Advocating for the Whole Person: A Reflection From a Level I Fieldwork Experience

During one of my Level I rotations, I encountered a situation that opened my eyes to the broader challenges our clients face—challenges that often extend beyond their diagnoses. As a bilingual student, I was asked by the clinic owner (who was not an occupational therapist) to talk with a Spanish-speaking client. I agreed, expecting a general conversation, but soon learned that the client was being dismissed from therapy due to consistent lateness. The clinic had decided they could no longer accommodate her or her son. When I spoke with the client, I discovered she spoke only Spanish, did not own a car, and relied on public transportation to attend her appointments. Her language barrier made it difficult to communicate with drivers, further complicating her efforts to navigate the city. She occasionally received help from a family friend, but that was not always an option. It became clear that her tardiness was not due to a lack of effort but rather due to barriers that were not being considered by the clinic.

As a student, I did my best to advocate for her, asking the clinic owner to provide resources for at-home services to address her transportation challenges. I could not help but wonder why this conversation had not been initiated by the clinic earlier. It was disheartening to see how easily she was reduced to just another number on the roster, rather than recognized as a person in need of extra support. With the Hispanic population growing in the U.S., I foresee this issue becoming more prevalent. It raises an important question: How can occupational therapy programs better prepare students to handle these complex situations? That day, it was a Spanish-speaking client, but tomorrow, it could be someone facing entirely different challenges.

My experience emphasized the importance of client-centered care; recognizing that every individual comes with unique contexts and challenges that must be considered in therapy. It also opened my eyes to the systemic issues that can inadvertently marginalize certain populations, especially within the Hispanic community. By stepping in to advocate for this client, I saw firsthand the difference it can make when someone is willing to listen and help find solutions. As occupational therapy students, we have a responsibility to address inequalities and advocate for our clients, even when we are still learning ourselves. This moment reinforced the value of integrating advocacy into our practice, ensuring that we not only provide interventions but also work to dismantle barriers that hinder occupational engagement. It is a powerful reminder that our role extends far beyond the clinic and into the social and systemic spheres that affect our clients’ daily lives.

Recently, I listened to Dr. ThOTs podcast, Season 4, Episode 13, where Trey Washington (OTR/L) posed an intriguing scenario: Imagine you are a certified hand therapist (CHT), and your client, post-hand surgery, has been instructed to rest for 6 weeks. However, due to financial pressure, they need to return to work immediately. What would you do? This question underscores the complexities we will face as practitioners, where the occupational and social realms intersect. As we prepare to enter the field, it is crucial that our programs equip us not only with clinical skills but also with the ability to navigate the human side of therapy—the barriers, the contexts, and the unique situations each client brings. How can we better prepare for these challenges? It is a question we must all consider as future occupational therapists.

Julamy Serrano Arocho is a second-year occupational therapy student at Brenau University in Georgia. Prior to occupational therapy school, Julamy served in the U.S. Air Force as a Nuclear Operations Officer and continues to serve in the Georgia Air National Guard as a Logistics Officer. Julamy holds a Master’s Degree in Exercise Science – Clinical from Liberty University. Her main occupational therapy interests are aging in place and acute care. Outside of occupational therapy school, Julamy enjoys spending time with her family, exploring different outdoor parks, and watching true crime shows.