact and engage Yes. The regulation's, the purpose. Exactly. Yeah. Purpose for interacting. Yep. And then we'll, don't, we'll there's underneath all of that, like Tracy said, there's our theories about sensory integration and the neuro, the neurology that supports these functions.

And so we'll then move into things like sensory discrimination, executive functioning, and integrating all of these pieces to come together to support development. So we're gonna start at the postal system because hopefully, that'll get you hooked in. And my experience of Tracy making this information super accessible, has helped a lot.

So hopefully, we can do that in this podcast and help you be helpful for you. Yeah, grab, hold onto some of this stuff that can sometimes be super confusing. Um, so yeah, I think that'll be the flow of our sessions. And whenever possible we'll try and base it around a story cuz that always captures me.

[00:52:14] Michelle: Yeah. And we will resonate hopefully with other people.A and that's why we are gonna use a composite case to make it fairly, universally, applicable at the start. Yeah. And through this process, we'll perhaps dive into more, complex cases with some comorbidities. Um, yeah. But we are just, starting in a way that will support, our discussion discussing the core concepts.

Our intention is not to lessen how complex, the children we work with present. And we are not trying to simplify that. Lots of our children and families are incredibly complex. So acknowledging that, but for the purposes of these mentoring sessions at the start, we are going to kind of simplify the case as much as we can at the start.

[00:53:04] Cory: Yeah. And I guess pull from many of our experiences so that, you know, we wanna maintain and respect the families that we do work with in a small country town of Orange. And complete confidentiality for all of those families that we love and support. So that's why we'll draw from composite cases.

[00:53:26] Tracy: yeah. Yeah. And it also, I think it, it gives a chance because we're all therapists doing this work. We're, every day we're treating kids and we're working with families and we're trying to bring our very best efforts to that. And in the work, having questions isn't a sign that you don't know what you're doing.

Having questions means that it's a reflection of the complexity, of both the children and also of the work that we're trying to pull off here. So, you know, human brains are complicated and the human developmental system, there's nothing more complex or fascinating. So we're hoping. You know, we give you permission to ask the questions We're gonna model for you the real questions that we really have.

And I think for most clinicians, whether they're occupational therapists or other pediatric clinicians, it's really, it's gonna be your journey too. You're, you've walked this walk, you've had these questions, and you've wondered, and the promise of mentoring in clinical reasoning is that we advance practice and we really can figure our way through those questions, and the, and really find a way forward and really maximize outcomes.

So what's really all about that and about taking care of kids the best way we possibly can, in this very complicated world that we live in.

[00:54:51] Michelle: I've seen, as I've worked around the traps, there is just such a high rate of burnout in, in these helping professions, including occupational therapists.

Look, we're, starting this podcast in 2020. So we're in a really complex, you know, international state of affairs at the moment.So people, therapists are carrying a load. and so, one of my hopes out of this is that it might prevent, therapists stress and burnout and that, so that we look after ourselves.

So that I can kind of thrive in this really complex, environments where I'm lending my nervous system to others where I'm lending, you know, my thoughts and my feelings and I'm, I'm kind of holding space, for children and their families. And so there's a vulnerability to me in, in the process of doing that, that without the support of our incredible team at Seed and people like you, Tracy, who support us, that it might feel too much for me to continue, because it's a load to bear for a therapist if you aren't supported by people. So, our eyes are on the children and their families and the communities in which they live. I, we all, as you've done for a long time, have the eye on the therapist as well and so that we are, you know, we are mindful of the work and the load that it can, have on us as therapists as well.

[00:56:31] Cory: Maybe our podcast can be a little backup for you guys, inadvertently. Because I get back up, but not everybody does. So we're here, we got you.

[00:56:41] Tracy: Yeah, absolutely. I love it. I love it. Beautiful intentions and I think, what a wonderful novel way to, to try to achieve those, goals. So it's, it's gonna be a fun journey.

[00:56:56] Cory: Yeah. Yep. And cuz you were saying, encouraging people to put your hand up, ask questions, do all of that.

No, we do have an email that you can email us. We won't, we've kind of got our topic set out for this series. So we won't necessarily be answering questions per se in this first series.

But, feel free to, send emails or even just give us feedback.

“Cory, you'll speak really funny or, you know, constructive feedback would be super awesome. Not because we have an Australian accent, we can't do much about that. Yeah, sorry about that. Sorry about that Australian accent. But, hopefully it's a novel for some people.

So if you do wanna send us an email, you can send an email to spiritedconversationspodcast@gmail.com. We'll start off next time with our case. And we'll kick off from it.

[00:57:52] Tracy: Absolutely. And we'll talk about posture and postural control and how we think about that and how we might approach it.

We'll, think about it from a theory perspective. We'll weave in conversation about assessment and treatment. We really wanna deepen your commitment to thinking about it. So that's what we're gonna do. And we think it's gonna be really, it'll be fun for us, and we hope it'll be fun for you too.

[00:58:18] Cory: Yeah.

[00:58:19] Michelle: I just wanna say thank you, Cory and Tracy, for sharing in this process. We're learning more things about each other. Oh, no, it's awesome. I haven't heard some of these stories about you, uh, before, so thank you.

[00:58:32] Cory: Yeah. I've got a few crackers up my sleeve.

[00:58:35] Michelle: Jumping on the, uh, podcast

[00:58:37] Cory: Absolutely. And I guess thank you to everybody that took the time to listen to us and our stories this week.

[00:58:44] Tracy: Yeah, Thanks seed. And it's gonna be lovely. So it's an honor a pleasure. And it's gonna be great.

[00:58:53] Cory: We'll, hopefully talk to you all soon.