Started the journey of getting a clinical doctorate in occupational therapy (OTD)!

I started my post-professional clinical doctorate program on September 2nd. It is an OTD (Occupational Therapy Doctorate) through Rocky Mountain University of Health Professions based in Provo, Utah.

It can be confusing to understand how doctorates work. Essentially clinical doctorates are used in actual practice. Doctors of psychology, optometry, dentistry, physical therapy, etc, are NOT actual MDs. They have a clinical doctorate like DDS, OD, PsyD, etc. Which is what I am getting as an OTD. For all of those areas, excepting perhaps psychology, most of them do not have PhDs. If they do have a PhD, it is in addition their clinical doctorate, not instead of.

Even in psychology I believe that most either have Masters or a PsyD (clinical). Many of these doctoral degrees can be entry-level (typically after a Bachelors). Meaning  the student has no actual practitioner experience and is starting from scratch.

However, there are plenty of practitioners who go into a post-professional program, which means we have been in practice for usually at least a year and typically 5+, so we have a lot of experience that guides our doctoral degree.

Most of the post-professional versions, at least in OT and probably most programs now, are primarily online. We all have our Masters (or older practitioners may have been grandfathered in through their Bachelors), and have been in practice for likely many years. In other words, many of us are established full-time practitioners with families. We have a very different level of experience going into this program.

At this point the next step is all of the scholarly work of research, writing, analysis. etc. At this level of schooling the professors are typically providing guided learning, not a typical lecture style where we are taking in basic information.

Getting a doctorate was not in my plans, at least not now, but as I describe later in this post, I had good reasons.

As I went through the orientation modules for this program, I was quickly humbled at how far technology has come for distance learning. I graduated from my Masters in OT program in 2009, and even back then distance education was not nearly as rigorous as it is now. But five years is a LONG time in the technology world. Back then people thought of online learning as the “University of Phoenix” style jokes. And now that I say that I may hear from angry people who had a good experience with that university. I don’t know anything but the stereotype that it was essentially a way to pay money, do a small amount of work, and get a degree. Please let me know if I am wrong (I certainly have not explored the evidence on it, this is completely hearsay!)

All I know is, I think some people still get skeptical when they hear of online programs. But these programs are rigorous, and interactive, and as I said above, humbling. I’m 32 and I was a very early adopter of technology. I started WORKING online when I was 13, way back before child labor laws and child protection laws were in place. (The labor wasn’t an issue – the protection was.)

And yet even with my familiarity with online work, more so than most people my age, I’ve had a lot of technology learning to do for this program! Wow. I am really impressed with a lot of the older professionals in this program, many of whom are NOT very familiar with online learning. To throw in a major tech learning curve on top of trying to do a doctoral degree while working full-time and taking care of a family? Wow. That’s discipline.

I used to think about doing a PhD, but realized that since I don’t have any strong interest in research or academia, it wouldn’t be a particularly enjoyable journey. I do love teaching, but not on the formal level of lectures of theory that students need to know for a test. And I love getting other people to research things, but I don’t want to do it myself.

I wrote another few pages about why I am doing this program now, and then I get hesitant about being so publicly transparent. I go back and forth on how much to share. I cut out those few pages and put them on my computer in case I decide to use them sometime later. I have shared in earlier posts that I have a very long history of depression and anxiety so I guess I can repeat that part. Some of it may be neurochemical, but most of it is based on over a decade of secrets (some of it thanks to that online world), and therefore a lot of pain.

I was relatively functional when I ignored it all, but it took a lot of energy to always wear a mask that made me look fine. It was exhausting and I paid a heavy price. As the years went by and the secrets continued to compress my soul, my weariness grew, and the darkness inside got so dense it felt like I was turning into a black hole. I was walking oh so perilously into Robin William’s world.

I crashed. Sometimes you have to hit rock bottom to get the momentum to (start to) bounce back.

To make this incredibly long story slightly shorter, and to not get too intimate, I had to fight. But even if you have a machete, you have to be in the thick of it to thin it! Wow I think my word play is so clever…hahaha.

So while I’m dealing with the fight, I haven’t been nearly as functional as I was when I ignored it all. But I also wasn’t okay. I’m better off now, with much more limited function, than I ever was before. Because now I at least know there is a light inside of me somewhere, even if I can’t see it. And sometimes I glimpse it, and sometimes I feel it. I’m just starting to feel better, but I struggle with feeling like the sky could fall any day now, where I wake up and the heaviness is back. It’s happened many times before, so it’s a legitimate fear.

Even doing better, I can’t tolerate much these days, and I will likely not be able to do full-time direct service again (or any job with a schedule controlled by others). I am introverted (I can still appear outgoing, but it’s draining), I don’t like unpredictability, typical work schedules are nearly crippling, and I have always had dread every time I’m about to see a client, no matter how much I love them and feel confident in my therapeutic ability. It’s not obvious because I am very, very skilled at wearing a mask when necessary, which has been at least half my life. Only in this last two years did it get increasingly impossible.

I am only working a few hours a week. I spend a lot of my time getting help in kind of a customized outpatient program.  But I’m making progress. I am doing this doctorate as a form of vocational rehabilitation so that I can stay within the field of OT even if I can’t do much direct service. Because it’s online (minus four days a semester), there is wiggle room within the modules to have off days, and the schedule is mine (often I work best late at night).

My goal with this “vocational rehab” clinical doctoral program, which is a lot less stressful (academics are my biggest strength) than direct service, is to find a way to stay firmly entrenched within the field of OT, but in ways that cater to my strengths and do not require a direct service model. I would love to keep a few direct service cases a week no matter what, but I am hoping to build up a curriculum for elementary schools as this doctoral program’s capstone project, or similar types of products, where I can work my own hours and have a lot of time for off hours/off days. I also hope that I will eventually be more up for furthering the Miss Awesomeness business cause of a more mainstream community empowerment model through the developmental knowledge that OT has provided me. Doing a presentation causes me less stress than direct service, weirdly enough.

The point of sharing all of this is that I want to get back to blogging. Some of it will be more typical blogging and pediatric-based, but some of it is going to be the journey of getting a clinical doctoral degree in occupational therapy. A lot of it will just be the “neurotypical” journey of getting an OTD, just like I did with my Master’s program where I rarely said anything about the mental health struggles. But sometimes, when it’s affecting me (which I anticipate being less and less), it will be acknowledged as a factor.

I have thought about doing this as a separate blog called 296.33, OTD, or something similar. (The ICD-9 code for depression for insurance purposes is 296.33 and I liked how it rhymed with OTD!)  I got feedback from many mentors and they varied in their opinion.

I know many, mentors or not, will disagree and feel I’m harming my future with this decision, but I need to do it anyway. I don’t want others to feel as alone as I have felt. I’m keeping it on the Miss Awesomeness blog for now, but may switch it over to  and delete any current entries. But maybe I’ll keep it here, and just show that it’s okay to be un-awesome sometimes. 😉 However, I am going to compromise and not share as much as I would like to, and keep it at a more formalized level (as formalized as you can get with vulnerability and transparency).

The good news is, even when frequently at varying low capacities, I’ve done a lot in the field of OT. It’s just that at full capacity, I can do so much more, and I know my potential. And I know 100% for sure I will be successful, and that I’m healing, and that the light is there. The journey will remain rocky but I’m learning how to anticipate the obstacles and dodge most of them. I still need a lot of support and am not able to do as much as I would like in the real world, but that’s slowly changing.

The singer Ingrid Michaelson has a song called “Keep Breathing” with a lyric in it that says “I want to change the world…instead I sleep.” See the video below.  That’s been me for a long time.  Now I’m ready to change that lyric to “I want to change the world…and I have started the process.”

This link goes to the song on Youtube. I couldn’t figure out how to embed it because the code kept showing up rather than the video.

Keep Breathing by Ingrid Michaelson