As we celebrate World Occupational Therapy Day, we are happy to share the second interview for the EHECADI Project. We continue to ask professionals in the healthcare sector about the realities of their roles, and in what ways they think their university experiences prepared them, or not, for what was to come. To do that we spoke with Margarida, an Occupational Therapist at the AFID Foundation in Portugal.

Occupational therapy is a varied profession which focuses on helping persons with disabilities and those with support needs, both physically and intellectually, to improve the quality of their daily lives. This involves helping individuals to comfortably participate in everything from work, school and household tasks to hobbies and social situations.

• Where do you work and what is your role in your current organisation?

Margarida: I work at AFID foundation. Within that, I work at our Activities and Training for Inclusion Centre as an occupational therapist. I’m also working in quality management. I help to ensure that quality standards are maintained in accordance with AFID's certifications (Social Security, ISO 9001:2015 and EQUASS).

• And what do you do in role, day to day, as an occupational therapist?

Margarida: As an occupational therapist I work directly with our clients. They have different types of needs, many of them have cognitive disabilities . So we do a lot of cognitive work, but it’s not limited to that. We have physical therapists in the centre, of course, but due to the load of work, we also help with physical rehabilitation.  

• Was this the role you always saw yourself doing?

Margarida: When I was younger, I wanted to be a physical therapist, and then someone told me that occupational therapy could be better for me, so I re-directed and studied that instead.

• Why do you think they told you occupation therapy was better?

Margarida: I know why, and I agree. Because in the occupational part, there is space for motivation. Physical therapists can also do that, of course, and think about the motivation of the person and what is important to them. But physical therapy is more about the body. You see the arm, or the muscle, or whatever requires attention as an isolated thing. As an occupational therapist we see the person as a whole – it’s not just the person in a vacuum, it’s also the environment, the occupation, everything around them. It is more holistic.

• Can you tell me a little bit about your studies?

Margarida: I studied occupational therapy for 4 years, and then I started to do a Master in Cognitive and Behavioural Neuroscience just because, but I didn’t finish because of Covid. Behavioural neuroscience was very interesting. I learned a lot and I apply it every day here.

• Do you think your studies prepared you well for the job?

Margarida: Yes, I do. Here in Portugal, in particular at the college where I studied Superior School of Health of Alcoitão (ESSA) every year of our studies we have internships. So in the first year you have 1 week in 5 places, and you’re just looking around and finding out what you enjoy. In second year, you start doing the evaluations, third year evaluation and intervention, and the fourth year is the biggest- you have 2 big internships and it’s the final part. So, I felt well prepared.

• So, what was good about your education was that it was very hands on?

Margarida: Yes, exactly. We always had the theoretical part first and then the practical part. It was a really good way to learn.

• Is there anything you would have wished to be different, or you felt was missing?

Margarida: No, I don’t think so. It’s just expensive because my college was private. In Portugal there are only 4 universities that offer occupational therapy. One in Lisbon, where I am from, and the others, although public universities, are in the centre and north of the country.

• And what would you say are the biggest challenges and the biggest rewards in your line of work?

Margarida: For me, because I work with people with disabilities, I really enjoy creating a therapeutical relationship. All the work we do, all the bonding we go through over the years. I love the relationships I have with my clients. The lasting results. Even though it is hard because they are getting older now. The range of the age of clients now is between 40 to 63 or so. The challenges of the profession I would say are getting to the results you want. It’s good when you see results, but it’s not always an easy road. In the social sector, unfortunately remuneration is not what makes us stay; although the health and education sector in our country is also undervalued, it still manages to do better than the social sector. There is a problem of underinvestment. But it’s a very important job. And we do it because we love it.

•  The EHECADI project will work to develop a course for healthcare students to have a better understanding of societal needs and be able to increase their employability. What do you think students should be taught in their studies now, to equip them for delivering quality support in the coming years?

Margarida: Something that is not valued is the power of observation. I only really understood its importance in my final year. I was working with children with autism and down syndrome and behavioural problems, and my tutor said to me ‘Observation is everything’. It’s what I teach my interns now. Observation is the first thing, and it is the main thing.

• The final question is, if there is one, what is the main thing you realise was different to what you expected once you started practicing your profession?

Margarida: The first feeling that all of us get when we finish college is ‘I don’t know anything’, or ‘I don’t know what to do’. For example, in occupational therapy we have models in place that guide our practice, and in college we learn 3 or 4 of them with the expectation of getting into a new job and still doing that. We have everything well planned and it’s not the reality. You don’t have the time. You are doing everything mentally, and you don’t have the time to write it down, whereas in college you have everything written. It’s not as structured. And it’s like a mental exercise every day, and on the one hand, it’s very tiring. But truly great at the same time. You start to connect the dots easily.