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Episode 735: Trauma-Informed Occupational Therapy with Alyson Stover · The Trauma Therapist

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Or welcome back to the Trauma Therapist Podcast. My name is Gaming Person.
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My mission is to help trauma therapist be their incredible cells, to be human,
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to be real, not just a clinician. I'm a big believer in
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who we are is more important than what we know, and this requires cultivating
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authenticity, genuineness, and vulnerability, and that requires intention. Can learn more
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about my courses and workshops by going to the Trauma Therapist project dot com.
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That's the Trauma Therapist Project dot com. Let's get started, all right,
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So five four, three, two and one, our folks, welcome back
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to the podcast. I'm very excited to have us. My guest today Alison
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Stover. Alison, welcome, thank you, I'm happy to be here.
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Awesome. So. Alison is an associate professor in the Department of Occupational Therapy
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at the University of Pittsburgh. She earned her jurors doctorate in Law with a
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postgraduate certificate in Health Law from UFP. Her day to day client practices focus
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on using occupation, self advocacy, and role defining to create a path to
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healing for individuals who've experienced intimate partner violence, sexual trauma, and PTSD.
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A survivor of trauma herself. Her focused areas of practice expertise include trauma informed
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occupational therapy, analyistic approaches to substance use disorder, and she is an AOTA
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Association of Occupational Therapy of America the American Occupational Therapy Board certified in pediatrics.
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Awesome, Alison, Welcome to the podcast. Thanks. So you are like
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certified and degreed up the Yang Yang but with a very specific focus, yes,
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which is really interesting. So we'll get to that, but before we
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do, share with the listeners where you're from originally and where you are currently.
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Yes. So I'm originally from Pittsburgh, Pennsylvania, and I spent a
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number of years in my youth traveling around to see where home should be,
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which ended up being back near Pittsburgh, Pennsylvania. So I'm now just north
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west northwest of Pittsburgh in Mercer County. So we are a rural county in
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between Pittsburgh, PA and Cleveland, Ohio. Nice Ridley from the East Coast.
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Fridley from New York and spent a lot of time in Philadelphia, Oh
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yeah, and so forth, so very accustomed to that. So let's get
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into this here. How did all this start for you. So, when
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I was young, I grew up in a very large and very connected family,
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much like Pittsburgh families usually are. So cousins were more like siblings.
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Aunts were more like other mothers, uncles more like other fathers. And when
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I was about eleven years old, my cousin, who was almost five at
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the time it was like a little sister to me, had experienced the traumatic
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brain injury kept her in the hospital for over two months. She went in
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your typical runaround, play around, have fun, almost five year old,
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and by the time she left, we were told that she likely would never
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walk again talk again, that most of her sensory systems would be impacted so
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she wouldn't see here or speak. Robin did an amazing amount of work over
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her lifetime. She's still she's now in her mid thirties, but she um,
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she does talk, she does walk, she does. What happened she
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had had experienced essentially an error with medication and put her into a coma,
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and the coma lasted for over forty eight hours, and in that time her
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brain just sort of started to shut down. So that's how she got the
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TBI. Yep, that's how she got the tcase, not from a fall
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or a crash, but what wow, no, so she had she was
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having what we thought was just um like maybe a really proglonged experience of a
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cold, and when we went in, it was really that her kidneys were
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shutting down and she had a kidney disease. And during the biopsies and some
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of the testing for kidney disease, she experienced this adverse of reaction to some
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of the drugs that they had to use and put her into a coma.
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So so I was very much a part of Robin's healing journey. She was
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very much a part of my life journey, And so I got to watch
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as she participated in all types of rehabilitation, and I fellow love with occupational
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therapy. But it wasn't just occupational therapy that I loved. I loved that
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there were people in the world that gave my cousin and my aunt and my
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uncle a voice when it felt like no one else was listening to them.
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I felt like I really appreciated that my cousins, her siblings were experiencing life
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differently than I was, growing up in a household that was so overwhelmed with
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doctor appointments and medical emergencies and unpredictableness. That I knew I wanted to practice
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occupational therapy, but I knew I needed to do it in a way that
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really was holistic, not just for each client that I encountered, but that
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allowed me to be holistic for the environment in which every individual lived, recognizing
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and representing that it's never just the client experience had seen the disease, the
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disability, the illness, the trauma, but really everybody that is connected to
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and loving with that individual. And so how old were you at this time
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when you recognize this? So I was about I was ten eleven when Robin
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got sick, and I was about fifteen years old when I decided I really
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needed to pursue this career moving forward. And so I was I was pretty
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young and had determined that this was what I was going to do. I
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was going to be all of the good people that brought success to Robin and
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her family, but I was going to be all of the good people in
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one practitioner. Hence your incredible bio. That's so freaking inspiring. So wow,
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First of all, so sorry to hear about your cousin. I mean
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there's no other words. It's tragic. So you're fifteen at this time,
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how did things unfold for you? So I then became one of Robin's primary
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respite care providers. So I would spend a week at a time with her,
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alleviating some of the responsibilities of my aunt and uncle so they could take
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a vacation, they could get some respit, as well as some of her
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siblings. And that became sort of my work journey at that point. I
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participated in a lot of the camps that she was a member of. I
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would volunteer help out, I would go on vacations with her so that she
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sort of had that one on one with her at all time. And I
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started to explore what occupational therapy training looked like. So I entered the University
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of Pittsburgh as an undergraduate, and I got a bachelor's in rehabilitation science,
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really learning all of the very medical components of healing wellness, ernie rehabilitation.
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And then I went immediately on to getting my master's inn Occupational therapy and and
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became an occupational therapist in which I practiced primarily in pediatrics. So I lived
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in California for a little bit. I lived in Charlotte, North Carolina for
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a while before returning back home to Pittsburgh. And while I was in Charlotte,
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North Carolina, that's where I was really introduced to the idea that Robin
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was not unique in her experience, her home, was not unique in their
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experience, that there's often more than just a developmental disability or an illness or
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an injury that's occurring in a child's life that is preventing them from really being
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able to experience wellness to their full capacity. And so I started to really
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investigate what were the things that were really large barriers to the children that I
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was working with and their ability to experience that that wellness, that they could
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do what they wanted when they wanted. And so I discovered that I had,
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at that point over fifty percent of my caseload was not living with a
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biological parent, and meaning that they were either in foster care or living with
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a kindred caregiver. So I recognized that there was a disconnect or a separation
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from from biological parents that was having an impact. And then I started to
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recognize that as I went through a variety of their medical history, people were
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very honest, and the recognition of the number of children who had who had
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parents or caregivers who were experiencing substance misuse to some capacity was actually greater than
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fifty percent. I knew that a number of the children I was working with
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had experienced poverty, and I recognized that there were a variety of things that
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were happening in the home that were very adverse to their experiences. And so
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this is where I started to discover that I needed to really become that advocate.
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I needed to recognize that I could provide services, resources healing that went
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beyond my traditional occupational therapy skills. So, for instance, maybe there was
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a child that could receive more services or better healthcare if it was affordable,
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and so I would help to connect them with maybe a Medicaid product in getting
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them signed up and registered for that, perhaps their family didn't know that they
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were eligible for another resource benefit, or that there was a church that had
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an incredible program that provided respite for parents for free. I knew how to
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investigate my community because Robin taught me that right. I knew what a person
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needed because I and my family had experienced those very same needs, and so
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I just used the way we investigated our community when we were raising Robin and
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started to investigate my community for the children and the families that I was working
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with. It was during this time that I started to encounter so many knows
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that I just wasn't expecting, Like this child could really benefit from additional support
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in the school system, and I thought they should be eligible for an individualized
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education plan, but then we would be told no, and that so suddenly
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the advocate in me felt very much like, wait a minute, but I
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know how to assess the child and what the child needs. I know what
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to assess the environment and what's missing. And oh and I looked at the
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community and I know what resources are available. What do you mean now?
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And that's what really propelled me to go to law school. Let me pause
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you for a second. Where's your cape? Come on, You're I'm like
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listening to you and I'm thinking, oh my god, Alison, I mean,
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you're so amazing and inspiring. It's crazy. Now you talked about you
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discovered that through these other elements that existed in a lot of the clients you
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were working with. Now are you saying that these elements were already existing within
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their lives prior to the situation that caused them to be debilitated, or is
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there a kind of a cause and effect or correlation or what. Sometimes that
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were existing before, sometimes that existed as a consequence of Sometimes it just both
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started to happen sort of simultaneously. There was no I can't tell you what
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happened first or what came next. What I can tell you is that that
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when a child would come to see me, they might be referred for something
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that people recognize occupational therapy for, like they have trouble tying their shoes or
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buttoning their clothes or writing their name. But then as I would start to
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work with that child to form a rapport and a relationship with them, I
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would hear about things like, um, I had a child whose father was
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incarcerated for murdering his mother, and he was five, and so he talked
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a lot about missing mom and about missing dad and about not being allowed to
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even visit dad. And I realized, like, no, he couldn't couldn't
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write his name, and he was having trouble buying his shoes. And we
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would certainly work on those motor skills, but there was likely some other elements
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of his life that were influencing that developmental delay, and that that was largely
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connected to some of the trauma that he was experiencing in his environment around him.
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Or the idea that there were times that children I would see children because
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they didn't they had very restrictive diet, they weren't eating very many foods.
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They had never had a fruit or a vegetable. And then when I would
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start to work with them, I would come to realize, sorry, that's
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my dog. I would come to realize that it's not that they didn't like
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with the fruit or the vegetable, but rather that they had never been in
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a home where fruits and vegetables were available to them. Or let's just pause
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here for second to think. Our sponsors, all right, we are back.
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Let me ask you something, Um, can you give our listeners a
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brief kind of thumbnail of what occupational therapy is? Sure, so that's that's
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one of my favorite thank you to put on one number. Sure, she's
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checking her dogs for those huskies. Those are tamaskins. So they are husky,
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German shepherd, malam mute and wolf dog. Wow. Yeah, they're
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definitely an interesting group, but so occupational therapy. What we really work for
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is we define occupations differently than most people. So occupations are anything you need
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to do, you want to do, or you're expected to do. And
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we recognize that at least fifty percent of your life, really fifty one percent
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of your life has to be filled doing occupations that are meaningful, purposeful,
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and psychologically rewarding to you. So I often say, like, I need
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to do laundry, but I hate doing laundry, and so doing laundry once
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a week for my home, I can still experience wellness. But if I
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worked at a laundry mat and I had to do laundry ten hours a day,
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five days a week, I probably wouldn't be experiencing wellness because even though
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I could do it, it wasn't rewarding or meaningful or purposeful to me.
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So occupational therapy really evaluates the person and says, hey, what is it
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that you need to do, you want to do, you're expected to do,
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and by the way, is that meaningful and purposeful to you? And
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then if you're not doing those things, what can we change? Can we
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change the way you do it so that you can be more into pendent with
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it? Maybe we just need to change the environment and how things are set
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up around you so that you can do it. Or maybe we can strengthen
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an actual skill within you so that you can do it, or maybe we
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do a little bit of all three. But our goal is to get every
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person doing because most healthcare practitioners believe that you must be well or get well
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in order to do where occupational therapy believes you must do in order to get
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well and be able to do in order to get well. I worked with
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occupational therapists when I was in my first position at a graduate school. We
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were working in a facility where we were assessing and treating young kids who are
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showing early signs of psychosis. Was part of a team, and one of
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those members was We had a few occupational therapists, and I really became to
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understand and appreciate the incredible work they do. So, um, I have
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a lot of appreciation for what you do in the role you play there.
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UM. So you were talking about along the way you were discovering in your
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path, Well, okay, what about this element? So let me focus
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on this and this element, let me focus on this, And I think
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you were right about to get into the topical subject of law. So yeah,
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continue, so I um, so I started to get too many notes.
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Um, so I could assess the need. Um, I could find
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the resource, but then when I asked to apply the resource to the need,
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I'd be told no. And so um. I wish there was a
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more um exciting story. But I was actually on vacation with a friend at
18:59
the beach and she had just graduated from law school and we were playing games,
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enjoying the beach, and I was complaining about this, and she said,
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well, if you think you know the pathway, so well, why
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don't you just go to law school and be the person who gets to say
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yeah? And I thought, okay, so, probably not the best way
19:22
to decide to go to law school. But two weeks later I sat down
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for the ELSATS and within six months I was admitted to in going to law
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school. Oh my god, Okay it was in law school that so I
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moved from North Carolina back to Pittsburgh to go to the University of Pittsburgh.
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I say, it's more than my alma mater. I think I bleed blue
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and gold. And I moved back home with my parents. At the time,
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I was married and and my husband had decided that while I was in
20:03
law school and um, and I was also working for Children's Hospital of Pittsburgh
20:08
as an occupational therapist, UM, that that maybe he needed a little more
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in his life. So he asked if we could have a baby. So
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I got pregnant, and about five months into um the pregnancy, my husband
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at the time told me that his girlfriend was not happy that we were having
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a baby. Um. Yeah, So I said, the good news was
20:33
is um he could just go be with his girlfriend. UM. So it
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was then and my career. So he said, you didn't know did you
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know about this girlfriend? Okay? Now, okay, So I had no
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idea. I was going to law school full time, I was working twenty
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five hours a week for Children's Hospital as an occupational therapist. UM, and
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you know, just and and being pregnant and trying to study and so so
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I separated from my husband at that time and have my baby by my well,
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I don't ever say I have my baby by myself. Had my baby
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with my mom, my dad, my brother, my cousin's. That huge
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family that I talked about was all around us. And so after that first
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year of law school, I spent working figuring out how to understand the law,
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and had a baby, and then from there I was able to really
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start to specialize in certain areas of the law and recognizing that I didn't like
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writing legislation. So I didn't want to write legislation, but I did like
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articulating what legislation could look like in the lives of real people. And so
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I started to work at the Health Law Clinic, which was a free clinic
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offered by the University of Pittsburgh to individuals who were getting the knows that my
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clients were getting when I was an occupiedational therapists, and so I was able
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to help people obtain Social Security, disability income and benefits, to obtain i
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EPs for children in the school systems, and be able to either design ways
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that maybe guardianship wasn't exactly the best mechanism, and could we do something like
22:22
power of attorney that still allowed some level of independence and choice in the in
22:26
the person versus just sort of stripping people away from from all of that by
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moving them into a restrictive guardianship relationship. And so um I did that for
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three years through law school, graduated, met my husband now who is my
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forever husband, I say, we got married and he lives in Mercer County,
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and so we moved. I moved to Mercer County, and that's where
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I really started to see that I had had the benefit of living in well
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resourced city before. So although I was frustrated that I could not connect resources
23:11
to people easily and that I often, got to know that at least there
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were resources that existed. I was in Pittsburgh, I was in Charlotte,
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I was just north of Los Angeles, so these were these were places where
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there was an abundance of resources. I came to Mercer County, where,
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you know, you're an hour and a half from a city, which is
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a really long way to go for simple resources like, um, you know,
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if there's a shelter to get sleep that night, or if there's a
23:45
program that can offer food. So that's when my husband and I decided that,
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well, if I knew how to connect people and resources, then we
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should probably know how to be the resources too. So we opened our private
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pediatric practice in Mercer County and started to provide resources. We offer occupational therapy,
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physical therapy, speech therapy, advocacy services, and then we provide a
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variety of community programming. So where there's a need we try to fill.
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Okay, you know, listening to you talk, Alison, it's not just
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incredible, but I mean to say that not a lot of people do what
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you do is an under you know, it's just as obvious. You know,
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you talked about your family, your large family. You're an intense bond.
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But obviously something has been driving you all along, you know, talk
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about that. So occupational therapy. Um, you know, we take a
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look at all the things that motivate people, and and values and beliefs are
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something that we integrate into our sessions often. I've always been raised with a
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really strong faith. Um. So I've uh. I was raised by parents
25:14
who introduced me to a faith that said, um, that that God lives
25:18
in every person, and that your job is to be the kindness and the
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goodness and the love that is purely in God to everybody you encounter. Um.
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So there's there's a very well known Bible verse about um. You know,
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but Lord, when did we see you hungry and feed you? And
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when did we see you cold? And clothe you and hurt? And He
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said, at any time you have seen or done to the least of these
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you have done for me. And that's sort of what's always driven me is
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that I've actually been given This is a gift to be able to have skills
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um that I can give to these people that that that, and they are
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hungry, they know they can come to me and I can help get the
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food. So I've always been driven by this idea that it's God living in
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me, and that's it's a gift that I am so privileged and honored to
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share. No, so right now, what's the name of your your organization
26:23
or your facility. So our outpatient pediatric practice is called Capable Kids, and
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this is where we have a We sort of had two goals with Capable Kids.
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One was that we knew that the children of our community needed access to
26:42
specialized resources that could recognize not just developmental delays or disabilities associated with childhood,
26:51
but also then needed to understand what that looks like in the context the very
26:56
complex home and community environments. It's not it's not the same thing. I
27:02
can do a feeding treatment in one place, but I can't ask that a
27:07
family that you know has thirty seven dollars every other week to spend on food
27:14
to spend fifteen of that on fruits and vegetables that a child isn't going to
27:18
even eat, right. So so it was understanding not just the disabling or
27:25
disability condition of the child, but how do that I meet that child's needs
27:30
and the complex environment in which they are the Other part of that was we
27:36
have a great community, but we didn't have these really the jobs that we
27:44
had were not ones that really helped to build careers. There weren't like career
27:48
ladder jobs. And so we had incredible people who lived here and they went
27:52
away and they gained these skills and in social work and occupational therapy and physical
27:59
therapy, but there was nowhere to come home and let your community benefit from
28:06
what you've learned. And so we wanted to be a place that you came
28:08
to with the recognition that you were going to be supported in professional development,
28:15
that we were going to build professional ladders for you, opportunities for you to
28:18
engage and state and national leadership, do some education as far as being able
28:26
to continue on and an instructor or an adjunct professor kind of role. So
28:33
that's what we established and capable kids with this place that understood the needs of
28:40
children in complex environments, but also understood the needs of people in the community
28:45
and how they wanted to build and grow in their careers. From there,
28:48
we recognize that we still felt barriers, right, So we were Capable Kids.
28:53
We treated children birth to twenty one years old. But when you found
28:59
that that child that you're working with has a parent or a caregiver or a
29:03
sibling or a grandparent that's taking care of them and also could really benefit from
29:10
the use of things like sensory integration or routine development or role development, but
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they were over twenty one, what did we do? So we developed Capable
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Families, which is a nonprofit and the nonprofit designs and develops occupation based community
29:30
programming. So we run a program for individuals who've experienced sexual trauma where we
29:38
were able to collaborate sexual trauma therapists with occupational therapy practitioners and do a very
29:48
collaborative twelve week program for healing and wellness. We were able to collaborate with
29:53
an intensive outpatient opioid youth program and we a chronic pain and opioid recovery program
30:03
together with them. So we just now use Capable Families as our our mechanism
30:08
to be able to provide those resources that for some reason we get told no
30:14
and the capable kids. Are a lot of people listening to this. Our
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therapists of all kinds, um My guess is a lot of them really aren't
30:26
too familiar with occupational therapists. Quite frankly, how do occupational therapists and mental
30:37
health therapists, how do they How can they work together? What are some
30:41
ways that they might do that? Yeah, great, that's that's a great
30:45
question. So I always say that in the work that I do, particularly
30:51
with individuals who have experienced trauma or individuals who made participate in substance misuse,
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um is the idea that they should all have a mental health counselor as well,
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and we should be working together. So there are things like I talked
31:06
about. Many mental health counselors are familiar now with the terms of sensory processing
31:11
and understanding if a child overactive they might need heavy work, or if a
31:15
child is very resistant, they might be hyper sensitive to touch, they don't
31:22
like the way certain things feel. But we know that trauma affects the sensory
31:26
processing very differently, so it might not be that I'm hypersensitive to touch.
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It may be that the sexual trauma that I experienced has created a unique fear
31:37
to certain types of touch or certain feelings, Like if I were in a
31:45
very humpy flannel sheet bed, I might really have a hypersensitivity to the flannel
31:52
sheet touch now, right. And so that complex understanding of the sensory system,
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it's something that is really expert in occupational therapy professional. But then we
32:05
can collaborate with the mental health professional because they truly understand sort of the emotional
32:12
experience or emotional response to it. So we can prepare their body so that
32:17
they can do the mind work or they can do the mind work, and
32:21
then we can calm the bodies. But you know, we hear a lot
32:24
about how the body keeps scores a book, and the body has its own
32:31
responsiveness to what the brain is telling a person that they are experiencing in their
32:37
world. Well, I see mental health counselors and occupational therapy professionals being the
32:43
perfect unification of a mind body professional experience. I can really integrate how they
32:50
can build a routine structure, a habit, identify meaningful and purposeful occupation,
32:57
and then I can figure out how they can do them and those environments while
33:00
the mental health counselor is processing through the trauma, the emotions, the coping
33:06
mechanisms, how to move forward, how to continue on the healing journey.
33:10
So a mental health professional might say, you know, I think that deep
33:15
breathing and journaling are going to be two incredible the useful coping mechanisms for you
33:22
as an occupational therapist. I can then find the way to integrate that meaningfully
33:27
into your routine so that you don't even have to think about it. So
33:30
we can build the routine together so that you are regularly doing those very great
33:36
coping mechanisms that are recommended by the mental health counselor. Wow, just from
33:44
minor, I'm speaking with Alison Stover of Capable Kids and Capable Families. We
33:50
can have those linked up at the show notes page here at the Traumas podcast
33:52
dot com. What's next for you, Allison? So I'm currently serving medical
34:00
school. I've said that. My husband says no, he said, I'm
34:07
done with school. So I'm currently serving the next three years as the president
34:13
of the American Occupational Therapy Association. So my goal and plan is, you
34:20
know, to really be very intentional these next three years about um spreading this
34:25
news, spreading this word, and finding ways that the collaboration can happen more
34:31
organically. So for a long time, occupational therapy has been viewed at the
34:37
rehabilitation profession that collaborates nicely with physical therapy and speech therapy and lives in a
34:46
medical world, a medical model world. We do certainly do that, That's
34:52
absolutely one of the lenses in which we view But I think we are an
34:57
incredible we have an incredib opportunity to really particularly as we are seeing the increase
35:06
in mental health experiences, you know, how do how do we meet the
35:09
needs of our community, but also make sure that we're not burning out the
35:14
professionals that are providing that pathway to healing. And so I'm being intentional about
35:20
finding organic ways to unite the mental health community with the occupational therapy community so
35:25
that we can be a force of healing and wellness, a pathway to recovery,
35:31
but also that we're being able to take care of ourselves and not burn
35:35
out. Awesome, Alison, what's the best way for people to contact you
35:39
to reach out? Yep, So email is the best way and my email
35:45
address is. You can either look up Allison Stover at the University of Pittsburgh
35:51
or it's just a D. Stover at pitt p I T T dot ed.
36:00
Okay, we'll have that linked up. Allison amazing, really and so
36:07
freaking inspiring. I'm so glad you came on this podcast. It was a
36:09
pleasure meeting you and you I'm got to have you back at a later date.
36:15
Yes, thank you. This was so much fun. Thank you so
36:16
much. All right, take care. Thanks