OT as parents??

Monday was a very interesting session. We talked about the different roles that OTs can have in the client-therapist relationship, such as collaborator, ally, mentor, parent, friend, advocate etc. Two that were somewhat more debatable or maybe controversial were parent and friend. People I think were generally cautious about using the term "friend" and my opinion was that it's good to be friendly, but not to actually become friends. That's not what we're there for, it can create conflict of interest, dependency on the client's part (I'm thinking of people who are particularly vulnerable to this - people who are socially excluded/isolated in some way) and maybe loss of professionalism. Not to mention illegal - not in our scope of practice! I think some elements of friendship are desirable in the therapeutic relationship, like being honest, warm, collaborative, listening, friendly and personable... But the role of "friend" I think we should avoid. Certainly in my study of/work with complex populations with complex needs, they can be quite vulnerable to exploitation (not that OTs would deliberately but it's sort of a subtle unconscious process) in that someone interested in them and in helping them comes along and they start thinking "Oh yay I finally have a friend who cares" but then the therapeutic relationship comes to an end one day, as it must, and then they are disappointed and "rejected" and all that. It's just not sustainable and being your client's friend is not the answer. We must help our clients to find/make friends in the context of activities and groups out in the community, help them find their solutions, not to BE the solution. How many clients can we realistically befriend anyway?

The other thing was parent. I recognised many aspects of the parental role and I agree some people almost need parenting, or re-parenting, to be un PC. Some people have never had a real parent, or one who fulfilled the role well. Nurturing, caring, providing rules, boundaries and structure, encouraging, those are all good things to certain clients in certain situations. I think even parenting can be "client-centred" in a way, because you are working for the ultimate good of the client. But I guess the adage that "Mother knows best" must be examined in terms of the OT role, especially vis a vis client centred practice. Does the OT know best? Does the client know best? Is there an absolute answer, a truth, a "right way" or "best way"? All very interesting thoughts.

ps I was really amazed at how differently others defined or regarded "parent". To me, parent is all about control and punishment, but to some others, it's about nurturing and tenderness! It's not cultural, because I'm sure some of my childhood friends think the opposite of me, and some kiwis must agree with me. Just goes to show how everything is relative. That is why we mustn't jump to conclusions or assume anything.