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OTS 136: Why the IEP is Not Your Treatment Plan


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Welcome to the show notes for Episode 136 of the OT Schoolhouse Podcast.


Do you ever walk away from IEP meetings with a plan in mind, only to forget it later?


In this episode, Jayson Davies, MA, OTR/L, discusses why the IEP is not your treatment plan and the crucial differences between the two.


With actionable tips and insights from the OTPF-4, Jayson explains why creating a treatment plan is essential and how it provides support, protection, and clear direction for OTPs.


Tune in now to learn more!



Listen now to learn the following objectives:


  • Learners will identify how the treatment plan is different than the IEP document

  • Learners will understand what specific information is on a treatment plan

  • Learners will identify ways to protect themselves legally



Quotes


“What the IEP doesn't include is that 'how' component, how we are actually going to help the student meet those goals.”

— Jayson Davies, MA, OTR/L


“The IEP is the who, what, when, where and why, then the treatment plan is the detailed how, to getting that student from where they are now to the goal that we want them to achieve a year from now”.

— Jayson Davies, MA, OTR/L


“Plans to discharge or graduate a student from occupational therapy services needs to start from day one from that very first evaluation or the very first time that you are having discussions with the IEP team about a student”.

— Jayson Davies, MA, OTR/L


“A treatment plan can be a form of protection for both you and your counterpart to ensure that there is communication between the both of you”. — Jayson Davies, MA, OTR/L



Resources




Episode Transcript

Expand to view the full episode transcript.

Jayson Davies   

Hello, and welcome back to the OT schoolhouse podcast. Thank you so much for being here we are in episode number 136. I can't believe I'm saying that. It's just a big number. But yeah, I'm so excited for you to be here today. This has been an episode a long time in the making. And even though I have a slight cough, you might hear it in my voice. I'm not letting it prevent me from sharing this information with you today. It's just you and I today and to get things started, I have a quick question for you. And that is, how many times have you walked away from an IEP meeting with a plan in your head of how you're going to support a student. And then two weeks later, it's just gone, or maybe a month, you forgot about it. And you're sitting there trying to treatment plan for the next week, next two weeks, whatever it might be. And you just can't remember all those great ideas that you had during the IEP? Well, at the start of my OT career, this seemed to happen to me every single week until I realized why. And that was because I was not creating a treatment plan for each individual student. Instead, I was relying on the IEP as my plan. And it wasn't until about three years in as an OT practitioner in the schools, that I started to realize this and came to the conclusion that an IEP is not a treatment plan, it is not your treatment plan, it shouldn't be your treatment plan. And today, I'm not only going to share why that is. But I'm also going to share with you the differences between an IEP and a treatment plan, why you should be creating a treatment plan, and also how to move forward with taking actions to you know, actually create a treatment plan that you can use to move forward. So as we get started here, I do just want to point out one thing, and that is that the OT practice framework, the fourth edition uses the terms treatment plan and intervention plan interchangeably, I'm going to do my best to simply use the term treatment plan. But if you catch me and I use the term intervention plan, I just want you to know that I'm using those interchangeably today. So treatment plan is an intervention plan. And an intervention plan is a treatment plan. All right. So let's go ahead and Cue the intro. And when we come back, we are going to be diving into the differences between an IEP and a treatment plan and how you can get started with creating your treatment plans. 

 

Amazing Narrator   

Hello, and welcome to the OT schoolhouse podcast, your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started. Here's your host, Jayson Davies, class is officially in session. 

 

Jayson Davies   

Oh right. To dive into this, we're going to start by discussing IEPs. And we're just going to talk about the basics of an IEP and kind of how it comes together. I'm not going to spend too much time here because I want to get into that actual intervention. treatment plan. Sorry, see, I already messed up and use intervention first. But anyways, we're gonna start by talking about the IEP first. And an IEP is a legally binding document that outlines a student's educational needs and services. And it's used to ensure that a student with a disability receives appropriate educational services. That's like the basic definition of an IEP. And I think most of us if we have worked in a school for more than a month, we kind of get the gist of an IEP, right. There's four main components to an IEP, President levels of performance, which both you and any other service provider is also going to provide right, you provide your plops the teacher provides their plops the speech therapists, the physical education or adaptive physical education teacher, everyone includes their plops from the plops we then move on to goals and goals might be individualized in the sense that you create OTs specific goals, or they might be collaborative, where you and the teacher develop a goal together. Gold can work both ways. Just pointing that out here really quickly. So we have present levels of performance plops, then we have our goals, then an IEP is also going to include accommodations and supports, right? So if you're implementing any accommodations, or if you're providing OT as a support instead of a service that can go here as well. And then finally, we have services. This is where you are actually putting the type of service that you're going to provide any frequencies or the frequencies I should say. So twice a month, 30 minutes individual pullout session, right like that is your services. Now IEPs do have more than that all encompassed in there, right? You have like testing accommodations, you have some basic information about the student, what they qualify as and a few other things that go into it. But when it comes down to the occupational therapist role or occupational therapy practitioners role within an IEP There's four main components and those were the present levels of performance plops goals, accommodations and support. and services, now we can contribute to the rest of the IEP. But again, those are the four main pieces. So if we think about an an IEP will include, if we're talking about like the who, what, when, where, why and how the IEP includes the who, meaning you the OT, the what the type of service, the when the frequency of your service, the where, and the why, where you're going to provide that service and the why being you're trying to help the student meet those goals, right. However, this is where we're going to transition into the treatment plan. Because what the IEP doesn't include, is that how components, how we are actually going to help the student meet those goals? What are you as the occupational therapy provider going to do as part of your service, so that the student one year from now is able to write more effectively is able to maybe self regulate within the classroom is able to be more organized within the classroom, right? It doesn't say how on the IEP. And unfortunately, that is the piece that is often missing with occupational therapy services, and not just occupational therapy services. But like all the related service providers, right, we go to an IEP, we put this plan in place, and we just think it's magically going to happen. But we don't move to the next step, the next phrase or the next process, if you want to call it about how we're actually going to help the student get from A to B, that's where our treatment plan comes into play. So let's talk about treatment plans. All right. So again, if the IEP is the who, what, when, where and why, then the treatment plan is the detailed how to getting that student from where they are now to the goal that we want them to achieve a year from now. And a treatment plan is a detailed a very detailed guide that is created by the occupational therapist and potentially in collaboration with the occupational therapy assistant that outlines the therapeutic treatments, where an IEP has inputs from, you know, everyone on the IEP team from the parent from the teacher from all the related service providers, the treatment plan is more dedicated to occupational therapy itself. Now, that doesn't mean that it won't necessarily have input from others. But it's more of that input that you have grabbed and brought in as opposed to like direct quote. So you might use some information that you've learned from someone, but you're not saying like in your treatment plan that the parent says this about the student, No, instead, you're just saying the student enjoys cars. And maybe I want to take that into account during my treatment plan. Anyhow, the treatment plan is designed to be very detailed, and it's designed to be a guide to help you with treatment, planning and providing your therapeutic interventions. And as much as I would like to take all the credit in the world for coming to this realization, I can't you know, this isn't anything new. In fact, occupational therapy practice framework from a OTA identifies three steps to creating your treatment plan. So I'm going to go through those really quickly. And you'll see how what I'm saying just like aligns with this. So the first step in developing your treatment plan from or according to, though TPF. Four is developing the plan, which includes selecting objective and measurable occupation based goals and related timeframes. So we've already got that in the IEP, developing your occupational therapy treatment approach, I see that one's not in the IEP usually, and methods for service delivery, including what types of treatment will be provided, who will provide the treatments and which service delivery approaches will be used. Some of that may be included in the IEP, if not all of it. But there are also pieces that may not be in your IEP. And those three things are just step one of developing your treatment intervention plan. Step two, according to a OTA in the OTP F is considering potential discharge needs and plans. And that is exactly why in the A to Z school based occupational therapy course that I offer. I say that your plans to discharge or graduate a student from occupational therapy services needs to start from day one from that very first evaluation or the very first time that you are having discussions with the IEP team about a student. That's when you should also have your very first discussion about when the student may no longer need occupational therapy services. That is part of your treatment plan. You should be putting in your treatment plan. All right, when will I know when the student is ready to graduate from OT services. If we're not putting that in our plan, then the students never going to be ready for OT services right like we need to actually put something in there objectively. And you know it, it can be a little gray, right? Especially when we're just getting to know the student. But we want to have a plan. And we should be sharing that plan with the IEP team. We come in, we have our evaluation, we say what we have to say about the student. But near the end, we shouldn't be kind of saying, hey, all right now based on this evaluation, I think we need to see student Johnny, you know, for this amount of services to help with this goal. But the plan is for the student to eventually no longer need OT services, and maybe a little bit beyond that. So a OTA does actually say in though TPF. For that, considering potential discharge plans should be in or a part of your treatment plan. So I'm laying out there, it should be part of your treatment plan. And the third and final point that OTP f4 makes about treatment planning is that we need to be considering making recommendations or referrals to other professionals as needed. So if you're in an IEP, and you're sitting there, and you're thinking to yourself, hey, maybe we need to consider referring this student out for physical therapy or for whatever other type of related service provider you might be thinking of, that can either a come up during the IEP or be maybe you have this thought, but you're not quite sure of how to go about doing that, that could go into your treatment plan to look into it. And to find out what your district policies are about referring a student for a another related service provider. All right, so that is what the OTP f4 says about developing a treatment plan. Now I want to take that a step further and share with you kind of what I put onto my treatment plan. So you have an idea of what that looks like. Okay, so of course, we have the goals, accommodations and services from the IEP, I like to start with that, of course, with the student's name and the teacher's name. So I have that data up there. But a lot of that stuff just gets carried directly over from the IEP. So at the top of the page, Taylor Swift, let's go with that date of birth, 1989, whatever it might be. And then we get down to the next part, right. And that's where we're going to put in those present levels of performance, the goals, and the frequency of service, so present levels of performance, to not go into extreme detail. She holds the pencil really weird, right? The goal is for her to, I don't really care if she writes obviously just fine. But whatever the goal is gonna be and whatever the services are, right, shout out to Sheryl Crow, by the way, who was an occupational therapist and was actually interviewed by slate.com. On Taylor Swift's grasp, when all that came out, I'll be sure to link to that in the show notes. But anyways, beyond that, we are going to go further, we're not just going to include the plops the services and the goals and also the accommodations. But we're going to add in more. beyond what's in the IEP, I'm also going to move on to my treatment plan any relevant information from my evaluation, whether I just completed that evaluation in the past, you know, 3060 days, or if that evaluations a year or two years old, if there's any relevant information in there, I want to make sure that I have it easily accessible by putting it in my treatment plan. Next, I'm going to add specific strategies and methodologies or programs that I plan to use. So if I'm sitting in that IEP or either right before, right after the IEP, and I'm thinking, hey, the zones of regulation program would be perfect for this student, maybe in a group setting, I'm going to add that into my treatment plan. You know, that's not something that might go into an IEP, maybe you're maybe it doesn't make its way into the IEP, but it should be on your treatment plan. So now you say okay, well, my services are one time a week for 30 minutes in a group setting. That's an IEP, but on your treatment plan, you're saying, those are my services, and I plan to use the zones of regulation program during those services. Or maybe you plan to work on a skill during OT sessions and then generalize it into the classroom or in your treatment plan, you can put that you can even go deeper as into like what activities you might use to help that student. And the reason that we're doing this here is honestly to make our job easier later on. As I mentioned at the top of the episode, we we quickly forget things. It's amazing how quickly we forget. And so we might have great ideas during that IEP. But a week later, two weeks later, a month later, we lose track of those ideas. And if they're not in the IEP, and we haven't created a treatment plan with those ideas in it, then we're going to forget about those ideas, right. We're not going to use the beads in the playdough with Taylor Swift because we forgot to put it in the treatment plan. So I like to use the treatment plan as a kind of starting point for it. treatment, individual treatment session planning right? When I'm in the IEP, when my focus is all on that student, I'm going to jot down every potential idea that I might have as a therapy session or a therapy plan for that student. That way, it makes my individual session treatment planning much easier. Now, if I'm going to be potentially collaborating with a teacher on something, I'm going to put on that treatment plan what that collaboration is going to look like, When am I going to go into the classroom? Is it going to be during writing time? Is it going to be at the beginning of the day? Because I need to see the students routine in the morning? Is it going to be at the end of the day, because we're working on organization and cleanup skills? Right. So that is another aspect that can go on to your treatment plan. A lot of times we have these great ideas while we're in the IEP, but poof, they're gone. If we don't write them down on our treatment plan. Another thing that you can add to your treatment plan, is your plan for monitoring progress, when where and how are you going to monitor that progress. A lot of times our goals kind of broadly say what we're going to measure, but they don't necessarily say how we're going to measure that. So that can go on your progress report as well. And last but not least, the piece of a treatment plan that is so important, but often gets so left out, is what keeps us honest as being an evidence based practitioner. And that is, by looking at the evidence, the treatment plan, if you have a template for a treatment plan, and you add at the bottom of that template, a box for evidence supporting therapy, then you're going to be prompted every time you look at this treatment plan to think about evidence. Now, whether you spend 30 seconds looking for evidence, five minutes, 10 minutes an hour looking for evidence, at least you're being prompted to think about the evidence, maybe you already know about the evidence that supports this goal, or this therapy treatment that you want to go with. And you don't need to like cite it right, this isn't an APA manual. You don't need to cite it. But you can just say put in that box, like the article that I read about this, right? That way, again, when you're thinking about it later, maybe you can go back and review that article. A lot of times, I will look for articles, while I am in that IEP. I know our focus needs to be on the IEP. And my focus when I'm doing this to his home IEP. I'm just know that I can potentially look up some articles while in that IEP. So that's my whole thought process. I know some people are very much like against that. My idea is that as long as I am focused on that student in an IEP, it's okay to do a little bit of research for that IEP right for that student. So I think that we should have a box at the bottom of our treatment plan. And maybe you don't title it evidence, maybe you title it something else, maybe relevant data, relevant notes or something like that. But something that's going to prompt you to put that evidence in there. If you are in a particularly litigious area, this can save you're behind, right? We are supposed to be evidence based practitioners within the schools. And so if you have a treatment plan, and okay, maybe not all your treatment plans have evidence built into them. But if some do, then obviously you are practicing as an evidence based practitioner. So that's just something that can both support the student because you're using evidence, and it can also save you. All right, I know I went over those pretty quickly. And I know I'm really excited, I can hear it in my voice. And when I get excited, I start to talk really fast. So I'm just going to quickly go over those really quickly what is on a treatment plan. So number one, goals, accommodations and services and other relevant information from the IEP. Then we're going to also add relevant information from evaluations, any of our past evaluations, number three specific strategies and programs you might want to use. Number four, if you plan to collaborate specifics around that collaboration, what it might look like. And number five, I think a month your plan for monitoring progress. And last but not least evidence to support the program that you intend to implement. Again, this is going above and beyond the IEP. But this is going to help you a month to month three months later, when you're trying to figure out what do I do for my session this week, you're easily going to be able to look back and say, oh, yeah, my treatment plan. I wanted to use the zones of regulation program. I'm going to continue with that. Or I wanted to use this handwriting program. I'm going to continue with that. This is your place. This is your document it's for you. It's not for anyone else. It's for you to help you organize and keep yourself on track so that the state and it can make that progress that you wanted them to make back on that IEP day. All right, so how do you actually start to use a treatment plan? And what does it look like? What can you do after this podcast as to get started with your treatment plan? Well, I've got four steps here. They're pretty simple, straightforward. But let me go through them. And then you can get started. The first step is to create a template. Simple as that, sit down at your computer, open Word, open Google Docs, whatever you use, and create a template doesn't need to look pretty, right, it's for your eyes only, if you want to make it pretty, make it pretty. If you don't care, then don't it doesn't need to be anything that really goes beyond your eyes. Now that you have that template, if you are a pencil and paper person, you know, print out like 50 copies of it. Or if you're a digital person, figure out a way that makes it easily copyable on your iPad or on your computer, and then bring it to every IEP that you attend every single one, you can work on it a little bit before the IEP, right there's some things that you already know ahead of time. But bring it to that IEP and write on it, use it as your basic notes. Basically, any ideas that you have during the IEP can go directly on to this therapy plan. And if you don't finish it, while you're at the IEP, set a few minutes aside after the IEP to complete it. All right, so create a template, figure out a way to make it easily accessible, bring it to the IEP meetings with you print it out and staple it to the child's folder that you look at every time you see the student, or put it in the binder that you have for that school or put it somewhere in the digital folder where you will regularly see it you don't want this to be something that you complete and put it away. You want it to be there that you can easily accessible and see it in fact, your therapy plan may change over the course of the year. And that's okay, you can add notes to it a little bit right like it should be something that can be easily seen easily adapted to and easily referred to when you need it. And then finally, the last step is to make sure that you actually adjust the template every so often, maybe it's yearly or every two years or so you want this to like reflect you as a therapist, you want it to be exactly what you need, you want it to be easy to implement. You don't want to make your job harder and updating your templates, whether it be this template or any other template, updating them. You know, every few years, every six months, when you're first getting started can be very helpful. Now before my email box gets flooded with requests, yes, I do have a template that I use as my treatment plan. And I do offer it to members of the OT school house collaborative. And of course, you're welcome to join OT school house collaborative anytime. And not only get this template, but countless other templates as well as professional development and group mentorship from myself that you could possibly need as an OT practitioner working in the schools. And if you'd like to grab this template, or if you'd like to see all the other templates and courses we have, you can learn more over at OTSchoolHouse.com slash collab. Whether you join for a month or for an entire year, on the annual plan, you get access to every single file every single course every single replay that we have within the OT school house collaborative, and I would love to see you there it just be so great to support you as a school based OT practitioner. Before we wrap up this podcast episode, there's two more things that I want to share with you. And that's kind of like the why behind the treatment plan, right? Like, not just because it's going to support us. I've talked a lot about, you know how this is a document for us. It's for us to put our thoughts, it's for us to put the evidence that we want to put in there so that it makes our life easier when we're planning for individual sessions down the road like that is a honestly big enough outcome or a big enough reason to stand by on its own, that it's just a helpful document, right. But there's another reason actually two more reasons why that you should use a treatment plan. And these are actually to protect you and your license. I don't know how often you look at your state board of occupational therapy rules and regulations and guidelines. You know, I don't do it very often here in California. But I did want to check it before I put this podcast episode together for you. And I didn't check every state but in California, they do require a treatment plan for your intervention. And if California does, in fact I know other states do but I'm assuming that most states require an intervention plan. Now whether or not an IEP is sufficient for your state's intervention plan. I don't know that and that's something that we might want to check up on. Right? If you're thinking about, no, I don't want to do an individual treatment plan, well, I would check with your state and determine if an IEP counts toward what they require as a treatment plan. If not, then that's even more the reason to be putting together a treatment plan. I'm not trying to scare you here by saying, you know, your state is going to come after you. If you don't have an intervention plan. I've never heard of that happening. I don't know if it's ever happened. But at the end of the day, right, we should be following the guidelines of a OTA, NBC OT as well as our State Board of occupational therapy. So yeah, that's one reason that we should be doing it in addition to just the support that we get from actually creating this template and using this template. But also, there's one other reason and that is if you are an OTA or if you work with an OTA, the treatment plan can be a form of protection for both you and your counterpart to ensure that there is communication between the both of you, right, whether you are the OT or you are the OTA, a treatment plan can help protect you. Because as an occupational therapist, you are required to provide some oversight. And again, that varies from state to state. But you are required to provide some amounts of support to that occupational therapy assistant. And a treatment plan is one way to do that. On the flip side as an occupational therapy assistant, if you have that treatment plan from the occupational therapist, then that protects you from being seen as acting as an occupational therapist, and can again, protect you from anyone trying to question your license. So just wanted to mention those two things. Because I think it's important, I think it's important not only to see how an occupational therapy treatment plan can support the students that we serve, but also support us by making our lives easier, but also just share a little bit about the legal aspects of why we should use a treatment plan. All right, that is going to wrap up this episode, Episode 136 of the OTs schoolhouse podcast, short, sweet, about 30 minutes long, just you and me, it was a good one, I hope that you found this insightful. If I changed your mind, I'm sorry, maybe I don't know. But at the end of the day, I just want you to be the best occupational therapy practitioner that you can be. And if spending a few extra minutes during an IEP or right after an IEP to develop a treatment plan can help you do that, then so be it. I'm just glad that we are taking the time to be the best therapy providers that we can be. So to summarize today's key points, the IEP is not your treatment plan. That is the biggest takeaway from this episode, where the IEP includes your plops your goals, your services, and accommodations, the treatment plan includes all of those plus so much more. It's the how you're going to implement all of those IEP related aspects, right. And then finally, the intervention plan is there to protect you legally. And to help you provide consistent goal directed therapy throughout the year, it's going to make your life easier, both practically and legally. Again, I don't want you to forget all those great ideas that you had during an IEP. So next time, use your template, write it down, put that treatment plan together. So that way you just make your life easier, right therapy, individual therapy sessions will be easier to put together once you have that plan in action. Thank you one more time so much for listening. And as a reminder, if you do want to grab the template that I use, you can head on over to OTSchoolHouse.com slash collab and join the OTs schoolhouse collaborative, where you'll get access to not only this template but dozens others, and access to all the professional development courses that we have over there. Resources Research really we're including everything that you need to be successful as a school based occupational therapy practitioner over there. So I hope to see you there. It's just a great resource. Everyone that is a part of it is just absolutely loving it. And I would love to support you there as well. So last time, thank you again for tuning in. Really appreciate you being here. I hope this episode helped and I will see you next time. 

 

Amazing Narrator   

Thank you for listening to the OT schoolhouse podcast. For more ways to help you and your students succeed right now. Head on over to OTs schoolhouse.com. Until next time, class is dismissed. 


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