Utilizing Expressive Arts and Occupational Therapy for Boosting Vitality by Taly Galor, and Galit Shezifi

Occupational therapists (OTs) are dedicated to offering practical, creative solutions for a variety of life challenges that their patients struggle with daily. Many OTs experience burnout at one point or another in their careers. Occupational therapist Taly Galor and expressive arts therapist Galit Shezifi offer ways to boost self-care and joy, and to reduce burnout for practitioners. This article briefly discusses what is burnout, and offers ideas to inspire hope, playfulness, and laughter.

Maslach & Jackson (1981) described burnout as a psychological syndrome that is defined by three dimensions: emotional exhaustion, depersonalisation, and reduced personal accomplishment. It occurs among individuals who work in high-demand, challenging service sectors. (Maslach & Jackson, 1981)

Occupational therapists and decision makers should consider burnout as a burning matter.

The burnout rate in the general working population is 13% (Bahrer-Kohler, 2013) whereas high levels of emotional exhaustion were reported by of OT study participants — 34.8% (Gupta, Paterson, Lysaght, & von Zweck, 2012). Unfortunately, one of the biggest challenges that professionals face is in recognizing and asking for help because usually, their jobs are on the line. The web of silence (Moll, 2014) and stigma affect help-seeking behaviors. (Dyrbye et al, 2015).

However, practitioners would benefit greatly from reaching out for personal and professional support. This can be a resource for both personal and professional growth.

One way could be changing your mindset. Instead of thinking of burnout as only a negative, use it as an opportunity to adopt a new perspective and ideas in your profession and toward your patients by using new tools.

Unfortunately, there are some risk factors for burnout that are specific to OTs. One factor is the lack of a concise and well-recognized professional identity faced by OTs, which is the subject of the ongoing debate concerning the role and function of the profession. (Craik, 1988; Edwards & Dirette, 2010). This can often make OTs feel they are just  “filling the gap” for other healthcare professionals. (Brown et al, 2017)

One affordable and effective evidence-based strategy to help reduce burnout that has a positive effect on others is engaging regularly and intentionally in humor and laughter. And there’s research to back it.  Occupational therapists report correlation between high-volume belly laughter and higher work engagement (Poulsen, Meredith, Khan, Henderson, Castrisos & Khan, 2014). Laughter as a therapeutic means is reported to be beneficial for organization, education and therapy since “laughter is both a sign of cure and a way of curing.” (James, 1979). Occupational therapists write about the therapeutic use of laughter for health motivation (Tooper, 1984), healing journeys, participation in everyday occupation (Elliot, 2013), and as an education tool (Southam, & Schwartz, 2004). Looking at the OT framework, laughter could be part of the therapeutic use of self (Kang, 2018) but also part of the play. (American

Occupational Therapy Association [AOTA], 2014)  Additionally, “humor is an activity of daily living, as important as eating. It is essential.” (Leber & Vanoli, 2001)

Despite the literature and the positive attitude of OTs toward using therapeutic humor (Leber & Vanoli, 2001), there are no recent and comprehensive publications on the issue,  and it’s not included in any training.

How can we incorporate more belly laughter, regarding politics, climate, worries and hardship? We could learn from our clients. Some of them experience a great loss or pain, but are able to find a positive attitude. Laughter for some of us is mainly a result of well-planned, nutritional and intentional diet. As many of us work daily to keep up with our health, marriage, fitness and paperwork, laughter is a daily routine that is free and enjoyable. Even though many of us were told to “wipe that smile” and “get serious” (Tooper, 1984), laughter is easier with a companion, so what could be a better way of peer mentoring?

 We suggest drawing inspiration from some of the following ideas:

1) Therapy group members named music, unstructured and spontaneous dancing, cartoons, films, toys, friends, and games as humorous  resources to be accessed when in need of a humor check or stress relief. (Elliot, 2013)

2) Using positive therapy with laughter, and “happiness or well-being exercises (Mora Ripoll & Quintana Casado, 2010) such as expressing gratitude daily.

3) Laughter yoga that can be done while sitting in a chair like https://www.laughteronlineuniversity.com/sgendry/

5) Learning laughing techniques such as spontaneous laughter (such as playing, clowning, magic) and simulated laughter (such as playful behaviors and physical contact). (Mora Ripoll , 2013)

6) State-of-the-art guidelines on using humor in OT. (Tooper, 1984)

7) OT-related satire (McCarthy  & Kuwada, 2018) and humor, memes and lighthearted OT culture.

OTs should stay tuned for signs of burnout and should reach out for help. This is critical in contributing to the effectiveness of OTs working in a variety of settings.

We suggest sharing experiences with colleagues and friends, and utilizing the resources described above as a group or on your own.

The greater the number of therapeutic laughter techniques that therapists have in their toolbox, the better chance for healing.  So start with a smile.

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