When it came time to choose a location for her fieldwork, Master of Occupational Therapy student Sarah Siebrandt knew she was ready for a challenge. At Centro de Rehabilitación, Educación, Capacitación, Estudios y Recursos, Inc., or CRECER, in Ecuador, she found the right challenge: a language barrier, a new country and being thousands of miles away from family and friends.
“In occupational therapy, we are continually giving our clients the ‘just right challenge’ — the specific amount of difficulty for them to be challenged by an activity yet be successful to help them grow and reach new goals,” she said. “Going to CRECER provided this for me.”
Siebrandt, Claressa Midgette and Kristen Grube are the first UF OT students to conduct their fieldwork experiences outside of the U.S., all at CRECER. The occupational therapy treatment center in Ibarra in northern Ecuador has another Gator connection. Its executive director is Elaine Keane, a 1985 UF OT graduate.
For Keane, co-founding CRECER in 2005 was the logical next step in a life devoted to service. In fact, she first heard about the field of occupational therapy while on a service learning assignment in high school. Not exactly sure what an occupational therapist did, she looked it up.
“I went to the library and I found a dictionary of occupational titles and it had a page description of occupational therapy,” Keane said. “I thought, ‘Wow that sounds really interesting.’ I never looked at another career.”
After graduation, Keane worked in a variety of settings and specializations, including school systems, hand therapy, nursing homes and teaching. She also earned a master’s in occupational therapy leadership from Misericordia University and a Doctor of Occupational Therapy degree from Chatham University.
Keane’s affinity for Ecuador grew out of service trips to the country and hosting a high school exchange student from Ecuador. Keane and the student’s mother, Susana Albuja, became close.
“As my Spanish got better and I could have more in-depth conversations with her, we found out we had a lot in common in our family values and her father reminded me a lot of my grandfather in terms of involvement in the community,” Keane said. “At some point I said, ‘I want to do more volunteer work. Do you want to do something together?’”
With Albuja’s connections in her hometown of Ibarra, the two started a program with Keane offering occupational therapy services a few weeks out of the year. But Keane felt she wasn’t accomplishing enough.
“I thought, ‘How can I make this bigger?’ The answer was students.”
Her first fieldwork partnership was with occupational therapy assistant students at a Maryland community college. Today, more than 600 occupational therapy students from 30 U.S. schools have done their fieldwork at CRECER. Since 2011, therapists have provided more than 15,000 hours of free occupational therapy services.
“The students get a rich cultural experience and our clients get OT services that they wouldn’t have access to otherwise,” Keane said.
As a proud UF graduate, Keane is happy to have added UF OT to CRECER’s student network.
“I am excited to have strengthened my connection with the Gator Nation and I look forward to having more students next year,” Keane said.
Keane lives in Ibarra full-time now, treating clients, leading students and establishing partnerships with the local government and health care providers to expand access to occupational therapy.
The majority of the clients who come to CRECER’s facility are children. The caseload typically includes children with cerebral palsy, autism, learning disabilities or Down syndrome.
“The parents of the children we treat at the clinic are so appreciative and trusting of the care we provide to their children,” said Midgette, who is finishing a 12-week assignment. “It makes me feel proud of the work I am doing here. This experience has made me a better (future) OT because it has increased my cultural competence and truly challenged me to provide treatment tailored to the individual.”
CRECER also reaches adult populations by placing OT students in nursing homes, community centers and nearby towns. Siebrandt did her fieldwork at an outpatient clinic and a senior center in a small community with a mostly indigenous population. Residents don’t speak or understand Spanish; they speak a dialect called Quechua.
“I relied on my body language and actions to express what I needed to, and learned to read their body language to understand what they were trying to tell me,” Siebrandt said. “I am sure that it will be rare for me to work with this population in the States — and if so, there are usually abundant virtual translators available — but I have found that the experience will help in communicating with non-verbal patients.”
Grube arrived at CRECER at the end of October for her six-week fieldwork assignment. She will work with clients three days a week at CRECER’s outpatient facility, focusing on handwriting, social skills, fine motor abilities and cognitive skills. The other two days she will work at an adult day care center.
“This opportunity is one more way in which the OT department is pursuing its bold 2025 vision to become a vibrant preeminent research and educational entity in the U.S.,” said Sherrilene Classen, Ph.D., M.P.H., OTR/L, professor and chair of the department of occupational therapy. “We continue to serve the occupational needs of people, organizations and populations in innovative ways.”