OTS 016: Clinic vs. School-Based and How We Can Learn From Each Other With The Anonymous OT

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Welcome to the show notes for Episode 16 of the OT Schoolhouse Podcast.

Join us as Abby has a conversation with fellow pediatric blogger, The Anonymous OT (whose name will be revealed) from TheAnonymousOT.com. An experienced pediatric OT, The Anonymous OT has practiced in school-based settings as well as in a clinic and in-home health settings. Together, Abby and our guest discuss the similarities and differences between school-based and clinic occupational therapy evaluations and services. A new place to review and search for continuing education courses is also reviewed.

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Links to Show References:

TheAnonymousOT

We recently named The Anonymous OT as one of our favorite blogs and now we're fortunate enough to have her join us on the podcast. Her post "In Defense of School Therapists" recently went viral in the OT social media world. Be sure to check out her blog at TheAnonymousOT.com

AOTA Professional Guidelines for School-Based OT

Briefly discussed in the episode, AOTA members can access the "Guidelines for Occupational Therapy Services in Early Intervention and Schools" Every school-based OT should have a general understanding of this document as well as your state guidelines which you can find here.

CECourseReview.com

Also Announced on this podcast was a new website to review and search for Continuing Education Courses. CEcourseReview.com is a place where you can look up courses before you take them and then review them after you have taken them. It may be small now, but you know this is going to be a valuable resource as it continues to grow.

If you have taken any of our podcast professional development courses, you can review them on CEcoursereview.com here!

Freebies!

Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs.

Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com

Well,

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Episode Transcript

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Amazing Narrator   

Hello and welcome to the OT schoolhouse podcast. Your source for the latest school based occupational therapy tips, interviews and research now to get the conversation started, here are your hosts, Jayson and Abby. Class is officially in session. 

Jayson Davies   

Hey everyone, welcome to the OT schoolhouse podcast. My name is Jayson Davies. I'm one of your hosts for the podcast here. Abby piranha is another host, and she will be with us shortly to do an interview with the anonymous ot many of you have probably heard of her. One of her recent blog posts about school based OTs actually went viral recently, kind of about how school based OTs are undervalued and under appreciated, and so we'll get into that interview in just a minute. Today's interview and podcast episode is not a continuing education opportunity for the podcast today. However, just want to remind you all that if you're interested in earning web based professional development, we have a promo code if you use ot school house all one word at medbridge education.com you'll actually earn $175 off your initial subscription. So be sure to check that out. If you enjoy watching videos to earn professional development, they have a wide assortment of different videos over there, and they actually allow you to watch the first chapter of any video completely for free, even before you sign up. So that's really kind of cool. And so you can watch the video, or maybe the first chapter of a few different videos, to find out which one you really want to watch, or if there's multiple ones that you want to watch. And from there, you can use our promo code, ot schoolhouse, all one word, to get $175 off your subscription. We are an affiliate for them, so we do earn a small commission. However, we do recommend them because they have a ton of courses for OTs and quite a bit of content that's related to school based. So other than that, we just want to remind you all that we'll be at ot the Occupational Therapy Association of California conference and later this month, october 25 I believe it is. We're actually going to be presenting session number 75 on Saturday afternoon, so we'd love to have you there say hi and get to know you a little bit better if you're going to be there. So with all that, I'm going to let Abby take over. She has an introduction and get into her interview with the anonymous OT. 

Abby Parana   

Hi and welcome to the OT school house podcast today, on the podcast, I have the anonymous OT. She is a pediatric occupational therapist with extensive experience working in home health, community, school and clinic based settings. She began her blog the anonymous ot as a way to provide candid insight and an open forum for both parents and professionals to freely discuss their experiences related to the world of pediatric occupational therapy, and now for the big reveal. Welcome Jessica to OT school, OTs Podcast. I'm super excited to talk to you today. 

Jessica (The Anonymous OT)   

Well, hello, yeah, hi. I'm a real person. My name is Jessica. 

Abby Parana   

Now that you've been unveiled, I know 

Jessica (The Anonymous OT)   

it's very exciting. I know everyone's been waiting on pins and needles, but I am a real person. It's 

Abby Parana   

true. I found your Well, I found your blog a while ago. I have to be honest, and I have always loved reading your blog posts, I found them very valuable, particularly when I first started as a newer therapist working with kids. So I really liked reading them. So thank you. 

Jessica (The Anonymous OT)   

Oh gosh, thank you. Thank you for reading. It's kind of crazy when you start something and you just kind of put something out in the world, and you kind of wait to hear back, and you kind of wonder how people are receiving it. So I guess five years later, it's definitely kind of caught traction, and I've just really enjoyed kind of the connections that I've made, which sounds weird when you start something called the anonymous OT, that you can actually make great connections and really just be inspired by the OTs that I've met in this process. 

Abby Parana   

Isn't that true? I think with online media, you get that opportunity to kind of connect with other occupational therapists that are trying to do the same thing, promote our profession, promote our ideas, and just connect with each other so that we can make ourselves better as therapists. 

Jessica (The Anonymous OT)   

I completely agree, yes. 

Abby Parana   

So let's get into your background. What what are you doing currently, and kind of what led you up to doing what you're practicing now as a therapist.  

Jessica (The Anonymous OT)   

Yeah. So I've been a mostly a clinic base. I would say the majority of my career has been in the clinic. I've definitely done a lot of the other things, but I always come back to clinic. That's kind of, I think, where my bread and butter is. But I was, I was never gonna be a pediatric OT. I went to OT school to be a hand therapist, and, you know, I was gonna, like, make cool splints. And, you know, and it just so happened. I had one of the best field work educators I could have ever asked for in one of my first level ones, you know, like, it was like, week two of school, and I was like, oh, man, pediatrics. I kind of like it. And, you know, I just kind of, I think that's why I tell a lot of my students, even when they come in to do a pediatrics rotation and then they're like, I'm never gonna do pediatrics. I'm like, no, never say, Never, right, you never know what will happen. 

Abby Parana   

Oh, that's hilarious, because I was the same way when I was in school. I was like, There's no way I'm doing pediatrics. Like, I'm just not gonna do it. I'm not working with kids. I'm not it was too intimidating for me. I got, like, a little nervous about dealing with the whole just kids, parents. I was really anxious about that, and I thought, Oh no, I'm going to do geriatrics, or I'm going to do neuro rehab or those types of things. But school based, I love the kids, like it just turned out that way. So I can really in that experience in that way.  

Jessica (The Anonymous OT)   

It's kind of crazy. Sometimes it just you fall into what you do, and you know, been doing it for many years now, and I, you know, it's an awesome experience. And even within pediatrics, there's so much you can do, whether it is school or clinic or home health or, you know, early intervention. So it's kind of great, because I've even explored within that kind of genre, or, you know, area of Pediatrics. But, you know, I think it's, it's clinic has always been my home, so I think that's where I come 

Abby Parana   

back to. So how long have you been practicing in pediatric therapy?  

Jessica (The Anonymous OT)   

About 10 years now. 10 years, yeah, yeah. 

Abby Parana   

And, and it's not you've done school based and clinic based as well. 

Jessica (The Anonymous OT)   

Yeah, yes, I dabble. I do a little bit of school, which is kind of, I just got back into part of my week is a contract in a school system, which prompted me to write a little bit about the school system recently, because you kind of forget about it when you're in the clinic. And I just kind of got back into the groove of school starting, and I'm like, oh, school therapist, like, you're amazing. And, you know, I think we take it for granted what other people are sometimes doing in other settings. So just recently, I kind of just had that right back in my face of like, oh yeah, we're all doing something a little bit different here, 

Abby Parana   

right? Which is actually how I ended up reaching out to you. I came across on my personal Facebook feed the article that you wrote in defense of school based OTs, which actually was kind of hit me at a time in my own moment as a school based therapist, where I had kind of a contentious IEP maybe not contentious isn't the right word, but it was one of these IEPs where I was very anxious going in, where I was new to the student, and I had too much background information to not be nervous about it. 

Jessica (The Anonymous OT)   

Sometimes there's too much background, right? Too much.  

Abby Parana   

And I thought, Oh, if I could just just not know any of this, so that I could just give my you know that I wouldn't, my nerves wouldn't be tainted by this. But when I read it, I thought, Oh, thank you for writing that. Because I just really thought to myself, Oh, my gosh, this gets it. It's a different school based, OT and clinic based are very different. And so what, what kind of led you to write that article? I guess I just what, what were you thinking when you decided that you would write it? Because anonymous, ot seems like a very you're doing that so you can share your opinions.  

Jessica (The Anonymous OT)   

Yeah, and it's, it's kind of the whole reason that I started it was, you know, I think pediatric OTs, we get kind of categorized in the like, the bubbly, awesome, fun rainbows and butterflies, which is not a bad thing to be associated at, you know, like, there are definitely worse things. But I think it makes talking about the hard stuff even harder, because people associate with us. I hear that all the time. Oh, you work with kids, how cute. And I'm like, Yeah, I got punched in the face yesterday too. But, like, there's, there's different things that people don't know. And I don't know that we always talk about it. We tend to talk about it, you know, in the break room or, you know, or in the waiting room waiting for a parent, you know, we're just having a rough day, and sometimes I think we feel guilty about it, almost like, Oh, we're not allowed to, you know, address how hard this can be. Sometimes, yes and, and, and that's was the, really, the whole point of the blog to begin with, and to kind of acknowledge that some of these things are hard to talk about, but, but everyone's kind of experiencing them. So when I went into this school not too long ago, and I'm like, carrying all this stuff on my shoulder, and there's nowhere for me to go, and I'm like, ooh, and I'm meeting these new kids for the first time, and I'm like, Okay, I don't know how they're gonna react. I'm pulling them from their school, you know, and I don't have anywhere to take them, and I, you know, it's just, and. It's so out of my bubble where if the kid walked into the clinic, you know, I was gonna have it set up perfectly, and it was gonna be, you know, the lighting was gonna be great. And I just had so much less control in that moment. And I was just like, yeah, school therapists do this all the time. And I just kind of felt like we needed to acknowledge that a little bit, that what what you guys do, is hard to do all the time, and I also think that it gets overlooked because people don't have a face a lot of times to put to your name. You know, sometimes you might not see you in an IEP meeting, or they might not know you as well as they know a clinic therapist. And I guess just in that moment when I'm like, in that stress of the school, I'm like, man, like, they really need a little more recognition. So that's kind of where the post came from. It was that moment of like, wow. Like, I wish I could just give you all a hug and say thank you for what you do. 

Abby Parana   

Thanks. And I think it, you know, I liked as well, that it really touches on that there is a difference really between what an OT does in a medical model or a clinic model versus what a school based ot does. We're kind of beholden to do to two to two different sets of circumstances and kind of rationale behind why we're providing therapy services to begin with. And that really, I mean, and I like that it was kind of like we can't compare the two in a us versus them way that we really need to support each other. 

Jessica (The Anonymous OT)   

Yes, which I, I, sometimes, I, and I've been in those situations where it feels like an us versus them, and I'm like me too. Why? Like, No, we should be on the same team. And I think we get defensive. And I think that as clinicians, as as OTs, we are caregivers, we are problem solvers, and I think a lot of the times we want to be the one to solve all the problems. So sometimes it's hard to, like, no, no, I got this. I got this. No, I'll tell them what to do. And it becomes almost this little like back and forth thing, when really it should be a collaboration. Because, gosh, the school therapist knows the kid in a setting that I never see them in, and I should, like, just take that as, like, awesome information. Like, please tell me everything you see at school, what works, what doesn't work. How can I help? And when I've had those experiences, the child makes so much more progress because we're a team. We're not working against each other 

Abby Parana   

and vice versa. I think you know, clinicians in a clinic, you guys have access to quite a few tools that we at school do not, you know, I come in with my little wheelie bag full of tricks, and I try to carry as many things as I can in my hands to provide a similar situation to a clinic I'm actually quite lucky to have. I have, like, almost a motor room at one of my schools where we have a swing and we have tunnels and we have, like, just a lot of space. We have a whole classroom to ourselves that is kind of awesome. Yeah, developed for the program that I'm in. So we get an opportunity to kind of give the kids better I want to say just a like, a better experience, as far as getting involved with their gross motor and their sensory motor and all of those components. So I've been lucky, but I've also been the OT that has said, like, where's a room I can see this kid in? Or do, is there an area? And they kind of direct me to a closet that isn't being utilized at the moment, and I have to try and figure out how to turn the hallway into treatment and try to turn these different environments into treatment so, but I know clinic based, so if you're picking up a child in a clinic for services, what kind of does your assessment look like, and what do you, I mean, what is the model that you're using? 

Jessica (The Anonymous OT)   

I mean, I, and this is what I realized from being in the in the school, is, you know, I kind of have the freedom to do what I want, you know, and to an extent, obviously, within the parameters of OT, but there's not necessarily that like that tie directly to the educational program, you know what I mean? So I can do, oh, gosh, I can do, you know, probably a lot of the things that you look at, but I have kind of a lot more wiggle room as far as, Oh, mom says she wants to work on this. Yeah, yeah. We'll throw that in there. I feel like the sensory integration piece, I tend to have a lot more freedom to expand on that, for sure. Yeah, I did. I actually just had a parent in the school system that was like, well, we want to transfer our services into the school because I don't have enough time to take him to the clinic, and he's doing sensory integration therapy in the clinic. Can't you just do that at school? And I'm like, that's not really how it works. No, we're very different models. It's different things. So I kind of had to explain that to her, that it seems more convenient, sure, but you're not getting it's not the same service. 

Abby Parana   

Right? And it and it just isn't, because we can't do we can provide strategies for children experiencing sensory difficulties if they are impact, if they are impacting their performance in the classroom. It's not that we're trying to fix it from a sensory integration model, like we're not trying to fix the actual deficit area. In those instances we because we don't have the tools.  

Jessica (The Anonymous OT)   

Exactly, exactly. And sometimes you might have to take more of an adaptive strategy in the classroom, and you know, as whereas sometimes we can use more of that full blown sensory integration theory, right? And so it's, and I think that's kind of the hard part for some parents to understand, is that it is different. 

Abby Parana   

Yes, definitely. 

Jessica (The Anonymous OT)   

But then that is also hard sometimes, when then you get the whole like, well, then tell them to do this. So, you know, they might see us working on a skill in the clinic, and they're like, well, can't you tell his school ot to work on that? Well, no, because they're working on something else, and, you know, they kind of have rules that they have to follow. So I kind of am bummed that there's a lot of times that it like, looks like you guys can't do something to a parent, when really, that's just the model that you guys are working in, right? So I think, I think it's my duty as a clinic therapist to help the parent understand that and to help educate them on what you guys are doing, so that they can really appreciate the services that they are getting in the clinic or in the school that they don't realize that they're getting. If that makes sense. 

Abby Parana   

No, that makes total sense, because also as a school, OT, I don't want to duplicate anything that you're doing in the clinic, but also the purpose of a child being at school is to be at school and be educated. And so as an OT, we support that because, or as an OT in the school setting, we are supporting that specifically because that is the purpose that that child needs to be at school, is to be educated at school, not to receive occupational therapy, whereas, if they're going to a clinic, they're specifically going there to receive occupational therapy. Perfect, that's 

Jessica (The Anonymous OT)   

perfect. Yes, yes, yes. Pretty accurate. 

Abby Parana   

Like, because I that to me, I'm because I get frustrated too, because I've also had where, oh, they can just get ot from you, and not at the clinic, but I know that they need kind of something a little bit more than what I can give them in a school setting, and so I encourage them to go get that outside 

Jessica (The Anonymous OT)   

of school. Yeah, and that's and that, I think that all comes from us just kind of working together and seeing each other as as equals. And I think it's hard too, because as a clinic therapist, all of a sudden you're kind of thrown in and you know mom, you know dad, you know grandma, you know the sibling, and you kind of are thrown into this world where, when things don't go right at school, you know, they just hear the teachers report that, Oh, this isn't going well, and then they look to you and you're like, but I also trust your school therapist. I know that they've got this so it's hard because you might have this connection, and parents tend to turn to you, and sometimes that frustration gets misplaced on who you know, what they think someone should be doing at school. And I think as clinic therapists, we really need to stand up for our colleagues and say, like, listen, I know they are working on everything that they can and just and being as supportive as we can to help minimize that kind of separation that we might feel right and 

Abby Parana   

just Yeah, exactly. Like, if we communicate better between the OTs, you know, in the clinic and at school, as well as just kind of being self aware. I liked how in the article you talk about that, about being kind of more a little bit self aware of your own like, why you might say, like, Oh no, that therapist isn't doing the right thing. Because I've been, I've I've actually done that as well, and I've read it, I've read an assessment, and I just thought I knew more. But I mean, I it was a while ago, because I've also, I'm pretty sure other OTs have read my assessments and thought the same thing. But so that's why I like that idea of just being like, oh, it's, it's being self aware that, okay, this is a snapshot for me and a snapshot for them. Exactly 

Jessica (The Anonymous OT)   

your thoughts. Yeah, it's so easy to be like, I'm not the one being called out right now. Awesome. Okay, yeah, sure, yes. Oh. And what are they doing over there? I don't even know, and it's so like, I did that a lot as an insecure therapist, when you're first starting, because you're like, oh, they like me. Oh, I'm doing a good job, because they're not mad at me. So therefore I'm gonna just roll with this feeling, because this feels good. But then you also have to realize that that could easily flip flop the other way. And I think it's just realizing that it's not about you, you know, it's, it's, it's just the situation and the circumstance. So I'm sure we're all guilty of that, and I know we've all probably read reports, although, haven't you read or, like, written a report, and you're like, oh my gosh, I hope no one judges me when they read this report. Yeah, like, you know, 

Abby Parana   

three years later, or I, the kid comes up for a triennial assessment, and I look at it again, and I was like, oh, gosh, I tried my best. Like, I always put forth a huge amount of effort into these assessments. You do too. I'm sure you really try to look at every single part that could be but sometimes, over time, I think with, particularly with occupational therapy, the more you practice, the more you see things, and the more you understand the cause, like you just get better at your observation skills. You get better at assessing kids. You just get better at it. And and I in three years, that's a long time to get better at these things. And so some reports that I even wrote, when I reread it and I read my recommendations, and then I realized that over those years, we've implemented them. And oh gosh, I'm really glad I got a chance to reassess this kid, because I need to revamp all of what I recommended before. And I think recognizing that, yes, OTs are humans, yeah, we should all 

Jessica (The Anonymous OT)   

be forced to read our evaluations from like, three to five years ago and just be like, I can never judge anyone. Like we all grow and come from a different place, like, 

Abby Parana   

it's okay, it's okay. We're all learning together. And I think that's the really cool part about what you're doing with Anonymous OT and you know what we're trying to promote with, like our own podcast too, just that conversation, realizing that we can really learn from each other. And that's really what I took out of the article. I loved that part of it, that don't pin each other against each other, we can really learn from everybody, as OTs in a collective group, 

Jessica (The Anonymous OT)   

yes, yes. I love that. Thank you. I was that was like what I was hoping that we could kind of like a good, like a feel good, we should work together, kind of kind of feeling 

Abby Parana   

that was totally it, yes, awesome. I also, as I because I loved your blog. You wrote this article that I found that was, Is it ethical? And I just thought that that was a really cool article, just in the sense of Yes, OTs were forced to make difficult decisions. Just what are your thoughts on that? 

Jessica (The Anonymous OT)   

Yeah. I mean, think about it. I actually, I thought it was interesting. You know, we talk about what we're willing to do as therapists, because we're usually bending over backwards. Like, think about the fact that you get, you get shown a hallway or, like, a stairwell, and you're like, Okay, I'm gonna treat here, because that's what's available, right? And someone made a really interesting comment on the blog. They were like, okay, but wait a second, in what other profession is that okay to treat under a stairwell, like, Should we be standing up for ourselves more? I was like, Oh, well, that's kind of a good point too. Like, I think we're all very, I don't mean to generalize all of us, but I feel like a lot of us in our profession are very, you know, we're problem solvers. We want people to feel good. We're caregivers, and so when we're given a hallway or a closet, we're like, okay, I'll make it work. And and that happens a lot in other ethical situations too. I mean, you're right. The first the first one I put in there, was like, you know, when your clinic won't even buy the real assessments? And you're like, wait a second, this is not good. I mean, there's so many situations, but you know, you're put in these kind of tough spots where your choice is like, what can I do that's ethical, but also still helps people, right? I think, I think that's what we're striving to do every single day. Like, how can I be the most effective as a therapist? And I think sometimes that takes us to the the ends of what our scope of practice is. I think it takes us to the ends of our own, sometimes our own mental health of you know, definitely to help someone else. We sacrifice a lot in that, which I think is important to remember too, that wait, maybe we should kind of stand up for some of these things and make our thoughts known so that we can be even more effective in our treatments. No, 

Abby Parana   

you're absolutely right, and that's kind of what I got after reading that. I was thinking to myself, Oh, gosh, yes, we need to be a little bit more assertive in a lot of ways, or I could stand to be a little. Bit more assertive in a lot of ways. 

Jessica (The Anonymous OT)   

I think assertive is a great word for it, yeah. Like, yes, assertive, yeah. 

Abby Parana   

So when you're stuck, like, No, my job is important well, and I know that it is, because when I go to, like, exit a child from services, then it becomes really important. But I need. 

Jessica (The Anonymous OT)   

y'all need me, yes, yes. 

Abby Parana   

But when I go to do the actual work of what I need to do, and all I can find is a hallway or a closet, I need to be a little bit more like, hey, we said this kid needs this. I need to provide it in a in a real way, in a real sense. 

Jessica (The Anonymous OT)   

Right? And but then there's also that part of you that's like, because I think OTs are very creative too, are I can make this work, this stairwell, okay, we got some proprioception. Like, you know, you're doing whatever. 

Abby Parana   

Oh, absolutely, I mean, and sometimes it works out. Sometimes you're just like, You know what? This actually works out fine. I've, I could train here every day. 

Jessica (The Anonymous OT)   

Yeah, you're using the natural environment, right? Like. 

Abby Parana   

Depth perception, opportunity going up and down stairs. Like, I don't know, you're 

Jessica (The Anonymous OT)   

made for this. We are made to spin a situation in, like, the most positive way. 

Abby Parana   

Right? So get something functional out of it exactly, exactly. So. 

Jessica (The Anonymous OT)   

I mean, I think we're also really good at it, so that sometimes makes it easier for us to be vulnerable, because we try to make the best out of the situation. 

Abby Parana   

Yes. Oh, definitely. So, if you had so when you're trying, I guess maybe not trying, but when you're recommending discontinuing services in a clinic your help, I guess you have a certain standard, or I'm sure you have a certain plateau, or if a child's met their goals or you can't progress any further. How does that work? Because I found in schools, it's extremely difficult at times to justify exiting a child. Although even if I've done an assessment and I feel they've plateaued, I almost feel like the plateau that's the most difficult time. 

Jessica (The Anonymous OT)   

Yeah, I think that that's what I always think about. Well, when it's almost like, when you work with a child, I mean, if you were working in another setting and someone had an injury, your goal is to get them back to where they were. You have a baseline of, like, even if you can't get there, you have a baseline of what you want to get to with children. The sky's the limit. Every kid, you know, when it when a child is born like, you know, the parents expectation is infinite, you know. And so it's kind of, it's so hard when you see that plateau to say, hey guys, I think this is where we are right now. And I think that's heartbreaking, and that's really hard, and I think that's sometimes why people end up pushing kids probably past when they should be done with therapy, because it's so hard, you almost feel like you're the bad guy. Like, Oh, you're the one that's gonna say that my child can't make more progress. Like, how dare you and you're like, but I'm also bound by the ethics of my practice and that, you know, right? It's no longer medically necessary. So you kind of have this internal fight of, again, it comes back to the ethical thing, and us trying to be, you know, do the right thing, but also support these families that we're very much a part of. So I think the plateau is the hardest. I think because you I always try to get as much hard evidence as I can, you know, to say, hey, look, here's our functional goals. Here's where we were last. Progress note, the progress note before that. And here we are today. And I can't, you know we need to show progress in order to continue services. And I usually also spin it as in the clinic. I'm like, You know what? Let's take a break. Let's have a moment of not having ot in your life and see what happens. And I will tell you that's usually the best scenario, because often when they get that break and they see everything's gonna be okay. I don't necessarily hear from them again and but it was that option of, like, you can come back if you need to. We'll just get another prescription, We'll reevaluate. But it's kind of giving yourself a little bit of separation, which I know is probably harder in the school. I don't know how, 

Abby Parana   

yeah, it can be, because typically we provide services for a very long time in school. It seems like there's not this, because I think your frequency and duration is probably 

Jessica (The Anonymous OT)   

greater for a while. Yes, yeah, oh, like that. Most of the times I'm seeing a kid one time a week for like an hour, yes, 

Abby Parana   

yeah. And most of the time we're doing at the most, it's usually one time a week for 30 minutes. And then we're trying to implement something that can be carried out by other people in the classroom, or we're trying to implement things so ours is kind of more dependent on access to curriculum and and. What they're doing in the classroom. And we're kind of coaching people to do Yes, something daily, 

Jessica (The Anonymous OT)   

yeah, and y'all do that in like, 15 or 30 minute increments a week, which, let me tell you, as a as a clinic therapist coming into the school, I'm like, oh, it's been 30 minutes. Oh, wait, like it's it goes by so fast, 

Abby Parana   

super fast. And there's a lot of behind the scenes, things that don't get counted into those 30 minutes. I almost feel like the 30 minutes are just the time with the kid, but actually there's, oh, I've printed out all these visuals I've made, you know, these, you know, sensory diet cards, or, like, talk to this teacher, and then I've emailed this person and called this person and observed them in here and there, and those don't really get counted in the 30 minutes sometimes.  

Jessica (The Anonymous OT)   

Yeah, yeah. I mean, again, this is just why I need to sing your praises, because you guys get stuck on and say more. But I think that that, I mean, I just feel like that gets under recognized, because, again, it's just something that people can't see. When a parent can watch me in a session and they see me sweating and picking stuff up and doing this and that, like they can kind of put a value to it, right? I think it's harder to put a value to something you don't see day in and day out. So that's again, that just comes back to, like, the whole reason for for for writing that, because they just think, I would love to put value to something that people don't necessarily see, 

Abby Parana   

Right? And I think to the clinic setting, when you're doing all these things, it's much more active the chat, it's it's kind of a whole different approach, in a way. So in school, you're not going to see a lot of OTs doing the same types of treatments, because we just that's not the goal for a lot of our treatments, or exactly, really, sometimes it's not even treatment. It's more collaborating with staff to make sure that the kids learning. 

Jessica (The Anonymous OT)   

Oh, totally Yes. I agree. Yeah. 

Abby Parana   

So, so what do you think about working with children as a therapist? I recently was thinking to myself that I feel like as OTs, we end up being vulnerable, but that also requires us to be brave, and that kind of made me when I'm thinking about exiting kids, those difficult conversations you have to put your professional self out there, and a lot of times it's not received perfectly. So how do you handle that kind of situation? 

Jessica (The Anonymous OT)   

I mean, it's hard. I mean, I think we keep coming back to this idea that like we're human, like we're human, and we have feelings, and, you know, it's hard to maintain a perfect that that kind of almost barrier of professionalism, when people kind of judge you, and we talk about this in school, you know, therapeutic use of self, who you are, is a part of who you are as a therapist. So I think that's really hard when you put yourself out there, and then you get that sort of feedback that's not so positive and right? I've had to let that go again. I think that comes with with age, I don't know, experience time that yeah, that you're you're not gonna please everyone and and that's okay, you know, as long as you follow what you believe is right, and you follow, you know, right? Our profile, you know, our profession has guidelines and things like that that we have to follow. And I think having that in your back end, and also, like some good co workers, that'll, you know, make you feel better. 

Abby Parana   

Very true, yes. And I think too, remembering right exactly, we have professional guidelines. We have things that, and I've kind of tried to start defaulting to that more often, like these are the guidelines for ot in schools. I have to follow these. And if that's the guideline, that's the guideline, I wish we had some sort of standardized test score, something that could be, like, very definitive. Our guidelines can be a little gray, but that's the beauty and the burden of being an occupational therapist. I think 

Jessica (The Anonymous OT)   

not. I mean, I agree with that so much, like, it's like, it's such an art and a science that it just, it's sometimes it's so hard because you're like, Man, I wish there was a like, a little bit more kind of cut and dry. That would make this a lot easier on me, because then again, you're also wrapped up, and you feel the emotions of the parents and the child, and you're like, Oh, I just want to make it work. And you have to just kind of be the bad guys, like, what it feels like the bad guy sometimes and and that's hard, but also necessary sometimes, and sometimes you're the one that kind of provides that perspective that other people didn't see, or acknowledging that we're at a certain point. So I mean, but the nice thing is that we're coming at it from a very holistic way. You know, we're looking. At the child. We're doing our best to to provide these recommendations with the whole child in mind, right? And I know, and I just feel like sometimes those, especially in an IEP meeting, I feel like there's just all this tension kind of before you even sit down. Because I'll talk to a parent, and they'll be like, I'm going for the IEP meeting tomorrow. And I'm like, okay, they're like, What should I say? And I'm like, what, you know, it's fine, like, it'll be great. Just talk to people like, I try to, like, make it not so intense, because there is just, like, this intensity about it that seems very like, almost unnecessary, but it feels like the parents are gearing up for battle. Everyone there is there to support you. And again, I think that's hard, because I've never met an OT that, like, wants to take services away that are like, I'm gonna take your ot away. No, like we we're there to help you. So when we do say now is, is time. I mean, for the most part, we really mean that like that really means that our hands are tied. We've done what we can do, and sometimes that end result isn't what people want to see, but it's the result of us doing what we can, 

Abby Parana   

right? And, oh, absolutely, it's just kind of, I almost think, like releasing my idea of how I think other people should react to what I'm saying. 

Jessica (The Anonymous OT)   

That's a very sense, yeah, no, that's perfect, yeah, like 

Abby Parana   

some, I mean, just to sum it up, it's like, Okay, I'm gonna have to, I have to give you this opinion, because you have ot services, and this is based on my assessment and based on what my findings are and the progress and the years and all of that. I have to give you this recommendation, and it's to, you know, exit services, the child can gain more educational benefit just in the classroom, as they are doing, and that can be a difficult thing to say. It's not that I'm giving up. I just feel that they are not getting benefit from my services, but they'll get more benefit in the classroom, yeah, that kind of thing, yeah, 

Jessica (The Anonymous OT)   

no, totally I agree. And, and kind of the same thing in the clinic. It's like, I want to be the one that makes all the difference, and I want to find all the pro the solutions to all the problems, but however, you don't really need me right now, like, you're okay without me, and it's almost exiting yourself too. Of like, hey, they're gonna be fine. Yeah, I don't know if that's more in the clinic, too. Of like, they don't need me. Like, there's like, you gotta kind of let that go. Like, Fly, little bird, you'll be fine. Like, yes, I think we get caught up in that too. And sometimes it's hard to realize, Oh no, they they don't need me. So almost in the clinic, I feel like you get wrapped up a little bit in that too, of like, okay, no, no, no. You can let them go, yes. 

Abby Parana   

And I worry about those kids too all the time, the ones that I'm not seeing anymore, I still just kind of want to check on them. Or I think I'll rack my brain. What did I miss? Was there something I missed? Like I would replay my assessment. I'll replay the past goals. I'll think and think and think, Oh, I could have done this for their handwriting. You know, even though I know that it probably wouldn't have made a huge difference, I still am like, Oh, I could have tried blue highlight paper and spread the yellow like I don't, 

Jessica (The Anonymous OT)   

yeah, but again, you're also talking about the hard part about OT is that there's not necessarily a cut and dry path that you take. It's not like, oh, handwriting problem. We're gonna do this, then this, then this. Like, Sure, there's evidence and there's best practice standards, but there's also this acceptance that, like, what works for one kid might not work for another, and I think that's what makes our profession messy, is that there's not an X Y Z of what you have to do, right, which can be frustrating, too. Like, oh, if there was only the x y z, I would do that, and they would be great. And we don't, we don't get to do that. We don't get to do that, yeah. 

Abby Parana   

So do you have any, I guess do you have any stories or any children that you worked with that you can think that you were like, Oh, this was just the best. Like, it's the story you would go to if you're having a rough day anything like, I sometimes I'll think back on my week and I'm like, I'm really grateful for that treatment session, because I had a blast, and that kid was awesome that day. Do you have anything like that that you try to do to just keep yourself fresh? 

Jessica (The Anonymous OT)   

I think that, yeah, you got to think I wrote about that once too, like, the little wins, we need, the little wins. And sometimes it's as much as, like, the kid put their shoes on today, like, yes, yes, that is my win. It made a difference. Yeah, I actually, it's funny you say that because I was actually just like crying the other day because I had this really tough family, and they didn't really believe it. This is also hard because people, like, think that you're like, talking about this crazy stuff when you start talking about sensory like, Who are you crazy? Easy lady, and what are you talking about, right? And I was trying to describe this child sensory issues, and they're like, yeah, yeah, you just want us to pay for services. And I'm like, No, I you know, here's what I found, like, take with it, what you will. And they actually ended up doing OT and they were so skeptical, and I actually just discharged them, and I got this long email from the parent that was like, we don't we didn't realize how bad things were and how far we've come. And we, we just thank you for looking at our child differently. And they sent like, this picture of him, like, going off to kindergarten. And I was just, oh, it's just falling I was like, sometimes it works. You know. 

Abby Parana   

Exactly, exactly that was.  

Jessica (The Anonymous OT)   

Actually, I'm gonna call that a big win, because that was, like someone that was making me feel like, oh, they don't even believe that I, like, am a legitimate practitioner. You know, when you start talking about sensors, sometimes you just lose people. And to go from that to this, oh my gosh, this, like, incredibly thoughtful Thank you. Letter was just like, well, I'm good for like, the next six months. Like, I'm good, I'm ready. Let's go. 

Abby Parana   

Right? It just keeps you going. And I think almost like, as OTs, we just need to focus on those little wins, like you said. Just focus on those little stories, the ones that you're like, oh, like, I, I recently had a student transition out of OT without an issue, when before it was dropping and crying, it's just running around the room trying to hide under things. And when we got him to just, okay, this is your drawer. It's time to go. And he went and put on his shoes, and he had his little thing, and he laughed. And I just remember thinking like, yes, yes, the square is gonna go swimmingly. That only was four sessions of tantrums, and now we're on the road to success. Like it was just those little moments where you're like, oh, transition without dropping to the ground and screaming. Like, this is fantastic. Like, I'm super excited about it.  

Jessica (The Anonymous OT)   

It's like, the moments where you feel like I'm actually making a difference. Because sometimes we get lost in that, we forget that. Or when I'm feeling most burnout is when I'm like, am I even, like, making a difference? Like, is this kid gonna be fine if they never see me again? And you like, kind of play that in your head, yeah. And when you have a moment where you're like, oh, oh, that's because of what we did, like, that's that's huge, and that can keep you going and keep you fresh. And you know it, we need those little moments. And you also have to look for them, because it's easy to kind of miss them. When you have those hard days.  

Abby Parana   

Oh, for sure, it can be really hard to miss though, or really hard to recognize them when you've had a hard day, or even when you're in a meeting and you just start thinking like, Ah, did I write the like, is this the right thing? And you just have to remember that yes, most likely one, you're not going to do any harm, I'm pretty sure, by playing with a child and make trying to promote skills, you're only going to do really good things for them, and they're going to gain something from it, for sure. 

Jessica (The Anonymous OT)   

Yeah, yeah. I agree. I agree. 

Abby Parana   

So speaking of staying fresh as an OT, we have to stay educated and of evidence based practice, which you have a really exciting new project that you were telling me about before we started this podcast. And I would love to hear you share it. It has to do with continuing education, and I just really think it's a brilliant idea. 

Jessica (The Anonymous OT)   

Well, thank you. And I don't know, I think a lot of other people are like this, because I've, I think all too often were picking something quick because it's like, oh my gosh, I don't think I got all my hours. Then, you know, sometimes you have those years where, like, wait, what I'm due Okay, so you end up just going for something quick, or, you know, or I've literally spent like, an hour looking for something like, when I need that motivation, like, I want a really good in person course that's just gonna like, oh, it's gonna give me, like, the motivation and inspiration. And sometimes it's just hard to find it, or it's hard to know if it's really what you want. Actually, just went to this course I was so excited about it. It was all about like, sensory and they spent like, 20 minutes just introducing the sensory systems, and I was like, oh, want, like, you know, it was like, Oh, this is not what I thought it would be, which, it was a great course, but it just wasn't what I was looking for. So what I've started, it's, it's called CE course review, and it's essentially, it's a work in progress, but I'm putting basically every continuing education course from every company in one place. So you can go in, you can put I want feeding courses, and you'll pull up every feeding course from any company. If you can imagine, that's a lot of courses, and I'm just going to keep growing. It, but I'm at the point right now where I'm really looking for a therapist to log on, maybe leave a review on some of your favorite courses. So if someone's pulling them up, they can say, like, Oh, this is a great one for a new grad, or, Oh, I really need to take this course on sensory integration. So that's that's where we are with it. And you can shoot me a message on there if there's, like, a course you want to see, or a feature you'd like to see, but it's called CE course review.com and just take a peek, and I would just be super grateful, because the more people that leave reviews, the better the resource becomes for everyone else. So it's really, it's not about, you know, knocking anything or, you know, it's just basically about helping you find the right course faster. 

Abby Parana   

I think that it's a brilliant idea. I also love the idea of being able to review a course and see what the other reviews have to offer. Because, yeah, you oftentimes I was thinking, Oh, I get a brochure in the mail, and I flip through it, and then I think this kind of applies. I guess it's in my area. Maybe I'll take it, but it's, I mean, continuing education is expensive, yes, and crazy expensive, crazy expensive, and we need to be able to review it. And I think too, if there is a review system like that that's being reviewed by professionals. I think that probably continuing education will even be a little bit more. 

Jessica (The Anonymous OT)   

That was my thought. 

Abby Parana   

Yeah, it was better, maybe not more better. That's a little. 

Jessica (The Anonymous OT)   

definitely older for everyone. I think that. I mean, I think it's holding something to a higher standard, yes. And when I tried to do it, like, when you were review, of course, there's like, five questions, like, what you can add your comments, but it's like, was the presenter effective? Sure, sometimes you go and you're like, oh, this, this instructor doesn't really, you know, they're not keeping my attention. Or even, like, Did you learn something? And some of the choices are like, Yes, I learned something new and it reinforced what I was already doing. Or, Yes, I learned something new and it broadened my skills. So sometimes you go to a course and it just reinforces what you're already doing, which sometimes you need those too, but it's kind of just letting people know kind of where the course is and what you can kind of take away from it. So Right? It's just an information system, basically. So if people were willing to log on, that would be awesome, because the more feedback I get from people, the more we can change it. Make it better, make it, you know, a better resource for everyone. 

Abby Parana   

Oh, I definitely think so. And as like my partner and I were trying to turn with ot school house into having our podcast be available for Professional Development and Continuing Ed and so I would find the feedback from people listening to the podcast and listening and taking, or, well, listening to the podcast, and then also just taking our quizzes and things that we're offering as Professional Development units, I that feedback to me would be invaluable, like, it would be really helpful at making our courses and presentations better as well. 

Jessica (The Anonymous OT)   

Totally, yeah, I agree. And, and how, and people might not even know, like, Oh, I could listen to a podcast and get continuing ed. Like, that's great, and maybe that works best for them. So again, it's just, it's having all those resources in one and just, I'm just trying to make life easier. We're gonna try. 

Abby Parana   

We, we're OTs. We, that's what we do. It's what we do. We try and make you path of least resistance. We're trying to make everybody independent and highly functional.  

Jessica (The Anonymous OT)   

That's all we want. That's all we want. Isn't that so much to add? 

Abby Parana   

Well, it has been a total pleasure, Jessica, having you on the podcast and chatting with you. I think we've covered some really interesting and important topics for OTs, working in schools and clinics, and just actually, in general, it's kind of nice to talk occupational therapy with another ot working in a different setting on the other side of the country. 

Jessica (The Anonymous OT)   

Right? We keep it fresh. That's right.  

Abby Parana   

I'm super glad that hurricane didn't get in the way.  

Jessica (The Anonymous OT)   

Yeah, we're safe. We're safe over here on the East Coast, but we're we're definitely thinking of those that were in the past, because that is just awful, but and thank you so much for having me. It has been a blast talking with you. I love like connecting with people again, it's awesome to be like behind this computer screen, but like meeting great people across the country. So thank you very much.  

Abby Parana   

Well, thank you for coming on the podcast, and hopefully we'll get a chance to chat again soon. And if you're ever out in Southern California, if I'm ever in your area, I will also come visit 

Jessica (The Anonymous OT)   

awesome. Sounds great. Thank you so much. 

Abby Parana   

All right. Well, take care and have a good night.  

Jayson Davies   

Thank you. All right. Well, that does it for today's episode of the OT school house podcast. I want to encourage you all to check out Jessica's website, both the anonymous OT and CE course review. It'd be really cool to have some of you actually review our courses over. There. I think she has them up. You just have to search for ot school house, and they pop up. So feel free to head on over there. Give us a quick review. Uh, we'd appreciate it, and I'm sure Jessica from the anonymous ot wood as well. Thank you again, Jessica for coming on. We appreciate having you, and you're welcome back anytime. One last thing before I let you go, be sure to check out ot schoolhouse.com forward slash Episode 16 for all the show notes and links to any of the content that Jessica and Abby talked about today, so we'll see you over there. Otherwise, take care. Have a good one. Bye, bye.  

Amazing Narrator   

Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed.

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OTS 016_ Clinic vs. School-Based and How We Can Learn From Each Other With The Anonymous O

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