What Does An Occupational Therapist Do?

I’m happy to host author Catherine Richmond as she discusses her “real life” job of occupational therapy. Hopefully, you can check out her novel, Through Rushing Water. Is that cover not gorgeous?

Welcome back, Catherine!

What do occupational therapists do? We work with people to set goals, find their motivation, and overcome conflict – does that sound familiar to you writers? So what does that mean in practice?

Currently I’m working in an acute care hospital. My patients might be dealing with anything from a knee replacement to alcohol withdrawal, cancer to pneumonia. OTs help patients return to taking care of themselves. A person who has had a stroke needs to learn how to open a toothpaste tube and feed himself one-handed. After a hip fracture, patients aren’t allowed to bend, twist, or cross their legs, so OTs teach how to use devices such as dressing sticks and sock aides to dress themselves. Families learn how to safely help the patient and support their improvement.

Patients who need more help after their medical crisis is resolved might continue to work with OTs in skilled nursing facilities, rehabilitation hospitals, outpatient clinics, or at home with home health care.

I’ve also worked as an OT in schools. Students with coordination problems learn to zip, open milk cartons, and write. Some children needed equipment such as a pencil grip, heavy lined paper, or a computer to complete their homework. I helped teachers adapt their curriculum to include students with handicaps. Children with severe handicaps might need positioning use their arms, changes to their food and feeding utensils for meals, and adaptations to allow them to interact with their environment.

What’s the difference between Occupational Therapy and Physical Therapy? There’s a lot of overlap! In the hospital, PTs work mostly on walking and stair climbing. The PT might teach leg exercises, while the OT works on arm exercises. In the school, physical therapists work closely with PE teachers to ensure students’ participation. OT overlaps with Speech Therapy, too. The ST works on swallowing and communication, while the OT makes sure the patient is sitting correctly and provides adaptive utensils.

In the early days of OT, a hundred years ago, patients stayed in hospitals for months and needed activities such as knitting and woodworking to pass the time. Since then, OT has grown and changed. So if you write about OT – and I hope you will! – be sure to consider the era and the context where your therapist is building a bridge between the person and the environment.


Catherine Richmond is the author of Spring for Susannah and Though Rushing Water. She supports her writing habit by working as an occupational therapist.

19th Century Contraception

This week I’m focusing on historical issues for authors. Today, I’m so pleased to have Catherine Richmond as she discusses 19th century contraception. I found this information really fascinating. What were the options for women during that era?

Welcome, Catherine.

In 1874 Dakota Territory, Susannah Mason’s miscarriage terrified her husband. Jesse took her to a doctor who diagnosed Susannah as too frail for childbearing, much less homesteading. With a century to go before the availability of The Pill, what contraceptive methods did the doctor prescribe?

First, he cautioned that his instructions were confidential. In fact, since the Comstock law passed the year before, mailing information about birth control had become illegal.

 So what did he recommend?

o   Abstinence. Quite a challenge in a soddy with only one bed!

o   Withdrawal. One of the least effective methods of preventing pregnancy.

o   Rhythm. Unfortunately, scientific knowledge at the time meant physicians gave incorrect information about fertility. The doctor’s recommendation actually increased the chance of pregancy.

o   Sponge. A sea sponge or a wad of cotton or wool, about the size of a green walnut or small apple, formed a barrier.

o   Douche. The recommended agent was widely-available vinegar.

o   French letter. For centuries, condoms had been used to protect against sexually transmitted diseases. Gradually their use expanded to contraception. In 1874 condoms were made of sheep intestines or rubber.


With medical advice being sparse and of questionable quality, women went to each other for guidance. Letters from the 19th century – if the descendants haven’t edited them out of the horror of discovering great-grandma knew about sex! – show wives coaching each other on use of the calendar. Mothers knew breastfeeding helped increase the time between pregancies. Women shared recipes, including one for a barrier made of boric acid and cocoa butter.

Researching 19th century contraception for Spring for Susannahwas fascinating.  And made me thankful that advances in science have made birth control safer and more reliable!


Catherine Richmond is the author of Spring for Susannah and Though Rushing Water. She supports her writing habit by working as an occupational therapist.