Thanks so much to Helen Brennan for sharing this in-depth and inspiring testimonial about integrating HANDLE into her work as an Occupational Therapist, following a HANDLE Level 1 and 2 weekend training course with Sean Williams.
“I am an Occupational Therapist (OT) who completed the introduction to HANDLE course many years ago. At the time I was working in the NHS as the lead OT for acute stroke care as well as imputing into neurosurgery, neurology and Intensive Care.
HANDLE opened my eyes, showing me that there is so much more we can do as therapists to support our patients regardless of diagnosis or in my practice, the stage of recovery post neurological event. Occupational Therapy for my patient group at the time was viewed by many as limited since the patients were too acutely unwell to be engaging in functional tasks. Through working with patients and their families, I was able to find a way in, an understanding without words about the patient before me. More often than not, the patients were exhibiting behaviours that others would call disruptive, reactive and on occasions aggressive. As I worked with the patients, in applying sensitivity and intuition, and through the application of the HANDLE philosophy and exercises, I came to recognise the therapeutic value of HANDLE in adults. I witnessed first hand the calming influence of HANDLE, and often felt in the eye contact gained with my patients that we understood one another. This was reflected in a a small number of families approaching me to ask whether I did private work as they felt too the therapeutic connection and the calming influence the approach had.
Since that time I have worked in the community neuro rehab teams as well as in-patient neuro-rehab. HANDLE has remained one of my fundamental approaches, as I feel clinically it enables me to support the subsystems of function, through better aiding the registration, processing and integration of sensory experiences. In fact, I would say HANDLE is no longer a conscious thing, it’s part of my overall approach. I feel as a therapist it equips you with a sixth sense.
While working as a locum on a stroke unit, I received the comment from the lead OT that they had never had so many people discharged with such good recovery in their affected upper limb. Out of 10 patients discharged in a 3 month period, 8 of them were mine, 7 of which had functional upper limb recovery. All received HANDLE exercises integrated into their programmes. One particular patient I recall, had no function in her right hand when I met her. In fact her hand was splinted 24/7. When she was discharged 3 months later, she was using her hand to hold a hairdryer and was baking.
I also had a patient who had double vision after a mild stroke. She wore an eye patch. We did face tapping one the Monday and on the Tuesday when I walked on to the ward she shouted me to come over. Her face beaming, she told me for the first time since her stroke she walked to the toilet in the morning without her eye patch and with no double vision! She believed it was the face tapping.
The accolades for HANDLE are too many to mention in this statement. I recognise there are many variables and know that HANDLE doesn’t stand alone. It’s included as part of an eclectic approach, although it’s principles are guiding ones. Many would attribute the gains patients report as being due to spontaneous recovery, maybe so, but I’m not convinced.
I had another patient who arrived on the stroke unit while I was away on leave. At the Monday morning handover on my first day back, the physio turned to me and said we are so glad you’re back. This patient had been refusing to see anyone else for treatment until I had seen them as they’d heard great things from a previous patient about what I did for them. When I went to see this patient the first thing they asked me is could I do face tapping with them! I worked with them for 2 months and on the day they left, they did face tapping on me!
I’d like to finish with a reflection on my most recent experience, which is with a gentleman I met when working in Australia. This gentleman had suffered from a significant brain haemorrhage leaving him with both physical and communication difficulties. When I first met him, he was overly active both physically and mentally. He lived in his head space, and this would interfere in the quality of his walking and speech. These were the focus of his two main goals. I worked with him, introducing face tapping, skull tapping, ear muffs and crazy straw, being mindful that he was hypersensitive to the area of his head where he had neurosurgery - the cerebellum. The first session was interesting as for the first time, the room fell silent, the energy lowered and the patient became calmer. They took the exercises away with them and the week after, both the patient and his carer reported huge gains in terms of quality of sleep and pronunciation of words, leading to more clarity and less frustration. The patient continued with these exercises and while the biggest gains were not necessarily on their functional abilities but on their sense of self, and their acceptance of needing to nurture the support systems to function. They started to meditate and complemented their exercises with breath work. I still wonder how that patient is doing now.
While HANDLE may be portrayed as being specific to children with neuro-developmental difficulties, I believe it can support anyone at any stage of life and with any neurological weakness / condition. For me HANDLE nurtures and enables our central nervous system to better integrate all the information being presented to us. We are all subjects of our own experience and for some of us, some areas of function are not as robust as others, causing restrictions to learning.”