Learning to Hold the Plan Loosely

Samar Arif · IQ Alumna 2026 · Community Based Project Lead

Samar reflects on leading the final Community Based Project at IQ, where a planned inpatient activity became a lesson in flexibility, patient-led participation, and person-centred care in practice.

A reflection by Samar Arif

My name is Samar Arif, and I am starting the sixth semester of my BS Psychology program at the Institute of Professional Psychology, Bahria University.

When I was looking at internship options, a lot of what I had seen was still classroom-based. Case studies, tests, theory, written applications. All of that mattered, but I wanted to understand what clinical work felt like when there was a real patient in front of me.

That is what drew me to IQ’s Neurodevelopmental Clinical Practicum.

The outline stood out because it sounded practical. I wanted to sit across from a patient, observe what was happening in real time, and work with approaches we had only studied before.

That is what the practicum gave me.

One of the final components of IQ’s Neurodevelopmental Clinical Practicum is the Community Based Project, or CBP for short. It brings together what trainees have been learning through observation, patient interaction, supervision, and planning. It also involves IQ’s inpatient community, which means trainees are not planning for one patient only. They are planning for a room full of people with different needs, diagnoses, comfort levels, and ways of participating.

Before this experience, I understood community-based activities mostly in theory. I knew that structured group activities could help inpatients with life skills, emotional regulation, and socialization. What I did not know was how much work goes into planning and leading those activities while keeping patients engaged in the moment.

For our Community Based Project, almost all the inpatients we were working with were living with psychosis or substance use disorders. The goal was to plan activities that supported participation, regulation, and social interaction in a way that felt manageable for the patients. Each trainee was asked to research methods that had been used in similar settings and could be adapted for our patients. We then chose activities that felt engaging and manageable for the population we were working with.

We selected the Drum Circle, Pipe Cleaner Flower Activity, Foil Butterfly Painting, and Clay Mirror Art.

Whoever proposed an activity became responsible for leading it, while the rest of the group assisted the patients. My supervisor gave me the role of leading the whole project. She told me, “You look like someone who can take responsibility,” and I agreed.

We were not given a fixed plan for every activity. That part was left to our research and preparation as a group. Her guidance was focused on the clinical side: how to handle patients, how to help them feel seen, how to connect with them so they could enjoy the activity instead of feeling forced, and how to keep them engaged without putting pressure on them.

As project lead, my role was broader than leading one activity. I had to make sure the project worked as a whole, which included coordinating resources, managing the budget, preparing the space, and introducing everyone at the start so patients felt welcomed and safe rather than watched.

We had originally planned five to six activities. Later, we realized that moving through too many stations would rush the patients. We did not want to complete activities just to tick them off a list. We wanted patients to have time to create something, stay with it, and enjoy it before moving on. So we reduced the plan to four activities.

That was the first adjustment.

On the day of the project, I reached early to make sure everything was ready. I remember feeling excited, but also nervous. I kept wondering whether I would say something wrong, whether a patient would react unexpectedly, or whether I would know what to do if the room became difficult.

The day went more smoothly than I expected.

A Moment That Stayed

The moment that stayed with me happened during the Drum Circle.

We had planned for one trainee to lead the activity while the patients followed along with spoons. Halfway through, she noticed that some patients were curious about the drum itself. Instead of sticking to the original plan, she started passing the drum around.

That changed the energy in the room.

The patients began creating their own rhythms and beats. Some who had been sitting quietly started showing interest while a few waited for their turn with the drum. They seemed more confident, less like they were performing for us and more like they were genuinely enjoying themselves. Instead of leading them, we found ourselves following their music. Even during the breaks, some of them kept coming back to the drum. That was the moment I understood why the Community Based Project comes at the end of the practicum.

By that point in the practicum, we had spent time learning how to observe, communicate, and think clinically. During the Drum Circle, those lessons came together in the room. We noticed what the patients were showing us, and the activity became more meaningful because we responded to that.

Another thing I learned was that participation does not look the same for everyone. Some patients asked for help. Some helped each other by leaning over to look at someone else’s flower or butterfly and offering suggestions. Others stayed in their own space and worked quietly.

I had gone in expecting every patient to engage with us directly. During the project, I realized that some of them were engaged without needing to interact with us constantly. One patient showed no interest in the activities at first, but later reached for the drum himself. That shift helped me understand that the project was working, even though it did not look exactly the way I had expected.

Concepts like person-centred care and therapeutic communication had always felt abstract to me. I had studied them, but I did not fully understand how they looked in practice.

Watching them happen in real time changed that.

When we let go of the fixed plan and responded to the patients’ interest, I saw person-centred care happening in the room. It was a choice we made on the spot, it was recovery-oriented practice showing up through the way we responded to the room.

I came into the project as someone who likes structure. I like setting expectations, knowing what comes next, and managing the workload accordingly.

I left more comfortable with flexibility.

The Drum Circle is the clearest example I have. The plan was one thing, the room decided something else, and the better version was the one we had not decided beforehand.

I think this will affect the way I approach future group activities and clinical work because I no longer feel that I need a backup plan for every possible patient reaction. I want to build in room for patients to redirect the activity themselves. If a patient reaches for something we did not offer, or takes an activity somewhere we had not planned, I want to treat that as useful information about what they need in that moment. I do not want to see it as noise or distraction.

That is a big change for someone like me, because I came in wanting structure.

Moving forward, I want to focus less on executing a plan perfectly and more on staying present enough to notice when the plan needs flexibility.

For psychology students considering this practicum, I would say this: look for opportunities where you can learn by working with patients directly. Reading and studying are important, but some lessons only make sense when you are in the room.

For future trainees, my advice is simple: go in with a plan, but hold it loosely.

The moments that matter most in this kind of work rarely show up exactly where you expect them.