Creativity in a private Occupational Therapy practice: a position

Introduction

Creativity has been described in many ways by people who study it regarding

how and when they are studying or just manifesting it. Although many synonyms can

be found about creativity no antonym exists for that word but just for its synonyms,

i.e. imaginative ≠ unimaginative. “True” creativity is the “drawing” of the originality

of one person’s thinking as transmitted in a culture through his actions. Its meaning is

embedded to the depths of every human intention towards evolution. Any attempt of

generalisation of creativity fails because it is not a unified concept but rather

individual and culturally defined possession; western cultures in contrast with the

eastern would not view a copy of a genuine craft as creative rather than skilful even

though the outcome is one of a creative process (Lubart, 1990, 1999; Lumsden, 1999).

The main arguments of this document is that although there are guidelines for

effective practice, treatments in occupational therapy do not emerge from an

instruction book but from the unparalleled uniqueness of every situation and

interaction of the therapist with the clients. Innovation in therapy lies on the ability of

the therapist to use knowledge and personal experience in order to get adapted to the

demands of every situation. Creative skills are required in everyday endeavours to

change concepts and perceptions (De Bono, 1993).

In a private OT paediatric practice there is a need for the occupational

therapist to employ a great amount of creativity in order to use the existing resources

to create interventions that are appropriate and effective for therapeutic change. This

is highly significant for the practice as long as clients’ health and satisfaction is

closely attached with its economic viability.

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This document wishes to elucidate the contributions of creativity in this

practice, where the self employed occupational therapist strives to solve the problems

emerging from the overlapping roles of manager and therapist. Hence, the way in

which the roles converge will be addressed. Moreover, the qualities and knowledge

that shape the occupational therapist’s artistry towards creative interventions through

the use of play as a creative medium will also be discussed.

Creativity within dichotomy

It is held that a creative product results from the full use of human potential

towards development of any kind. Everyday life endeavours “carry” creativity more

or less. Creativity is an integral part of the human contest with nature depending on

individual capacities, and unique cultures that each of us carries throughout life

evolution (Wilcock, 1998; 2006).

Sternberg and Lubart (1999), argue that individuals, organisations and

societies must adapt existing resources to changing task demands in order to remain

competitive. The fact that a private OT paediatric practice should be adapted to the

needs of the different service users, as well as follow procedures that are vital for its

function and sustainability points at the efforts that a self employed occupational

therapist should put in order to create solutions for individual c, i.e. creativity is novel

and adaptive solutions to problems (Amabile, 1996).

Creativity seems to be internal in problem solving, i.e. create a solution. The

creative process initiates by the identification of the problem and involves gathering

of experience, material, and information that is related with it; generation of ideas

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about the possible approaches that can be used for a solution to be reached; validation

of the actions taken; and evaluation of the outcome (Amabile, 1989; Lubart, 1990;

Pierce, 2003). In the creative process of intervention doing is essential for its

integration, in terms of being its epitome; it provides the outcome for evaluation. In

contrast with the fermentations within a creative mind, doing is undoubtedly

observable (Feist, 1999). Reilly (1962) hypothesised that occupation represents the

wholeness of human. OT traditionally adopts a holistic approach in rehabilitation that

confluences all the theories in the occupational perspective of human. Creativity

involves all the capacities needed for engagement in occupations but also is a capacity

in its own right emerging from all types of activities, products and ideas (Wilcock,

1998; Atkinson & Wells, 2003). In an occupational sense, creativity has a curative

quality in terms of contributing in engagement in occupations towards well being.

The following patterns address the conditions under which the self employed

therapist creates his interventions and wishes to provide an insight to the mechanisms

that are related to the creative process regarding the individual occupational therapist

in the particular setting. This has been conceived as one of the seven dimensions, i.e.

the environmental dimension, of creative working, described by Atkinson and Wells

(2003). Although the self employed OT has great degree of autonomy, he needs to

prove that he is “good” professional, and create a safe and accessible environment

with plenty opportunities for his clients to engage in occupations.

By reviewing a self employed occupational therapist’s ordinary day can be

elicited that OT intervention is a continuous problem-solving process due to the group

of activities or tasks that are essential both for survival or self-growth (intrinsic

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drivers), and professional identity reasons (socio-cultural reasons). Efforts towards

this direction have been described as a highly creative process (Pierce, 2003).

Creativity for an individual is relevant when solving problems in the job and daily life

(Sternberg & Lubart, 1999). For instance, the OT needs to organise and evaluate time,

space, and materials of the private practice in order to provide a comfortable

therapeutic environment which will increase satisfaction of service users. Apart from

the individual beliefs of how OT services should be provided, this is also linked with

the need to gather income to preserve both the functions of the practice and self.

Empirically speaking, this is experienced as a continuous “battle” for balancing the

intrinsic motivations and social considerations for conformity. Lubart (1990) refers

that in western societies there is a strong opposition between individualism and

pressures of conformity to community norms, which is likely to hinder creativity.

Amabile (1989; 1996) implies that motivation towards tasks depends on the

level of intrinsic will of a person, the presence or absence of external limitations, and

the individual ability to rationalise constraints of the environment. However, enabling

extrinsic motivation can also increase creativity (Amabile, 1996). In the private

practice peripheral constraints frequently depress the intrinsic values of the therapist

due to the fact that outcomes concerning the economic sustainability of the practice

overlapping with the process of the intervention. The therapist has to deal with

individual multiple goals that are related both to client issues and individual

conformity at the same time. That is, to provide successful treatments in order to be

rewarded both spiritually (i.e. enjoy participation in the process of therapeutic

change), and economically in order to live as part of the society and its expectations.

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In response to the latter example, it has been interpreted that Sternberg and

Lubart (1999) offer a short of enabling extrinsic motivation by highlighting the

relation of creativity with economic aspects, i.e. innovative and effective services will

increase the popularity of the private practice raising the possibilities for economic

sustainability. That provides a bridge in the dichotomy of roles and goals that emerge

in this private practice, in terms of placing the central aim of OT’s intervention, i.e.

enabling occupation, as the driving force for all the developments. Personally

speaking the passionate interest in OT’s view of health, as well as children’s primary

occupation-play and its use in the therapeutic process is the inner spark that gives

birth to creativity in this particular practice and guaranties its financial viability.

Pierce (2001; 2003) demonstrates how powerful occupation-based practice can

be established on the knowledge of occupation through creative procedures. She

proposes that knowledge of occupation is OT’s benchmark for development and

effectiveness in interventions. That is, the creative use of occupational language, as

well as the creative and precise use of occupation in practice. Knowledge of

occupation for the self employed OT, considering the above dichotomy, is both the

“product” that a private OT practice “sells” to service consumers for its survival, and

the therapist’s node for creative thinking; it is the origin of self satisfaction and

motivation.

Csikszentmihalyi (1997) suggests that we are surrounded by infinite domains;

systems that have particular rules and procedures, of which we need to be aware in

order to be creative. In his “systems approach” to creativity he suggests that a creative

system depends on people (gatekeepers – clients, health professionals) who assess if

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the individual uses the domain in an acceptable way, i.e. field. It has been interpreted

that internalising the knowledge of the domain and the concerns of the field, i.e.

professional standards and cultural consideration of health, is vital for the creative

problem solving in intervention, in terms of creating appropriate, but also

individualised therapeutic conditions. It can be concluded that the knowledgeable

occupational therapist increases clients’ understanding of the domains that are related

to their condition, enabling them to meet the occupational goals of their choice.

Likewise, he must have the skills in order to manipulate

equipment/material/situations, and be endued with aptitude to foresee possible

outcomes or potential ways to work for therapeutic interventions which will also

guaranty his income.

Amabile (1996) implies that the overall creative performance of a person, i.e.

production of actions, as assessed by appropriate judges (professional bodies, clients,

colleagues, self) relies on three components. These are, the domain relevant skills

including the knowledge, the technical skills and special talent about the domain; the

creativity relevant skills including all the cognitive fermentations and working style

towards generating solutions for a problem; and task motivation which determines

the individual approach to a given situation. Presuming that occupational therapists

participate in the wider domain of OT; values, beliefs, theoretical base, competency

standards of the discipline, scientific or non-scientific knowledge about occupations

and health as learned from formal or informal educational procedures constitute the

range of information and experience that an occupational therapist needs for

enhancing his creativity as well as to apply creative interventions with therapeutic

quality, i.e. accepted by the gatekeepers, (Atkinson and Wells, 2003).

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The art of playing with children and their families

Considering the problem solving quality of creativity, the role of the therapist

is attached with the responsibility to manage a disabling [problematic] situation in

order to make it functional. Atkinson and Wells (2003), suggest that creativity is the

tool of making an intervention to work. That is, to explore, present, and use an

approach in a creative way. In everyday practice the therapist involves in

collaborative processes such as facilitating, guiding, educating, training, challenging,

listening, supporting, reflecting etc, in order to enable people to develop occupational

skills that will shape their lives (CAOT, 2002 p.180). Royeen (2003) highlights that

the art of our practice refers to the occupational situations we create in order to make

things doable and meaningful. During sessions [almost instinctively] we create

therapeutic conditions by fluctuating between roles in accordance to the needs of the

moment. Atkinson and Wells (2003) cite that we create our product from the

therapeutic process through using ourselves and the resources (i.e. our creativity); this

creates a motif that transforms on every different occasion. The fact that we hardly

follow therapeutic “recipes” mandates a commitment to self values and beliefs, as our

“protocols” of practice. Knowing ourselves and accepting this knowledge (i.e.

recognise our values, strengths and weaknesses), is a basic prerequisite for developing

therapeutic artistry in order use our selves creatively as tools in therapy (Atkinson &

Wells, 2003).

It is believed that client centred approach in occupational therapy is essential

for orientate our role in intervention and for conditioning our relationship with the

clients. It is a system that establishes clients together with therapists as the field of the

particular health domain. Client centred practice manifests the values and beliefs of

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OT; it provides the ground for clients’ active participation in all parts of problem

solving, i.e. doing is being creative (Dickie, 2004). It provides the guidance for

appropriate cognitive fermentation and conductive work style towards achieving

therapeutic change with our clients. Sumsion (2006) stresses client-centred practice as

an alternative way of thinking or attitude. Concepts like partnership, communication,

choice and power are central to OT, all aiming to empower people to utilise their full

potential towards health (Sumsion, 2005). Rights, values, meaning and choices of the

client is central to the client-centred intervention in non-judgemental manner (Law et

al., 2002). In practice that means that the OT listens to clients’ aspirations and

observes their abilities, facilitates them to envision their potential and identify their

needs, supports them to their decisions either orthodox or paradox, provide them with

information and open communication (CAOT, 2002 p.51). Atkinson and Wells (2003)

describe all the above qualities as the art of using self in the intervention to enhance

people’s creativity, i.e. ability in problem solving.

In the paediatric practice child is the primary client. Children are naturally

creative in evolutionary terms. They “flirt” with life at every moment by disposing

themselves to play as part of their personality (O’Brein, 2000). Play is a continuous

[interactive] exploration of the environment; it serves as a vehicle for creative

problem solving; it is a source of innovation in culture because of its creative potential

(Parham & Premeau, 1997). Characteristics of play make it a powerful, naturally

creative medium in intervention.

However, children that are being referred to occupational therapy, usually

experience difficulties of performing occupations of which play is one of the most

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important (Bryze, 1997; O’Brien, 2000; Morrison & Metzger, 2001; Knox, 2005).

Regarding creativity, facilitating children to engage in playful activities is equal to

building skills for creative function. Towards this direction as part of his artistry, the

occupational therapist “manipulates” child’s play in order to maintain the creative

procedure evolving. As long as play is naturally creative (Parham & Primeau, 1997),

it has been interpreted that the occupational therapist’s efforts articulate around

keeping the components of the creative performance (i.e. domain and creativity

relevant skills and motivation) at an optimal level to facilitate child’s engagement in

play. For instance, a child that wants to climb on steps of the slider and slide in the

ball-stank, needs the physical knowledge that this task demands (i.e. domain skills),

and also needs to position body appropriately to perform (i.e. creativity skills). If task

is hampered by disability, motivation is likely to be increased if the child will be

wrapped with a cloth which then can be used as an elevator.

Play differs from all other occupations by the source of motivation and degree

of freedom that is associated with (Bundy, 1997). In order to use it effectively as an

intervention technique as well as to identify how the creativity relates with play,

occupational therapists must be aware of the nature of play and playfulness (O’Brein,

2000). Observable playful behaviours (i.e. playfulness) during child’s play constitute

its three characteristics: children are enthusiastically engaged in play process and

having fun i.e. intrinsic motivation; they make the decisions about when and how

they will share with others, initiate or modify play, challenge themselves, and shape

the outcomes, i.e. internal control; they use objects in unconventional ways or bend

social rules, i.e. suspension of reality (Bundy, 1997; O’Brein, 2000). It can be

supported that children’s playful attitude pictures Dooling’s (1979) description of the

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artisan “…he himself is there with what he uniquely is…he is the owner and not the

servant of his concept… concept depends on him for a new form through which it can

be transmitted”. Play is children’s way of life through which they create their crafts,

i.e. games, and in a sense their development.

When children play with all the above characteristics converging towards the

internal rather than the external extreme of motivation and control continuums, in

environments that allow the reality to be suspended they are involved in a pure

creative process (Bundy, 1997). For example, a child wants to create a game with the

ball-stank because they are intrinsically motivated by the sensation of the movement

that this activity offers. What this object (ball-stank) represents for that child is also

their own choice; may be the water of the sea that enables them to swim like a fishes

or just a “fresh” tactile stimulation. An external destruction from child’s focus on their

engagement in this vigorous imaginative problem solving situation may interrupt the

balance needed for playfulness to occur. Therefore, the therapist plays in parallel at

the same “world” with the child facilitating their intentions to be applied.

Amabile (1989, 1996) supports that people are most creative when they feel

motivated by the joy and challenge of the occupation itself and not by external

pressures. Children play for the sake of playing (O’Brien, 2000; Morrison & Metzger,

2001; Knox, 2005); they often forego sleep or food in order to play more. Intrinsic

motivation is essential to creativity (Amabile, 1996; Sternberg & Lubart, 1999;

Collins & Amabile, 1999); it is strongly linked with the reward that someone expects

from the participation in the process of an occupation rather than by any conventional

material (Chikszentmihalyi, 2000). For the occupational therapist it is highly

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significant to accept that children are naturally motivated intrinsically in order to

adapt himself to children’s creative life style, as well as to educate parents how to

extract their child’s creativity from the disabled situation. For that reason the therapist

of such practice becomes a child himself participating in play. Atkinson and Wells

(2003), suggest that the way the occupational therapist uses self to communicate (e.g.

verbal and non verbal language) is important to the creative process.

In a therapeutic session the group of activities that take place may have non-

specific aims (i.e. develop friendship) with participation in general activities

introduced by the therapist, e.g. story telling, or specific aims (i.e. create a game) with

engagement in activities chosen from the child, e.g. role playing the astronauts using

hopping balls. Atkinson and Wells (2003) describe those activities as the extremes of

the continuum of creative therapies. They argue that the degree of flexibility of the

therapist to move on this continuum justifies his therapeutic artistry. A playful

therapeutic session is usually driven by the interest of a child, but also from extrinsic

motivations provided by the therapist; therefore, it fluctuates between the two ends of

this continuum in relation to the amount of direction that the therapist is allowed to

address [by the child], the type of play, and the use of material. Empirically speaking

the nature of play does not allow the therapist to hold a robust position during the

session. Engagement in play usually weaves general and certain activities, e.g. story

telling may lead to astronaut role playing and spaceship building with cushions.

As mentioned, over times in a therapeutic session the therapist provides the

motivation for the child in order to engage in play. Amabile (1996) suggests that

although extrinsic motivation may decrease the possibility for exploration, set-

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breaking and risk-taking (i.e. creativity), if used in an enabling way (i.e. trigger

intrinsic motivation) can facilitate the creative process, especially when the intrinsic

motivation is in high levels, as with playful children. For example, the therapist may

motivate the child to use the ball-stank by “bribing” them with a material reward, i.e.

a candy, or get in the pool and create a “funny story” about sea life that will attract the

child to follow. Although the former destructs child from focusing on the procedure

and the internal reward, the latter enables child to become familiar with the activity

and develop an individual way to engage.

Amabile (1989) also hypothesise that intrinsic motivation is the intersection of

creativity, i.e. the area where children’s talents, skills and interests overlap. In that

sense, observing and following child’s play provides with great amount of

information about their preferences for integrating the atmosphere of a therapeutic

session or the home environment around child’s interest, i.e. make the information

accessible or attractive. For instance, a setting which is inappropriate for a child with

a sensory integration dysfunction (e.g. over or under challenging) may inhibit their

motivation for using the environment to play, therefore, block the creative process

from evolving.

Usually the environment of play, in the private setting, is loose and gives the

opportunity to the child to use objects or self, creatively. Atkinson and Wells (2003)

imply that the resources (i.e. space and material), the qualities (i.e. texture, flexibility

and manageability), and the process involved in play (i.e. how the session develops)

determine the responsiveness of the therapist and the effectiveness of a session as

well. In other words, environment regulates both child’s and therapist’s creativity. For

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example, a physical activity with kicking would not be performed comfortably in an

office; without a ball or a substitute of a ball the environment would not be able to

satisfy the child’s need to kick in order to score a goal; a watercolour painting could

be accomplished without brushes, but not without colours. Empirically speaking, an

environment plentiful of resources, in terms of quantity, is not a prerequisite for

effective play. Material that can be used in multiple ways can be more creativity

enhancing. For example, play-doh offers the opportunity to the child to play without a

concrete goal; its development is not certain in terms of the shapes that the end

product can take, which also allows reuse. In contrast with an inflexible material, i.e.

puzzle, play-doh permits the child to develop internal control, hence increase their

playfulness to enhance creativity.

Materials of play can be seen as the tools that make play and playfulness occur

and creativity to develop. Dooling (1979) describes tools as the extension of mind;

they help the thoughts to be applied by bringing about finer control over one’s hand

activity towards shaping something. Tools in play are in suspense (O Brien, 2000);

children can use a modelling balloon as a sword to become knights, or their finger to

pretend the screwdriver during Lego construction. Therefore, it can be said that use of

play material enhances creativity; with the use of objects children create something

that it was not there before, i.e. novel. Play material is used by children systematically

and facilitates the generation of new ideas. De Bono (1993), implies that the use of

tools facilitate the development of creative thinking. Facilitating children to use play

materials is important in sessions in order to sustain the creative process

uninterrupted. For example, facilitating a child to use a skateboard as a tool for sliding

(i.e. engage in the activity in a carpeted room), challenges their sensory-motor

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systems. The child is likely to generate ideas of how to adjust the body posture in

order to control their balance, and in the future to use body appropriately to try

skateboard tricks in their own style on more slippery grounds.

By the discussion that far, emerges that there is a relationship of the maker

(i.e. child), the outcome (i.e. play and playfulness), and the tool (i.e. play material)

that keeps the creative process flowing. In this process the occupational therapist is

the observer; he has a “duty” to preserve the process by trying to make this three-way

relationship to develop “fluently”. Atkinson and Wells (2003) point out that the use of

self as an observing tool provides evidence of how children interact in therapy and

how they engage in play. Observation provides real time qualitative evidences which

help therapist to muster his therapeutic skills in order to use his self creatively during

a session. Additionally, observing his own self the therapist can realise how his

approach impacts on play (Atkinson & Wells, 2003); at a time he might need to be

supportive and then challenging depending on the responses and behaviours of the

child.

Although the private practice is a setting that is related to children’s creativity,

it is just a small part of child’s life. The natural environment of children’s creativity is

home, i.e. its original context. As addressed earlier creativity occurs in a broader

system of interaction of human with the environment (Csikszentmihalyi, 1997; 1999).

The people with which children interact (parents, carers); the freedom of choice to

play; the cultural approval of play via indications from an adult and arrangements of

the physical environment, i.e. what play is?; a safe, comfortable, and friendly

environment determine the conditions, i.e. system, under which play occurs (Parham

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& Primeau, 1997), and in extend where creativity evolves. For instance, Dickie (2004)

noticed that her socio-cultural background blinded her from recognising other

peoples’ creativity; a roadblock that occupational therapists need to avoid in practice,

and educate family to follow.

Amabile (1989) suggests that family is the environment that nurtures the

creativity of a child; parents visualise their child in adulthood, creating scenarios

about their child’s growth. Power and Dell Orto (2003) refer to disability as a new

condition that challenges family’s values, dreams, and everyday expectations. It can

be parallelised with a severe, unexpected, extrinsic factor that influences family’s

creativity.

Many therapeutic sessions are taking place in the house of the family. It has

been interpreted that using self as a tool to facilitate families embody play in a variety

of activities at a daily basis is important. Engaging in playful activities or fantasy can

have a positive effect in creativity (Amabile, 1996). For example, a child with

difficulties in eating might get motivated by using the fork as an aeroplane to transfer

the food from the plate into mouth during lunch time, or can help mother to do the

gross cleaning with playful attitude. Parham and Primeau (1997) describe this process

as occupational scaffolding, where the parents built their children’s play. During this

process children are very concentrated because they are doing something unfamiliar;

they collect information for the new domain. In respect of the development of

therapeutic artistry, observing family’s play during everyday routines can increase

awareness about child’s abilities and provide with “fresh” ideas of how play can be

used in other settings (Parham & Primeau, 1997). In the therapeutic relationship

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parents are seen as co-therapists, they are in charge of the children and their

development. This relationship with parents increases the validity of the therapeutic

reasoning and facilitates the communication of knowledge (Atkinson & Wells, 2003).

Parents are at the infancy of a disabling situation. Although they are unlikely to

provide a solution they usually provide the principles for the appropriate approach to

emerge, for those who know how to listen and watch (De Bono, 1993).

Pierce (2003) cites that each time we came across a situation that is new and

challenging we use creativity and design process in order to find a solution; creativity

is required for relatively unfamiliar tasks. As long as the disabling situation is a

domain that is new to the family, it can be inferred that it provides a fertile ground for

problem solving. By offering access to knowledge that is related to their experience,

the occupational therapist provides the opportunity to the family to increase their

creative capacity. Similarly, as long as every case is unique, the therapist needs to

increase his knowledge for the particular situation-domain. From a humanistic

perspective, this attitude towards education, i.e. exchange of knowledge, can be seen

as the role of the therapist as a facilitator of knowledge (Knowles et al., 1998).

Regarding that role as part of the therapeutic artistry, the occupational

therapist must be aware of situations that influence peoples’ creativity in order to

perform the role creatively. Lubart (1990) stresses that pressure on somebody’s

creativity can be exercised by a person or a situation (i.e. self, parent, professional,

society etc) in many forms (i.e. advice, laughter, isolation, dogmatism etc). It can be

inferred that the interest of an intervention on outcomes via linear use of certain

techniques-recipes, i.e. NDT and SI, rather than open exchange of integrated

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knowledge, addresses a form of pressure that discourages, people to engage in playful

activities and disorients therapist’s judgement. A degree of control on outcome by

imposed methodologies (i.e. controlled external motivation) hampers both clients’ and

therapist’s creativity (Amabile, 1996, Collins & Amabile, 1999). Atkinson and Wells

(2003) suggest that the ability of being open minded about the outcomes of a session,

i.e. being flexible and reflexive, enhances mastery in therapy. Being flexible and

reflexive about the outcomes mandates a similar attitude in judgement.

Csikszentmihalyi (1999) stresses the importance of judgement in the

manifestation of creativity. Supporting rather than judging our clients’ engagement in

everyday occupations of their choice, as well as facilitating access to all relevant

knowledge is essential for enhancing family’s creativity. Atkinson and Wells (2003)

suggest that the therapist’s intrapersonal traits (i.e. physical, social and cultural

background), affect the relationships with clients and vice versa. In order this to be

developed as an enabling situation, judgement must not be linear, but rather emerge

from an integrated reflective procedure with our clients (Atkinson and Wells, 2003).

Reflection facilitates the generation of situation-focused theory, supports the

maintenance of the learning potential, and results to practical wisdom (Gibbs, 1988;

Fish and Coles, 2002; Johns, 2005). Atkinson and Wells (2003) tackle the importance

of reflection both for reasoning and the quality of the intervention as a whole.

Reflection can take place during or/and after the session; it questions every action

taken in relation to the outcome, which is rather negotiated than judged. Every

therapeutic session in any setting can be seen as a creative process which contains

many sub-processes. It can be said that the therapist must be alerted at all times in

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order to be able to react properly. This may be instinctive, but reflection transforms

instinct into artistry.

Conclusion

Knowing about creativity is not relevant to being more creative. It is rather the

knowledge of creativity that makes someone aware for its necessity. It can be

concluded that embedded in practice such knowledge can redefine the role of the

therapist in the intervention or even reconstruct a whole OT practice, in terms of

attitude; it manifests a significant centre of attention that has extensively been

ignored. The concept of creativity adds strength to the central values and beliefs of

occupational therapy about human. That is, every person has a personal style and

ideas that are being applied with a particular way.

This paper is the embodiment of a creative process; the concept of creativity

transformed from a blurred image of thoughts to a more concrete value. There was an

instinctive belief that creativity is present to a private paediatric practice due to its

“playful” nature. This has not just consolidated but also got expanded. Creativity has

been attached with different individual meanings, and provided insights of how that

knowledge can influence practice. The view of the therapist as a tool in the dispose of

children and their families can be the cornerstone of intrinsic motivation, i.e. being a

live object that transforms occasionally. This view crystallises the role of occupational

therapist in the therapeutic process and guaranties the accurate application of client

centred interventions.

[5,134]

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