An Occupational Therapy Group Pilot in 2024
Amy Gowland (Occupational Therapist)
In collaboration with
Addison, Harper, Payton and Beth (Group Members)
January 2025
Strength in Shadows was a group that I created following recognition that there was something missing in working with clients aged between 14-25yrs. Whilst they were seeing me as their Occupational Therapist (OT) and had other members within their care team, a common theme that was arising during their consultations was the fear of not being able to connect with others due to their invisible conditions.
The power of small group-based therapy has been witnessed firsthand with this group, allowing everyone to share their thoughts, feelings and stories, whilst being able to connect with others of a similar age, going through similar journeys in their lives This approach has aspired to foster a sense of belonging and understanding, reducing the isolation experienced by many within the invisible illness and pain space. Through engaging with others going through a similar journey, it helps to allow a sense of realisation that they are not alone, sharing information amongst each other, stepping outside their comfort zone, and not just working 1:1 with a clinician all the time.
The term "shadows" was chosen as it symbolises the hidden aspects of the conditions that these clients present with, which are not always visible to the outside world but do present and interfere with their daily life. Despite the challenges that may be concealed, the use of the word "strength" was easy to pick, as such emphasises the inner power, courage, resilience and creativity that individuals continue to develop and demonstrate as they navigate their daily lives in the presence of their health concerns.
STRENGTHS AND SHADOWS
This was a hard question for the group to be able to answer when I asked them directly about their strengths. Understandably, at the start of the group, there was a lot of uncertainty from the group about being able to connect with others, but this did not last long at all!!
At times, invisible conditions can feel like lingering clouds casting a shadow over a bright and colourful garden. The flowers, representing one’s strengths and qualities, are always there, but the shadows created by the cloud can dim the colour of the flowers, making it hard for them to be seen. But we know that even flowers have to push through dirt before they
So what were some of the strengths that were rediscovered throughout this journey?
RESILIENCE
This is a true testament to the inner strength and capacity for growth that this group has shown. Despite numerous challenges that they might be facing in light of their invisible illness, with being misunderstood or isolated, they were able to demonstrate unique coping strategies to share with each other and foster opportunities for growth.
For example, one of the big shadows that was discussed throughout the series was exclusion and isolation, with one group member stating: “You don't get invited to stuff because you aren't there, and people forget about you”. But, this has not dampened any desire to try to develop new connections with others.
COURAGE
The continual bravery and never give up attitude within this group was extraordinary, despite the difficulties that they face on a regular basis. The courage to self-advocate, to ask for help when it is needed and to strive towards nurturing a life that is meaningful and important to them, is something that is inspiring to see.
For example, along the shadow themes of exclusion and isolation and guilt, one member stated: “I hate having to ask my friends to sit down, have a break, slow down and stop what they’re doing, it makes me feel like a burden”. But the courage to request a change in plans or find alternative activities is something that was very clear throughout the group.
CREATIVITY
The ability to have an outlet to channel their self-expression and journey with their invisible illness is one that is admirable and astounding with what they have been able to create. Artistic expression provides an opportunity for communication through modalities that provide a greater sense of comfort, whilst expressing emotions, achievements and struggles, which often can be difficult to verbalise. It is evident that for this group, creative outlets are mediums which allow them to gain a sense of control, in a world which can feel as though they don’t have control in, fostering a means for empowerment and opening opportunities for dialogue with others.
A picture is worth a thousand words and this is just that:
MATURITY
It is very apparent that for those living with invisible conditions, and particularly within this group, that they have developed a sense of maturity well beyond their years. This is due to what they have already experienced and the increased self-awareness and responsibility that can come with navigating living with a persistent condition. Such offers an opportunity for the demonstration of empathy, patience and appreciation of achievements (no matter the size of them). It is a huge reflection of the strength and wisdom that is shown by this group.
One of the big shadow themes was centred around grief and loss, with many having had to stop doing something that they love because of their health or not necessarily having the same childhood as others growing up. One group member stated: “Having to grieve something that most people don’t realise they could even lose”. This is a pure demonstration of maturity in itself.
MOTIVATION AND PERSISTENCE
The motivation and persistence demonstrated is a means of determination that drives a desire to be uniquely and authentically themselves, despite their ongoing challenges in relation to their chronic conditions. It is a true reflection of the strength, courage and hope they demonstrate in the face of adversity.
CHALLENGING COMFORT ZONES
Acknowledging that it is ok to try new things and step out of your comfort zone, fosters greater confidence, resilience and motivation for further progress within their journey. There are so many opportunities for growth with stepping out of your comfort zone and this was evident throughout the group with all members trying to connect with others that were unfamiliar to them.
This was apparent throughout the shadow theme correlating with self-perception and self-image. Some of the quotes that group members shared included:
“Struggling to see myself for who I truly am, past the health issues”
“I don’t even know how to introduce myself anymore because dance was always my go to thing to talk about when meeting someone”
However, whilst these might present, the skills that come with challenging their comfort zones and increasing their confidence and capacity for communication has shone through for this amazing group.
Thank You
A huge thank you to this cohort for your commitment and willingness to give it a go! Remember, strength is not just physical or mental, it is so many other things. And yes, you might have shadows, but remember, shadows change their shape and size as the light moves around, it is not static – so like a dancing silhouette.
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