OTD Student Experiences 'Humanity' Through Butler Hospital Fieldwork

Molly Gould OTD ’24 knew as a teenager that they wanted to work in the helping professions. Drawn to caring for other people, they enrolled in Johnson & Wales University’s Occupational Therapy Doctorate (OTD) program to learn how to assist and inspire people to maximize their health and well-being.

Last semester, they put their learning into practice at Butler Hospital through an internship they’ll always remember.

Experiencing the Humanity of Occupational Therapy

Since 1844, Butler Hospital has been synonymous with quality psychiatric and substance abuse care for adolescents, adults and seniors, providing a range of addiction and rehabilitation services for the southeastern New England community. Johnson & Wales and Butler enjoy a partnership in which JWU psychology and occupational therapy students intern at Butler — with several JWU alums now working among the hospital’s stellar staff.

For their second Level II fieldwork experience, Molly spent roughly three months at Butler doing mostly independent work as an OTD student.

“I was lucky enough to land the director of OT as my site supervisor, as we both held a mutual passion for working with the intellectual/developmental disability (IDD) population,” Molly shares. “This meant I was working on one of the two intensive care units where people with higher-level needs were placed.”

Molly worked with people who were in active psychosis, had personality disorders, were in active addiction, had experienced trauma, were houseless and/or had attempted suicide. The populations ranged from “people who were quiet and insular, responding to internal stimuli” to “people who spoke in loud, run-on sentences that had you wondering when they were able to take a breath.”

Ultimately, Molly noted, “It was wonderful to be surrounded by so much humanity.”

What Fieldwork Looks Like at a Psychiatric Hospital

In contrast to their OTD peers in less intensive units, Molly ran 1-2 groups a day, being mindful that due to acuity and sleeping patterns, different people had different scheduling needs. “My primary focus was running a discussion group in the mornings and completing assessments in the afternoons,” shares Molly.

They would come onto the unit after a daily 8am triage in the OT office for “rounds” with the unit psychiatrists, nurses and social workers. There, they group would discuss what had occurred during the last shift, review the profiles of new patients on the unit and problem-solve and collaborate on med changes, discharge plans and more. Then Molly would plan for their discussion groups.

“Based on what I was hearing about the unit that morning, I would choose what I felt to be an appropriate topic for the population,” Molly explains. Their group protocols would include topics such as “Behavioral Activation,” “Managing Stress,” “Cognitive Defusion,” “Setting Healthy Boundaries” and “Self-Compassion.”

Molly held their morning groups at 9:30 after walking around the unit inviting patients to attend, and they would start each group with an introduction, ground rules and an ice breaker to help encourage people to talk. After explaining what the topic meant, Molly would ask participants to try and define or explain what they understood about it. They would then proceed to teach people about the topic and encourage group members to share their thoughts and feelings.

Moderating the groups was a challenge. “Remember, this is an intensive unit, so it was not without intense moments,” Molly notes. “I became really, really good at setting boundaries.”

Internship Independence Builds Self-Confidence on the Job

Molly appreciated that their supervisor at Butler was “incredibly knowledgeable” but, given all the off-unit responsibilities of the hospital’s director of OT, the management style was hands-off, allowing Molly the freedom to find their way as an occupational therapist.

“While she was always available to meet with me when necessary, I found that this aligned really well with my preferred supervision style,” says Molly. “Once I found my footing, I was able to throw myself into the work and build independence and confidence as a practitioner. Without a supervisor constantly there to monitor me on the unit, I was forced to have to talk to nursing, social work, doctors and support staff to problem-solve.”

Able to prove their competence and ability fairly early on, Molly continuously improved their goal of self-confidence as an OT through decision-making and rapport-building.

“It was rewarding to meet with my supervisor at the end of the fieldwork experience and see just how much I had grown in that area,” Molly shares. “I could confidently say that I knew what I was doing, and that was supported by the glowing notes my supervisor had for me.”

The Benefit of Great Colleagues

Molly considers themselves “blessed” to have worked with peers at Butler.

“I was able to visit the geriatric unit on Wednesdays and work with 2-3 other students throughout the day, helping with mobility assessments or just being an extra set of hands for staff for incontinence changes,” Molly explains. “I loved getting to sit and chat with patients on that floor.”

Otherwise, Molly would sometimes team up with another student to complete certain assessments, such as the Assessment of Independent Functioning — a hefty assessment consisting of leather lacing, cognitive testing and packets of questions and small tasks that all helped paint a picture of someone’s ability to safely care for themselves independently. The results of those assessments were intended to help inform the doctors and social workers in their respective units in their care and discharge planning.

“We students would collaborate and learn from each other, taking turns completing portions of the assessments, comparing our respective understanding and scoring, and discussing what we would each recommend,” states Molly. “It was a great way to build interprofessional skills and learn new perspectives, as well as make new friends and have fun at work.”

Molly has nothing but praise for Butler’s staff. “The team I worked with were some of the most hard-working, empathetic, compassionate and funny people I’ve met,” they say. “I learned just as much from them as I did from my supervisor and the patients.”

Putting OTD Skills Learned in the Classroom into Practice

Molly credits their learnings at JWU, from understanding the medical model to grasping biomechanics and medical conditions to inform what level of assistance someone might need, for being a better OT student at Butler.

“JWU’s OTD curriculum was designed to build competency from the floor up, due to it being an entry-level program,” Molly explains. From the basics of the history of occupational therapy, they explored what OT has done for people historically and what it could do now. They then tackled mental health (which Molly notes “is always going to be a factor of our work no matter what population or setting you find yourself working in”), physical disability, geriatrics and pediatrics, all while building knowledge of conditions, kinesiology and neurology.

But that wasn’t all.

“At the same time, we’re collaborating with other professions at the university, such as Nutrition or Engineering & Design,” notes Molly. “I think this gave us a good perspective on how vast the OT profession is, and how we can work with anyone to find client-based solutions using our OT toolkit.”

In their first year tackling the OT practice framework, Molly had found themself thinking, “Woah, this is a lot. I need to learn all about occupation, theory, performance skills, performance and client factors — and each of those things can be broken down into many different little things.” Yet by the time they were placed at Butler in their second year, Molly was already familiar and comfortable with occupational therapy.

“Without thinking it, I know I’m approaching this person with the model of human occupation in mind, so I need to identify what their motivations and habits are,” Molly explains. “If this person has a memory disorder, I’m not going to use the rehabilitative approach but rather modify the environment to best support their needs. Or if a person needs to wear a hard boot on their left lower extremity and their higher-level cognitive functioning is currently impaired due to the delusions they are experiencing, how can I explain the importance of wearing the boot and an appropriate wear schedule in a way that they’re going to understand me?”

“It seems like a lot, but after sitting in that classroom for two years going over this stuff, it really does start to become second nature,” Molly says.

Why Molly Chose to Study OTD at Johnson & Wales

Molly had realized that many of the prerequisites for occupational therapy programs aligned perfectly with their expressive art therapy undergraduate program. “From there, it was a simple decision of which progression (expressive art therapist or OT) was going to support the kind of life I wanted to pursue,” they said.

JWU’s location, small class sizes, amazing opportunities for fieldwork such as at Butler Hospital, reasonable price for a doctorate program and the chance to eat fantastic food from culinary students attracted Molly.

But they discovered the most invaluable asset of all here: JWU’s faculty. They first realized this while attending a JWU information session led by Program Director Nancy Dooley and Associate Dean Rebecca Simon, leading Molly to drop their plans to look at Tufts and Boston University. “I didn’t even apply to the other programs,” they share. “[Dooley and Simon] were the coolest ‘doctors’ I’d ever seen, and I instantly felt the need to impress them; that’s how I really knew I wanted to go here. I wanted to be around these teachers.”

Continues Molly, “Not only do we have incredibly talented, intelligent, creative faculty (Assistant Professor Monique Dawes, Assistant Professor Kathryn Burke and Professor Andrea Fairman-Laferrier, to name a few), but we have teachers that advocate for us and care about us.”

The ways JWU cares for Molly are numerous. “One of my teachers helped me make the call to the counseling center when I was really struggling with my mental health,” says Molly. “Our lab assistant Richard Borges gave me a 3D-printed gelatinous cube he made when testing the machine because he knows I love Dungeons & Dragons. My faculty advisor was always available to talk to me, about anything, and I always left feeling seen, heard and optimistic in the face of whatever I was struggling with.”

Molly’s Dream Career Path

Molly is currently completing their capstone experience — a self-directed research project they crafted alongside their faculty capstone supervisor, Kathryn Burke, OTD, OTR/L, and their current site supervisor Wendy Friend, director of nursing at The Fogarty Center.

“I am creating a training session for residential and other staff to address sexuality with the participants they work with, who all have some sort of IDD,” reports Molly. “If I could make a job out of comprehensive and diversity-inclusive sex education, human rights advocacy, pleasure-based advocacy and working with the disability community, it would be a dream come true.”

Molly shares, “I am so lucky that Dr. Burke came to our program at the time she did, because this type of work was not otherwise offered as a potential capstone project — it just so happened that Dr. Burke is a passionate advocate for sex as an activity of daily living (ADL) and has done work on such in her career.”

“Because of her, I know that I could pursue this passion in my career as a consultant, as a researcher, as an educator of practitioners/students/staff, as an educator of adults or of youth,” Molly continues. “Even if I don’t end up with the sex educator job title right out of school, I know that the principles of this work are always going to influence the work I do.”

As for Butler, Molly notes that they aren’t done with the hospital yet. “My résumé is going to make its way there one day, I’m sure of it,” they say.

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