Different,But Same

OPEN IN VIEWER

I want to start with a round of applause for Boston University Department of Occupational Therapy for their generous support and sponsorship. I also want to thank BU for their unending commitment to advancing occupational therapy and moving us into a thriving future. We are better because of you.

Wow, looking out at all of you reminds me of a recent conversation with a great friend. She asked me, “How are you feeling? What are you looking forward to the most at INSPIRE?”

The answer is THIS.

But how do I describe THIS in words?

Well, never one to turn down a good challenge, I began to reflect on what THIS is. And my reflections led me on a journey of being in the presence of occupational therapy, or more specifically, the presence of occupational therapy in various environments—environments of chaos, disruption, and change.

The same chaos, disruption, and change we see in the contexts of each person we cross paths with, whether in the hospital, the clinic, the skilled nursing facility, or in class or in the grocery store. The same chaos, disruption, and change we see in the contexts of each of us.

And, of course, I found a book: Palaces for the People, by Eric Klinenberg.

So let’s go on this journey now, together. I am going to start with Eric Klinenberg’s book and an interesting observation that he made in 1995 as a resident of Chicago, Illinois. It was during the summer of that year that Chicago experienced an unprecedented heat wave, a heat wave that would take the lives of 739 more people than the predicted mortality rate, during a brief seven-day stretch of July 14 to July 20.

Klinenberg’s observation? Well, he explains it best: “Consider Englewood and Auburn Gresham, two adjacent neighborhoods on the hyper-segregated South Side of Chicago. In 1995, they were both 99% African American, with similar proportions of elderly residents. Both had high rates of poverty, unemployment, and violent crime. Englewood was one of the most perilous places during the disaster, with 33 deaths per 100,000 residents. But Auburn Gresham’s death rate was [only] 3 deaths per 100,000 residents, making it one of the most resilient places in the city. . . . ” (Klinenberg, 2018). Interesting—two places, both different, and yet also the same. But how could this be true?

Fortunately, Klinenberg tells us. In Englewood, “the neighborhood had been abandoned,” having lost 50% of its residents and nearly all the commercial business throughout the 30 years preceding the heat wave. This resulted in a neighborhood atmosphere where people didn’t know who “liv[ed] across the street . . . and old folks [were] apprehensive about leaving their homes.” This “discourage[ed] interaction and imped[ed] mutual support” (Klinenberg, 2018). Conversely, “residents of Auburn Gresham walked to diners, parks, barbershops, and grocery stores. They participated in book clubs and church groups. They knew their neighbors. . . . [It was a] place where causal interaction was a feature of everyday life. During the heat wave, these ordinary routines made it easy for people to check in on one another and knock on the doors of elderly, vulnerable neighbors” (Klinenberg, 2018). And the most amazing finding of Klinenberg? It was these ordinary routines that provided the residents of Auburn Gresham the same protection as having a “working air conditioner in every home.” This is when I was introduced to collective effervescence, and I finally discovered how different could be the same. Even more exciting, I found a way that I could define the THIS to my friend and really the presence of occupational therapy in any environment.

So, what is collective effervescence? In an article by Gabriel et al. (2019), the authors share the original definition of this term first discussed by Emil Durkheim over 100 years ago. Collective effervescence is what happens when we have a place to gather, and in that place we experience bonding, learning, and connection with others we believe have a shared purpose, values, or beliefs and that this brings about hope, energy, and what Durkheim calls a “sensation of sacredness.”

Gabriel et al. (2019) explored the existence of a “group” further and found that collective effervescence can be experienced in everyday activities, such as riding the bus, selecting produce in the grocery store, or attending a yoga class.

In Auburn Gresham they had a place to gather. They walked to diners, parks, barbershops, and grocery stores. And these places where they gathered created opportunities for bonding, learning, and connection. They participated in book clubs and church groups.

They knew their neighbors.

They shared values, beliefs, and purpose with one another. These ordinary routines made it easy for people to check in on one another and knock on the doors of elderly, vulnerable neighbors. Betty Swanson, a resident of Auburn Gresham for more than 50 years, said, “It’s what we always do when it’s very hot or very cold here.” And as a result, they had hope, energy, and a sensation of sacredness. The residents of Auburn Gresham had the same protection as having a “working air conditioner in every home.” Klinenberg goes on to say that, most extraordinarily, Auburn Gresham was “always significantly safer and healthier” than Englewood, including having a life expectancy that was 5 years higher.

Wow, collective effervescence led to residents of Auburn Gresham having longer lives than those residing in Englewood. I needed to know more about these two worlds that were able to give life.

The more I read about collective effervescence from older studies to recent literature to guest essays in The New York Times, it became apparent that the opportunity to experience collective effervescence is a necessary and powerful tool in combatting loneliness, an epidemic in our country, and one that AOTA Speaker of the RA, Michael Urban, has brilliantly advocated requires the presence of occupational therapy for healing. But collective effervescence doesn’t just eliminate loneliness, it protects us from depression, anxiety, and the many consequences of stress.

And how do individuals experience collective effervescence? Well, according to Durkheim, when that “sensation of sacredness” emerges. But, Gabriel et al. (2019) shared that this can emerge when riding the bus, selecting produce in the grocery store, or attending a yoga class—you know, participating in occupations. My aha moment.

The reason the presence of occupational therapy feels like collective effervescence is because we cannot participate in the things we need to do, the things we want to do, or the things we are expected to do without the presence of occupational therapy. In other words, to get to a “sensation of sacredness” we must be able to participate in occupations.

And when our ability to engage in collective effervescence is interrupted, we see a rise in distrust and civic participation wanes. Sounds a lot like occupational imbalance, maybe even occupational deprivation?

Have you seen this? Or, more importantly, have you felt this?

The next stop on my journey brought me to the ingredients of collective effervescence.

Sherry Turkle, an MIT psychologist and scholar, shared the following:

▪ We must develop capacity for empathy.

▪ We must create opportunities to experience the joy of being heard, being understood.

▪ We must advance self-reflection.

▪ We must build the environments that facilitate successful participation.

Additionally, Turkle stressed that these ingredients must be carried out in a “human way.” She stated that “conversation is the most human—and humanizing—thing we do,” and that we must “search for the commonalities in those who are different.” Phew . . . a simple question, when my friend asked me, “What are you looking most forward to at INSPIRE,” and look at all I had learned.

I asked myself when was the last time that I felt that collective effervescence in the presence of occupational therapy, and I immediately smiled at the memory of the OTs at the Pelvic Health Summit in August of 2023.

As you may, or may not, remember, the AOTA Board of Directors had voted on strategic priorities for the 2024 fiscal year last May. These six priorities included:

Women’s health, inclusive of all genders, and pelvic health

Mental and behavioral health

The occupational therapy entrepreneur

Operationalizing DEIJAB

A large, nationwide, “What is OT?” campaign

Improving the AOTA member experience

So one of my first trips for the new fiscal year was attendance at the OTs in Pelvic Health Summit. This incredible event is organized by pioneers in bringing visibility to the power of occupational therapy in pelvic health: Lindsey Vestal, Kelsey Mathias, and Heidi Carpenter.

While I was there, I danced in an aisle of bubbles, learned that trauma resides in our pelvis, and that occupational therapy and physical therapy can work together to create a wellness that will in fact build a stronger world for mothers and children, and we are all either a mother or a child or even both at some point in our lives. Thank you to Drs. Rebeca Segraves and Jenna Segraves in particular for that last lesson.

Was this collective effervescence?

Happens when one is in a group—check! We were a collection of over 150 excited occupational therapy and physical therapy practitioners.

Experience bonding, learning, and connection—check! I learned that I could help my clients and myself to sweep trauma from our pelvic floor, that asking about defecation disorders was part of my professional responsibility, and that OT and PT should be included on every floor of the hospital, including labor and delivery.

With others we believe we have a shared purpose, values, or beliefs—check! Like a family reunion from my youth, we all had the same shirt on. And that this brings about hope, energy, and a sensation of sacredness—double check!

Check! I belonged, we belonged . . . I danced down an aisle of bubbles. So, with that memory, and the call to action provided by Turkle to “turn away from our screens and reclaim conversation, focusing on the people and places in front of us,” I traveled across the country to capture as much occupational therapy collective effervescence as I could find, focusing on those places where our strategic priorities were happening every day.

Step 1, Turkle talks about developing the capacity of empathy. Come with me to meet Quiara Smith, owner of Aloha Integrative Therapy in Santa Rosa, California, a pediatric pelvic floor occupational therapist and entrepreneur. A visionary whose practice represents a perfect union of evidence-based knowledge and personalized, client-centered care.

This is Quiara with a 6-year-old client with constipation and bowel leakage that was causing him immense anxiety, disrupting not only his daily life, but also hindering the family’s ability to participate in community activities. When his mother was discussing previous encounters with other health care professionals, she said options were limited and compassion seemed scarce. She was frustrated but often felt that she just “had to accept it,” that her son would just “have to accept it.”

Until she had a conversation with Quiara and within 30 minutes gained invaluable insights into her child’s body and felt hope.

Quiara’s holistic approach transformed her client’s perspective on working on his “potty struggles.” Instead of dreading his OT appointments, he eagerly anticipated his sessions. His newfound enthusiasm extended beyond the clinic, as he began feeling comfortable to attend birthday parties and trips to the library, empowered by his progress and newfound sense of agency.

His mother shared with me the impact of OT, tearfully saying that their work with Quiara went beyond intervention—it was life-changing. Through Quiara’s unwavering support and innovative approach, her son not only experienced success with toileting, but also regained his confidence and joy in everyday activities. And while his mother shared all of this with me, and I watched Quiara treat, I learned about the impact of empathy on the life of a family, and I saw interventions that were familiar in my own practice. Turkle’s words echoed: “Search for the commonalities in those who are different.” My pediatric occupational therapy was different from Quiara’s, but it was also the same. My families needed empathy, and so did her families. And there it was—collective effervescence.

As I traveled to Sacramento, California, to observe the work of Carlin Reaume in her practice, Supported Mama, I wondered how collective effervescence would show up on this visit. In another article (Rimé & Páez, 2023), they state that, “the capacity of individuals to deal with existence rests on collective representations,” but “given that daily life is spent in relative isolation, people’s collective resources erode progressively.” As I met Carlin’s first client, a woman with two young children and a day-to-day routine that I understood at a visceral level, I witnessed the profound impact of applying empathy expertly as it moved this woman from a space of relative isolation to an experience of collective representation.

She says, “I feed everybody, I bathe everybody . . . I have a supportive partner, but his work is not that flexible, so he leaves.” You can almost see her isolation. She then says, “It is a lot. But I don’t know where I can cut or what I can cut. So what gets cut is me walking around with legs that might fail for 2 years or for years having prolapse and not being able to fix it.” As she makes this last statement, she reaches out to Carlin, the very person who walked with her on her journey of healing those deficits she just named. Then we watch her exhale, her shoulders relax, she smiles and says, “Yeah.” With what seemed like a simple question, “I want to start by checking in with you, will you share with me how things have been going,” Carlin cultivated empathy with her client, she forged a collective experience. And this is what I think those authors were referring to when they said, “When they partake in the societal ensemble and share these representations, individuals face the world with confidence and vital energy” (Rimé & Páez, 2023).

Carlin empowered her client to face the world with confidence and vital energy. YOU empower YOUR clients to face the world with confidence and vital energy. Different, but the same, right?

As I traveled with Carlin throughout her day, from Supported Mama to the University of the Pacific OTD Program to the Jacquelyn, a club meticulously crafted to foster community, creativity, and wellness, I learned about the intricate experiences of mothers and the consequences of neglecting their health concerns. I met some of the most innovative and humble OT faculty and their extraordinary OTD students, and I shared my ideal design of health care and wellness in a space embracing prevention, primary care, and validation in a social setting versus the traditional medical office.

And as we shared our exhaustion, and our excitement, our experiences of burnout and frustration, I experienced a revitalization of energy and confidence.

Again, I encountered that collective effervescence.

Maintaining my commitment to an evidence-based, data-driven practice of occupational therapy, I had to see if this could be supported in other areas. So I boarded a plane in San Francisco and headed to Gulf Port, Mississippi, where I hopped into a car and drove to Irvington, Alabama, to meet Lisa Parnell and her impressive group of occupational therapy practitioners at My Life Occupational Therapy Services. Lisa is an inspirational entrepreneur much like Quiara and Carlin, but her practice area seemed very distinct from their emphasis on pelvic health and my focus on outpatient pediatrics. She and her dynamic partner-in-OT, Katie Plosczynski, have integrated lymphedema treatment, lymphatic drainage, and scar release therapy into an occupational therapy approach that is centered around health, happiness, and overall wellness.

Mr. Bob’s story revealed another aspect of the empathy cultivated through occupational therapy. As I share this story with you all, I have relied on Lisa’s sister’s reel for some of the details. Mr. Bob is 93 years old and his wife, Mary, is 78. Mary loves to dance, and Mr. Bob has been her biggest fan, sitting and smiling throughout her dance floor performances. Mr. Bob has been experiencing functional decline for several years, preventing him from joining his wife in this occupation they had enjoyed throughout most of their marriage. Lisa, understanding the body and the importance of occupation in wellness, applied her unique application of lymphatic drainage and body mechanics to enable Mr. Bob to dance with his wife on New Year’s Eve. That night Mr. Bob forgot he relied on his walker for mobility; he forgot he was 93 years old. Mary smiled throughout the entire song like a bride on her wedding day. The entire restaurant stood up and clapped at the conclusion of the dance, and the room erupted with laughter and expressions of joy.

Pizarro et al. (2022) cite self-transcendent emotions as one of the elements that transforms an ordinary experience into an extraordinary experience, or collective effervescence. The authors describe the relevance of empathy developed through self-transcendent emotions in this way: “[P]eople perceive that they share emotions with others, which reinforces their collective identity and empathy with group members, and attention is thus directed outwards” (Pizarro et al., 2022).

Were you smiling at Mr. Bob’s victory? Did you recall a client that has their own “dancing again” story? Have you attended a session here at INSPIRE that evoked admiration, pride, or gratitude in the work a peer was presenting?

Ok, so now I had some evidence to support that collective effervescence is replicated in occupational therapy practice outside of California, but I wanted more. More of what? More evidence or more experiences of collective effervescence in occupational therapy? That was a question I couldn’t answer.

I did still have three more elements of collective effervescence that I hadn’t even brought into my reflections. In the research article, “Feeling Heard: Operationalizing a Key Concept for Social Relations,” Roos, Postmes, and Koudenburg (2023) integrated concepts found throughout various disciplines to define this ambiguous concept. The authors concluded that feeling heard was constructed of five elements within two levels. The interpersonal level includes my voice, your attention, empathy, and respect.

At the collective level, feeling heard requires that we have common ground.

This time I jumped in my car and traveled to the East Coast to meet Dr. Kathryn Ellis, a humble, yet influential, change agent committed to transforming sexual health and intimacy from a taboo topic to accessible resources for a holistic experience of wellness.

Dr. Ellis was recently interviewed by NPR to discuss her contributions to ReSex, a project initiated by the Veterans Hub in Kyiv to address questions surrounding sex and intimacy postcombat injuries.

ReSex uses Dr. Ellis’s book, Sex and Intimacy for Wounded Veterans, for most of the material included in the manuals (Ellis & Dennison, 2015). Although Dr. Ellis has many products that speak to her ability to see people, it is actually the time I spent with her that I experienced being heard, being understood, and often without even saying a word.

Sitting in Dr. Ellis’s office, we began to speak of her work. She shared a story from her tenure at Walter Reed, the inciting incident that motivated her to develop the WRNMMC Occupational Therapy Sexuality and Intimacy Clinic. Wounded soldiers returning from combat often have not had a shower for months, sometimes a full year. The “first shower” becomes a celebratory event at Walter Reed, and as a basic ADL, this shower often includes occupational therapy in the performance. It was finally the turn of a soldier who had recently experienced the amputation of three of his limbs. As his occupational therapist and his wife entered the bathroom to begin the event, his wife playfully pulled off her shirt and said, “well, this is not the place for a wet t-shirt contest,” as she smiled at her husband. The OT in the session was stunned, and feeling as though she was invading a space she didn’t belong, transformed playful to clinical and rushed back to her peers to share her uncomfortable encounter.

Dr. Ellis understood and heard three people that day, and hundreds, or really thousands, of people throughout her next 10+ years of work. She understood the wounded soldier who felt the way Trystan, from the NPR article, a wounded Ukraine soldier, felt.

He shared, “[I]t was kind of problem to find a sexual partner, because people say, ‘You’re handicapped, no, it’s not going to work.’” For the soldier at Walter Reed, this fear of rejection was elevated by the potential refusal coming from his wife.

Dr. Ellis heard his wife, a woman longing to find intimacy with a husband she had missed for months and almost lost in a terrible assault to his body in combat, and again during the surgeries that saved his life. This woman was grieving, and grateful, and scared of causing greater injury to her husband, and confused about this new sense of desire paired with an old understanding of body image, and lonely.

Dr. Ellis saw the distressed occupational therapy practitioner that day while simultaneously seeing me over 12 years later, sitting in a chair in her office, desperate to learn how to be the therapist that has the confidence and competence to respond differently. And desperate to be the teacher who leads her students to be a new generation of occupational therapy practitioners who are prepared and ready to walk with that soldier and his wife to understand practical strategies for participation in a meaningful ADL and use sexual healing to bring about physical and mental recovery from the many traumas of war.

As I thought about Dr. Ellis’s work, I began to explore what it was about her approach to hearing and understanding people that made her, like so many occupational therapy professionals, able to do this in the most intimate and stigmatized spaces of human experience. This is when I discovered another element secretly stored in our OT toolboxes: curiosity.

And all of this was on my mind as I journeyed back to the other side of the country to Casper, Wyoming, where I met some of the most bold and insightful OTD students from the University of Nebraska, Casper, satellite—thank you, Angela, for a dinner of collective effervescence and my favorite sweatshirt—as well as some very curious occupational therapy professionals.

One of those perfectly curious occupational therapy practitioners was Karol Santistevan, an empathetic entrepreneur, a certified Special Olympics Equestrian Coach, former rodeo employee, and owner of Ropes and Roses Therapy Services. While I was touring her clinic, or really this beautiful acreage in Wyoming, Karol shared her work, some of the most meaningful occupation-centric programming delivered directly to meet the needs of her community. From equine-assisted therapy PTSD groups for women and men, to programming focused on navigating the experiences of grief, to empowering OTD students to develop and implement a 12-week program to support foster children who have experienced trauma, Karol exemplifies the brilliance of what occupational therapy can look like when influenced through the lens of curiosity.

I began to remember the first time I heard my community. The work is hard. Do you ever reflect on you, your curiosity? Do you feel heard? Understood? In your work? In your OT ambitions? In your day-to-day? Many of you have heard me speak of Rakhi Srivastava, owner of Queen City Pelvic Health and Wellness, innovative entrepreneur, visionary occupational therapist, courageous advocate, tired momma of a toddler, and now one of my most thoughtful friends. Rakhi, while exhausted from an infant with difficult sleep patterns, was on Instagram at an “off-peak” hour and posted a comment, one that was filled with empathy and advocacy . . . and curiosity . . . about AOTA’s role in defining and defending the scope of OT practice.

I spent a day with Rakhi, visiting her practice locations in Cincinnati, Ohio, and Fort Thomas, Kentucky. I learned about the challenges experienced by OT practitioners and OT entrepreneurs when spanning state borders, resulting in a practice that should be the “same,” but is regulated so differently. I heard about the direct, client-specific consequences and barriers to access resulting from regulations, like not having the ability to opt out of Medicare as a provider. I observed how wellness can reach elevated outcomes when occupational therapy and physical therapy push aside discussions of scope creep and fears of not belonging and instead focus on expanding access through shared intervention frameworks. And I heard that word again: hope.

As I listened to her experiences, I heard my curiosity.

I learned the outcome of their curiosity. That curiosity that we have is joy and hope. That you are the reason someone feels joy in being heard, being understood and now, today, has hope. Now at this point I became aware that I still had two more elements of collective effervescence to explore, and not much time. I mean that literally, right now, I realize I still have two more elements to share with you all, and I do not have much time left!

And we are finally at a familiar “place”—yes, pun absolutely intended. Returning to my text on collective effervescence, I wanted to see what Klinenberg had to say about creating an environment to facilitate success before looking to see if it was reflected in how we understand environment. As Klinenberg began to analyze various physical factors existing in housing projects in St. Louis, he introduced his readers to C. Ray Jeffery, the criminologist who wrote Crime Prevention Through Environmental Design, who said, “There are no criminals, only environmental circumstances which result in criminal behavior. Given the proper environmental structure, anyone will be a criminal or a noncriminal” (Jeffery, 1977). And this took me to Seattle, Washington, for the Northwest Flower and Garden Show to hear a presentation delivered by Drs. Amy Wagenfeld and Shannon Marder.

It was estimated that 55,000–60,000 guests attended the 2024 Northwest Flower and Garden Show, the second largest horticulture and garden exhibition in the country. Experts throughout the United States, Canada, and the U.K. submit to present at the show, resulting in the very difficult job of reducing thousands of submissions to just 115 presentations. Drs. Wagenfeld and Marder were one of the 115 submissions selected to present this year, an opportunity to showcase their outstanding work in nature-based occupational therapy with about 54,998 of their closest horticulture enthusiast peers. And of those 54,998 horticulture enthusiast peers, about seven of us knew what occupational therapy was (mostly because we were occupational therapy professionals) before their lecture, but everyone left in love with the profession they never even knew they needed.

Talk about a nationwide “What is OT” campaign!

It was during this presentation that Amy opened with sharing her own nature-based healing story.

I want to share her story with you all now. In 2001, Amy was writing her doctoral dissertation, editing her first occupational therapy textbook, teaching a course, and maintaining a pediatric practice. I know some of you are feeling the empathy and the feeling understood elements from earlier. While she and her son were sitting in the kitchen, each working on their own homework assignment for the evening, something flipped Amy into a state of frustration.

Using her own words, she spiralled into an expression of “profanity and complaints,” which was very out of character for her. She was an “out-of-control” mother—again, her words, not mine—when her son suggested, “Mom, why don’t you go out in your garden for a while.” And so she did, and in that moment she felt the cool breeze on her face, smelled the calming lavender scent, and heard the birds calling to one another in the distance, and she returned to the centered, kind, and patient mother her son recognized.

And while I was listening to her presentation, I heard C. Ray Jeffery say, “There are no out-of-control moms, only environmental circumstances which result in out-of-control behavior.”

In their presentation, Amy and Shannon shared details about the P.R.O.D.U.C.E. program, developed by an occupational therapy colleague, Lauren Telesmanic, and about adapting indoor environments to bring nature in if you cannot be outdoors and how to build programs in unmodifiable public sites. Each story capturing the distinct value of occupational therapy’s unique application of environmental design to accomplish life-changing outcomes. Each story detailing effective protocols to bring these programs into my own practice, today. Each story fully recounted in their new text, Nature-Based Allied Health Practice (Wagenfeld & Marder, 2023).

And there it was again, collective effervescence. So I purchased some plants and their book.

My next stop was in Colorado to visit the STAR Institute. This was an environment that I knew more about, an environment that I try to replicate in my own private practice in Pennsylvania. I wanted to know: Would sensory environments look like Mr. Jeffery’s environmental circumstances? The STAR Institute, now under the direction of Dr. Virginia Speilmann, is a world leader in research, education, and therapy for differences in sensory processing. They articulate the sensory experience as an integration of environmental factors and personal factors to provide a pointed example of context. Just listen: “Our bodies and brains use specialized systems to register all the different sensory information in our environment and piece it together to build a complete picture of what is going on around us, with our bodies, within our bodies, where we are, and what time of day it is. Sensory processing shapes our experiences in the world and impacts our feelings.”

As Dr. Speilmann took me on a tour of the STAR Institute, we discussed children who were labelled “flight risks,” “aggressive,” “classroom distractions,” and a “bad kid” and how their parents and caregivers were forced to find new schools for their “troubled” children. We also shared that overwhelming sense of joy when these children were given the environment to be their authentic selves. “Sacred sensation,” perhaps?

Did you hear it too? “There are no bad kids, only environmental circumstances which result in misbehavior.”

As I was leaving, Dr. Speilmann, an outstanding and impressive contributor to occupational therapy herself, shared her doctoral work in professional reflection with me. And there it was, the final element to collective effervescence: advanced self-reflection.

There was only one place I could accomplish that. So I went home to Capable Kids in Hermitage, Pennsylvania.

I began this reflection listening to one of my favorite podcasts, OT Potential with Sarah Lyon. Sarah Lyon shares, “Health care practitioners are not at risk for being replaced by AI, they are at risk for being replaced with other health care practitioners who are using AI.”

Could collective effervescence be in the technology space too? The outstanding clinicians at Capable Kids—shoutout to the best, Alyssa, Megan, Jo, and Morgan!—we immediately got to work advancing my individual professional self-reflection to a shared group reflection. We identified the barriers, the pain points, the issues we were facing day after day in our clinic.

Do any of these sound familiar?

▪ overwhelming caseloads, with back-to-back treatments scheduled every day

▪ 6, 9, 12+ month waitlists

▪ increasing insurance denials

▪ increasing documentation demands

▪ decreasing opportunities to individualize and personalize care

▪ major and regular interruptions to continuity of care and little home and community carryover

▪ exhaustion

▪ burnout

As we started exploring the literature, we found that the clinical applications of AI in the delivery of health care are endless. We could use it to inform our clinical reasoning, create more informed decisions, and improve and progress client care.

But we need the right AI, the best AI. We are, after all, occupational therapy practitioners. And then we were introduced to an AI app that has revolutionized how we provide care to our clients while simultaneously revitalizing our energy.

Koro has pioneered an approach that’s groundbreaking to optimize child development outcomes while elevating occupational therapy to primary care. So when Capable Kids was offered an opportunity to team up and conduct research in which we were investigating the impact of occupational therapy with Koro on children in Maine, the findings revealed the transformative effects of employing this OT AI approach in children’s development.

Listen to one story, a seven-year-old girl coming to Capable Kids and experiencing a journey with OT and Koro. We observed she had advanced to more difficult levels, but that her score would decrease. Initially. However, this setback didn’t deter her determination and she persisted in practicing, eventually achieving improvement once more.

This reoccurring pattern suggests an inherent strength in her ability to tackle new challenges. This insight was particularly significant.

For a child with autism, it’s generally said to have difficulties with adjusting to changes and handling frustration. It appears that Koro, along with her occupational therapist, provided her with the ideal level of challenge, enabling her to navigate through increasingly difficult paths. Moreover, discovering her resilience and adaptability sheds light on her potential to overcome obstacles and achieve success in her daily endeavors and future challenges.

As we shared these new discoveries, I knew for a fact that occupational therapy is collective effervescence.

So what now? How do we use collective effervescence to move occupational therapy forward?

First, we must be intentional about reflection, with curiosity, on our own occupational therapy journey.

Next, with compassion, we look for the commonalities among our occupational therapy community and seek out places of learning and places of teaching, resisting polarization, the division, the competition, and instead build our collective power.

And finally, with courage, we must share the collective effervescence that exists within occupational therapy with everyone, including ourselves, especially ourselves.

I have a challenge for each of you and one more thing to share. My challenge? Go be collective effervescence on purpose. We are at the “gathering” that Emil Durkheim described over 100 years ago.

Find someone you haven’t spoken to before, someone you don’t know, and begin a conversation based on the shared excitement of INSPIRE—maybe someone you heard me speak of today—you can find them here or in the exhibit hall at the conclusion of this address. Ask them questions, explore their “sensation of sacredness” for yourself. Bring some of that home in a way that you can immediately and concretely integrate into your classrooms, treatment sessions, occupational therapy practice. And build your professional resilience, restore your vital energy in the space created for just that purpose.

Finally, when you go home share collective effervescence with someone who was unable to attend and post your experience, remembering to tag AOTA, so we can spread the feeling of energy and harmony in the shared “sacred belief” of occupational therapy.

If you are a member of my family, please stand if you are able.

Thank you for replenishing my vital energy.

If you are a member of my Pitt OT family, please stand if you are able, or shine a light from your phone.

Thank you for replenishing my vital energy.

If you are Becky Austill-Clausen, please stand if you are able.

You are harmony, thank you for replenishing my vital energy.

If you are AOTA staff, Charles Jeffers, and Katie Jordan, please stand if you are able or shine a light from your phone.

Thank you for replenishing my vital energy.

If you are currently, or have ever served as, an AOTA volunteer, please stand if you are able or shine a light from your phone.

Thank you for replenishing my vital energy.

If you have ever practiced and/or studied occupational therapy or attended an AOTA event, please stand if you are able or shine a light from your phone.

Thank you for replenishing my vital energy.

And this, friends, is the power of united collective effervescence. Let’s go light up the rest of the world. Thank you.