I found the two word check in mentioned in the podcast a simple method of checking emotion so I did some exploring on its use. Here is a link on one use of the tool with children.
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Wow! @sherry, what an awesome find!! Learning about the Two-Word check-in was probably my favorite part of the podcast. (Iāve found myself using it on myself 
- it is so helpful and simple!)
@lauren2 also shared the feeling wheel in her note in case your client is having diffiuculty finding the right wordsā¦ Iāve find myself referencing it several times to sort out my own emotions 
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I LOVE the term self-management and will begin to use that tomorrow with my TBI clients. Thatās basically what Iām doing the most in the outpatient TBI program yet have never thought to call it that, so cool.
I wonder if not increasing independence in ADLs has to do with already finding adaptations or just finding it easier to switch hands etc. once further along in the injury. If itās working (or too much work, in their mind, than just having someone help) then why put in the reps to get a neurological change or use cumbersome adaptive equipment? Being Client centered in routine OT care I could see just dropping that as a goal (youāve been brushing your teeth left handed for 10 years and donāt want to change, great, moving along to your real goal of feeding your cat) which then wouldnāt change their level of independence on a bADL measurement. IADLs / return to work are so much more motivating for Clients to work on, I feel like.
Thanks for the article.
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Yes!! @kyrstin, I agree the potential of self-management extends far beyond stroke to any condition that will have long term effects (which is most of conditions we work with.) I actually just did a quick Google search and found several articles related to self-management and TBI:
https://clinicaltrials.gov/ct2/show/NCT02893345
Iām also glad you brought up the lack of change in ADL status in chronic stroke. I think your thoughts are spot on, and align with what Lauren said above. Iām linking below my favorite stroke-related article weāve looked at in the Club, because it lays out interventions that are most effective for the chronic phase versus acute phase. It is possible to make rehab gains in both phase, but the apporach and goals should be different:
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Kyrstin, although we didnāt specifically call out the reason for not increasing independence in that stage of recovery, I think youāre right on! It has also been my experience that by that time in OP care, often patients and caregivers are embedded in routines that can be really difficult to change (even if the patient is getting more assistance than they want or need). I think early conversation and expectation on shifting toward a self-management model can help with this. I really enjoyed the topic and glad it was helpful. Iām curious to hear how this shift in language changes your practice (and your clientsā response).
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Welcome Jennifer! Yes, there is definitely cross over to other populations and having children help set goals is a great example. I see a shift in how weāre seeing ourselves as therapists in this coaching mindset and with an approach that we have insights but the client truly has the understanding and agency to make changes that can best serve them.
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Definitely! I hope to see it as part of a larger paradigm shift in healthcare from expert-patient perspective to more of a team approach.
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