Debora A. Davidson, PhD, OTR/L, Clinical Occupational Therapy Editor

Debora A. Davidson, PhD, OTR/L, Clinical Occupational Therapy Editor

Are you aware of the positive psychology concept called flow?  It is a powerful force that we OTs can use to help clients to heal and gain strength from. Here’s a quick definition:

Flow is a psychological state that occurs when an individual is engaged in a task that is so engaging that they become extremely focused, to the exclusion of distractions, discomfort and time.

In his 2004 Ted Talk, Mihali Csíkszentmihályi relates flow to a state of ecstasy or joy that adds greatly to one’s quality of life.  Flow is different from some other types of ecstasy, as it is a state of that is connected with occupation.  I love the feeling of flow, and I am lucky to have accessed it during a range of activities that are easily available to me. Writing, lecturing and working with my clients have all resulted in flow at various times.

I know that many others derive flow very differently. Sewing, making music, creating a splint, or playing a sport might result in flow for others. These are not easy or mindless occupations; rather they are complex and challenging activities that challenge me at the “just right” level that A. Jean Ayres also wrote about. Here is what I know from having experienced flow: it is therapeutic and rejuvenating in a unique and important way, and OTs should try to help clients to achieve it as often as possible.

I have had my experience validated by watching my clients’ and students’ experiences of flow. When they achieve flow states, their eyes shine. They are oblivious to distractions. They are focused and engaged and “lose themselves” in the moment. They sustain their attention and persist through difficulties. When the session must end, they look up in surprise that the time has gone by so quickly and feel sad that our work must stop for the day.  Best of all, they leave our session feeling rejuvenated, calm and satisfied.  Often I hear comments such as “That was really therapeutic!” or “I really got a lot done.”  Always, they wish to come back and re-engage again at another time. Flow drives away stress, self-consciousness, anxiety and boredom. Flow is healing and affirming.

How can we help to facilitate states of flow?

  1. Offer tasks in which the desired outcome and progress is clearly defined.
  2. The task itself should provide immediate feedback, so that the do-er is assisted to continuously adjust his or her actions and improve performance.
  3. There must be a dynamic balance between the do-er’s level of ability and the challenge required. A little sense of risk and suspense (“Can I really do this?”) is good. If the ratio of challenge to skill is off, though, you will end up with anxiety or apathy — anti- flow.
  4. Make sure there is enough time allotted for the do-er to engage and immerse. As noted previously, they will want to prolong the experience once flow begins. This is a great way to get some quality practice and sustained attention to task going.

You will need all of your skills in activity analysis, client-centeredness and creative problem-solving to meet this challenge.  And who knows? You may find yourself “flowing” right along with your clients.

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