OTS 206: Moving Beyond “Sensory vs. Behavior” in School Based OT
- 1 day ago
- 43 min read
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Welcome to the show notes for Episode 206 of the OT Schoolhouse Podcast.
What if we've been asking the wrong question all along?
For years, school-based occupational therapy practitioners have debated whether challenging student behaviors are driven by sensory processing differences or behavior. But what if that distinction isn't the most important one?
In this episode, Jayson is joined by Kristen Brokamp, OTR/L and Breanna Lynch, OTR/L, co-founders of Holding Space Collaborative, to explore how OTPs can move beyond labels and instead focus on participation, regulation, trauma-informed care, and systems-level change.
Together, they discuss why behavior is often a signal—not the problem itself—and how occupational therapy practitioners are uniquely positioned to help schools build environments that promote wellness, collaboration, and meaningful participation for every student.
Whether you're supporting students individually, consulting with teachers, or hoping to expand OT's impact throughout your school, this conversation will challenge your thinking and inspire new possibilities.
Listen now to learn the following objectives:
— Learners will identify why focusing solely on "sensory vs. behavior" may limit occupational therapy intervention.
— Learners will recognize OT's role in supporting school-wide wellness and prevention efforts.
— Learners will identify opportunities to implement systems-level strategies that promote student participation and regulation.
Guest(s) Bio
Breanna Lynch, MOT, OTR/L is a native New Yorker who now calls Cincinnati, Ohio, home after graduating with her undergraduate and Masters degrees from Xavier University. Breanna co-owns Holding Space Collaborative with longtime friend and therapist, Kristen Brokamp. She brings extensive knowledge in program and systems development for preventative mental health work in schools and community partnerships. She is passionate about promoting care using a trauma-responsive and equity-centered lens. Breanna’s other special interests include reflex integration, gut health, and interdisciplinary teamwork. Outside of work you can find her outside with her family, drinking coffee, and being a tourist in her own neighborhood.
Kristen Brokamp, MOT, OTR/L is an occupational therapist and private practice owner born and raised in Cincinnati. She completed her undergraduate work at Ohio State University and Masters in Occupational Therapy at the University of Indianapolis. She expands on previous experience in school-based, adult inpatient and acute rehabilitation, pediatric outpatient, and home- and community-based settings. She strongly believes that strengthening caregiver mental health is a key component to overall child and family wellness. Her therapeutic passions include airway health, sensory processing and reflex integration, and easy-to-implement strategies to support child and family activity participation. Outside of all things OT, you can find Kristen out and about with her family, traveling, and listening to music.
Quotes
“We like to refer to Ross Greene quotes…The essential function of challenging behavior is to communicate to adults that a kid doesn’t possess the skills to handle certain demands in certain situations.”
— Kristen Brokamp
“You might be the only one that’s wondering the big picture.”
— Kristen Brokamp
"We can only function as well as the system we're in."
— Breanna Lynch
"There's no one person who has the capacity to address the behavioral needs of all students in the school."
— Breanna Lynch
"We can only function as well as the system that we’re in”
—Breanna Lynch
"The place where OTs can really shine is when we can bring in the occupation and play."
—Breanna Lynch
"OTs do it better."
— Jayson Davies
Resources
Episode Transcript
Expand to view episode transcript
Jayson Davies
Is it sensory? Is it behavior? Is it something completely else? If you have worked in the schools for more than five minutes, you have heard that question before, and honestly, it's the wrong question. And it's time to change it up. I'm Jayson Davies, and welcome to the OT Schoolhouse Podcast. Today, I'm sitting down with Breanna Lynch and Kristen Brokamp, co-owners of the Holding Space Collab in Cincinnati, Ohio, who have spent nearly seven years helping to facilitate AOTS pediatric trauma community of practice, and who are also now doing some of the most innovative system level work I've heard of in school-based occupational therapy. We're talking about redesigning in-school suspension rooms into actual intervention spaces, building tiered wellness programs inside of public school districts, and most importantly, making the case that OT practitioners are not just equipped to support behavior when sensory is involved, but instead that we are equipped to support behavior all the time, not just when sensory is involved. Yep, I said it. We can support behavior beyond sensory, and Brianna and Kristen are here to share with you exactly how they're doing just that. Let's cue the intro and dive into it.
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 is your host, Jayson Davies. Class is officially in session.
Jayson Davies
Kristen and Breanna, welcome to the OT Schoolhouse Podcast. It's such a pleasure to have you here. I'm really excited because we are going to be talking about the quote-unquote elephant in the OT room, especially in the school setting, and that is sensory versus behavior a little bit. But before we get into that, I just want to jump right into it, and I want to give both of you an opportunity to kind of share what it means to you to support behavior but beyond sensory. Breanna, would you like to kind of kick us off?
Breanna Lynch
Yeah, sure. So I think maybe the bigger question that we tend to look at is how do we support a student as holistically as possible? When we get into the is it behavior? Is it sensory? Sometimes we just get stuck in a rut, and it stops us from really thinking of how to support the student as much as possible. So I think something that OTs do really well is being able to sometimes tease out those things, but I don't think it's really all that necessary. So supporting behavior looks like to us supporting regulation, and now I think definitely we see more in the post-COVID world as we understand mental health better as we understand regulation, nervous system regulation, all these kind of like fad words that you see popping up in social media that touch every every little piece. In education, OTs can really be that person to collaborate with the team and figure out what are all the different areas and how is the behavior or the regulation, dysregulation impacting the student, and then move on to how can we really support that?
Jayson Davies
Absolutely. And Kristen, what what came up to or what came to your mind as I talked about you know beyond sensory and supporting students?
Kristen Brokamp
Sure, I'll second everything Brianna said and consider that if we're asking the question, is it sensory or is it behavior? Then we are too narrowed in to that question, and like Brianna said, need to take a wider, holistic view of what's impacting function and participation for the student. And I we like to refer to Ross Green quotes specifically one that mentions the essential function of challenging behavior is to communicate to adults that a kid doesn't possess the skills to handle certain demands in certain situations, and we know that as OTs we're skilled and probably you know one of the only team members who are looking at the environmental considerations, the task considerations, and the individual personal skills that a kid has that help them to participate, or that then present as behavioral difficulties. Right. So consider. those aspects as the OT, whether or not they're sensory challenges or other challenges, is where I feel we belong.
Jayson Davies
Yeah, absolutely, and I love that you both brought up like the holistic nature of occupational therapy, right? Like you even said it, Breanna. I think like it doesn't matter. Like it, I mean, when it comes to the actual treatment side, right? Like we kind of have to know which way we're going to go treatment wise. But and and I'll kind of pose this as a question for you. Like, can we not provide occupational therapy support to a student that? Has behavioral difficulties that are not based on sensory. I know we had this question planned for later, but I think that's like the question of the moment. So, yeah, what do you think? Can can we address behavior that isn't sensory related?
Breanna Lynch
100 times over, yes, yes, absolutely. No, like no questions asked. Yeah, I mean, I think, like I said before, like, does it matter? Does it matter what the origin is? We don't know everything about every student. I know I touched on on like the piece of trauma responsive care, right? It's kind of that same understanding of having a trauma informed lens. Like I don't know everything about every individual that I meet, but I can still meet them where they're at with care and compassion and wonder to help support them. Right. So the same thing. Right. Who? What's? Who cares? It's this is the problem or the challenge that's inhibiting participation. That's making it difficult for the student to access the curriculum, the the extracurricular activities, whatever it is, right? So let's just see that for what it is. Okay, that's a that's the fact that we're kind of using, and then let's build intervention around that, right? I mean, I feel like that is the that's the heart of occupational therapy is figuring out okay there's this occupational performance thing that's challenging for this student so let's help support them through that
Jayson Davies
yeah yeah yeah and now both of you have you know experience as occupational therapy practitioners you're not brand new out of you know OT school, but I would imagine that maybe once upon a time you both kind of struggled with this whole idea of sensory versus behavior. And so, Kristen, I want to come to you and kind of ask you, like, do you recall you know as a newer pediatric therapist, kind of having this internal struggle of sensory versus behavior, or maybe sensory versus trauma, or kind of just that internal struggle that I think we've all experienced. Did you have that, and was there something that helped you kind of break out of that a little bit?
Kristen Brokamp
Oh, absolutely. I feel even if if you're starting out in school school based practice, especially having a mentor to guide you through the bigger picture thinking is essential, but not a lot of students have that right off the bat. Caseloads are high, and overwhelm and right traveling between district schools for direct intervention students is really difficult. So it's it's it's hard, and I hear Brianna talking about intervention for behavioral supports. And ideally, yes, that's amazing. And in a picture of perfect world and system, we're able to do that for every single student. But what can that intervention look like on a school level or a team level, and maybe not a direct intervention with a student level. So, thinking on those terms of what intervention means and what supports are in place.
Jayson Davies
Yeah, yeah, absolutely. And in fact, you know, I'm going to jump down to this because I went and looked at the article, Brianna, that you and I think it was Nicole published in the OT practice, and I've got this here. It's right here. You presented nationally on this topic, or sorry, yeah. In the in the praxis article, you and Nicole and Abe noted that establishing a wellness promotion can only be. You noted establishing wellness promotion can only be accomplished with system level innovation resulting from advocacy, and that's kind of what I just heard from what Kristen said. Like we can't necessarily do this just one on one. We have to develop this system level approach in order to support all student behavior. Brianna, I'll let you kind of follow up on what Kristen was saying in that quote a little bit and what that means to you.
Breanna Lynch
Yeah, I think you know. Back to your initial question, I still think Kristen obviously comes at it with a lot of experience in school-based practice too. I don't know that many new grads are thinking about about how maybe I would break out of the individual student intervention model, and and so I think that's a piece to acknowledge is that initially I don't think I would have ever thought like that as a new practitioner. I feel like most of the time you're like this is my caseload and this is what I do and I just do it to the best of my ability because I don't even know what I'm doing.
Jayson Davies
True.
Breanna Lynch
right? So, so I think that's you know from back being a new practitioner, it was like you just do the best with what you have, and I think that continues to be true. I'm still doing the best with what I have. I just have things that are different now, right? So. That article is based on a lot of really great work that I did with Nicole and Abe from a from an implementation, a realistic school-based implementation side, and also in advocacy on the state and national level and research. So there's kind of like the both and there, but really we can only function as well as the system that we're in. So,
Jayson Davies
I love it.
Breanna Lynch
If the system doesn't have the capacity for the innovation for this this outside the box thinking, if we live in a system which we do on a larger standpoint that doesn't value all education for all students all the time. Then it's hard. It's hard to do what we're saying. So I also want to make sure, and Kristen did this already, to acknowledge that it's really hard to function in a system that's not built for this, right? And so, part of what we're really passionate about in our practice and our business is to continue to reimagine what it looks like, and to build capacity within the system we have. Right. So, what does it look like to have a system that maybe is not necessarily going to change, you know, drastically? How do we build capacity and reimagine something? Redesign small pieces of it. Look at the roles and responsibilities of different team members, right? To to remake a system that is a better fit for the team members, a better fit for students, better fit for families, right? So that we can start to implement some of these wellness and behavioral type interventions on a bigger a bigger level. There's no one person that has the capacity to address the behavioral needs of all students in the school. So, yeah.
Jayson Davies
that's a powerful that's a powerful line, and I I think it's I mean you had a few powerful lines already in the first 10 minutes of this episode, both of you, and it's true, right? Like I think we often try to make something that's very gray into black and white, and you know it. There's so many quotes out there that just like throw that out the window. Like it takes a village, right? Like to to support a student or to support a child, and I don't think any one OT can support anything, just like I don't think any one SLP or ABA therapist or teacher can support an entire child, and it really does take a team. But the flip side of that is like sometimes we don't feel like we're always as much a part of the team as we'd like to be, and you just brought up the idea of that being a systematic problem. That's not an OT problem. It's a systematic problem, and that's something I say a lot as well. So, so really appreciate that. We've already jumped around a little bit more than I anticipated in the first five minutes of the podcast, which is totally on me. But I do want to back up and let you both kind of share a little bit, kind of because you you've talked a little bit about your business now and what you're doing. But I want to give you both the opportunity to kind of share, Kristen. You you talked about school base, Brianna, a little bit more pediatric side, but I want to let you both kind of share how you got to what you're doing today. Brianna was just talking, so Kristen, I'll come to you first and kind of share how you got to where where you and Brianna are working now together.
Kristen Brokamp
Absolutely. So I'm about 10 years in to my occupational therapy practice. I'm graduated from the University of Indianapolis, which had a great program. I felt like in a holistic development of practitioners, as well as evidence-based, a big evidence-based push and team treatment push. So when I got my first job in Cincinnati, it was at an outpatient pediatric practice, but they also did school-based practice. So I was a little bit of school-based practice and a little bit of outpatient pediatric treatment that was in a multidisciplinary trauma clinic, so we'll touch on that I think in a little bit because that's how me and Brianna developed into this holding space business that we are so passionate about. But from the school side of things, I had an amazing mentor who had been practicing for over 20 years, building up my knowledge of school-based practice and really suggesting and wondering what it could look like or when it could look like that I was developing relationships with school personnel, teachers, support staff and win that OT really building my confidence as an OT to prove and provide what we could in the schools, but also showcasing from an RTI MTSS tiered stand. Point of how we could integrate our knowledge and our skills into regular conversations and relationships that are built in throughout the schools. So that was super super influential for my practice development. Then eventually went to more school based practice, and from there have developed the holding space private practice that Brean and I do together. So I will let her.
Jayson Davies
Awesome.
Kristen Brokamp
Share as well.
Jayson Davies
Congrats, Kristen! I love it. I I think a lot of OTs start in a similar type of world where they have both that pediatric and school-based, and to be honest, I I often sometimes advise therapists to go into the pediatric world a little bit before in the schools because I think there's so much that you learn in the pediatric outpatient that you can bring to the schools and and vice versa. To be honest, but but yeah, no, I love that you got both both sides of it. That's that's fantastic. And Brianna, what about you? How did you kind of get to where you are today?
Breanna Lynch
Yeah, so a little bit different than Kristen. We met because we were working together in that outpatient pediatric setting. But my entire caseload, my whole week, was in the outpatient clinic in a variety of different clinics, but in that outpatient setting. And I really didn't get into school-based practice until I started working on the prevention and wellness team at a school district. Of course, there was lots of overlap with the families I was working with and outpatient of what their needs were at school, and kind of collaborating with the school OT or other school professionals to support the the kids I was seeing outpatient. But moved into a role that has shaped a lot of kind of our systems level work. Where I just happened to be an OT in that role, but the team was a multidisciplinary team, and our entire aim was to enhance the prevention and wellness promotion of students and staff across the district, and hopefully already we've made the point that we feel like OTs are positioned to do that. But that really gave me this very interesting lens. I grew and and was stretched as a therapist in so many ways to learn so much about special education from the practice and from like the legal side and some social work things and all of this was amidst COVID, so it was just like a really, I got a really interesting, just really threw in thrown into the deep end there, and it really helped me to hone my appreciation for the ways that OTs can look at shared problem solving, look at team collaboration. I feel like obviously super biased, but I feel like we're the best of the best of of trying to bring the team together to to look at a student or a scenario or a classroom in a really broad and oftentimes positive light. Like what's going well in this scenario? What's going well for this student? Let's look at all the things that this family is is trying to do to support their student. Like those kinds of things, I feel like OTs do so well, and I was able to bring that lens to a much larger team. In that, I feel like Kristen and I, along the way, have been always collaborating on on different work endeavors, and then also outside projects. When when we were new grads, we were working in a multidisciplinary trauma clinic, and that was something that we had to. We had amazing mentorship and supervision and support. We also were like, "What are we doing? So, so we really were super self-directed in figuring out, like, okay, we need to read all the research we can get. Which honestly, at the time, was very little within the occupational therapy scope of practice. So we read all different discipline research. We went to conferences. We did all the things. We started a community of practice within AOTA, all in the spirit of our own professional growth and learning, so that we could, you know, feel confident that we were the best therapist we could possibly be when we showed up at this very specialty clinic, and so that from there we spent a lot of time together, and and we grew really awesome friendship and and built this like vision that we had notes of together of one day we were going to have this practice together and it was going to was going to wrap all these things and all these interests up in a bow, and so holding space collaborative came to be almost four years ago now, and it's we're we're building a dream.
Jayson Davies
So that's awesome, man! Such a such a variety of experience between the two two of you, and I love it. I love how you're bringing it all together with holding space and more. That in a second, but we're going to take our first break here. When we come back, we're going to talk a little bit about what you might consider the missing word in the whole sensory versus sensory and behavior discussion. So we'll be right back. All right, we are back, and that word that I was talking about here is trauma. Trauma is not found in the term sensory versus behavior. I don't think it's really even implied when we say behavior, although you should absolutely assume that it should be implied. I think, but even as you were talking earlier, you know about your experiences in the past. It sounds like this, the work that you two had together kind of started within a trauma-informed approach, and I would love to get both of your takes on how trauma fits into sensory versus behavior. So, with that, I'll let the two of you speak on it.
Breanna Lynch
Sure. Yeah, I mean, our practice has always included a trauma informed and trauma responsive lens. So I can say we don't really know any differently. Not that I would say either of us came out of grad school like knowing anything really in that vein, But I think we've talked about this before, the two of us, and we talk about it with our employees and and like the fieldwork students we have is kind of like what came first was it was it the trauma and then we see like sensory processing changes or behavioral changes, or were there always these sensory processing things, and then there was also trauma? And again, like we always just come back to like, does it matter? You can stay on that hamster wheel forever, but like, does it really matter? And is it going to change the treatment? And like, 10 out of 10 times, it's not going to change how you approach the treatment. You're just seeing a student, a child, an adult, anybody. Here's how they show up. All right, let's go from here. But and I should say not but and we do know from mounting research that trauma impacts sensory processing. So I think without a doubt, those two are inextricably connected, and I don't think you can support and know that you're supporting a wide variety of individuals with trauma, which the majority of us have experienced adversity that's considered an adverse childhood experience without understanding how sensory processing is impacted, so I I do think that it's really hard to separate those two, and I also think that's why occupational therapy practitioners are in the just right spot. There, we have the the tools and the knowledge of sensory processing to help to kind of problem solve that with the team.
Jayson Davies
Yeah. And and I mean trauma is so unique. You talked about that, like what came first, the trauma or sensory. And you know, when you think about trauma, I think a lot of people try and try and like, okay, well, there's a change to the brain in the moment that that trauma was experienced. But I don't know that that's you know actually true. Like it almost trauma impacts from to from the day of the trauma, you know out out from there, and it's the experiences combined with the trauma, the the post traumatic experiences combined with that trauma experience that really start to I don't know. Like I'm not a trauma expert here, but like it's not just a one-time event. It happens over a period of time, and the same thing, like kind of with sensory. We don't know what came first: the sensory experiences first, or the sensory in combination with the trauma experiences and all that. So, yeah, I don't think, like you said, I don't think we can separate out behavior versus sensory versus trauma. Like this, all kind of comes together into this holistic. And I don't know, maybe the title of this podcast will be sensory versus behavior. Doesn't matter, like because that's kind of what it comes down to.
Kristen Brokamp
Yeah, I mean, and I'll add on that. Yeah, what, and especially as a new grad when you're coming in, and does it matter if you know what the trauma is? The trauma, or a trauma, is a subjective experience of something that has happened throughout someone's lifespan, and we know that if it happens in the early years, it impacts right the brain development and sensory processing and all skills moving forward. But what if, as a new grad, and you don't have all that information yet, you can still come to the table asking, you know, what has led you to this point? Right, not maybe not outwardly, because they might not be able to answer that. But what experiences have you had? What skills have you developed that has have led you to this point? I don't need to know all the answers right now, but I'm here, right, with you to help make sense of what skills we're working on and what would be helpful moving forward. So even calling it a trauma kind of defines that you need to know exactly point in time or what happened, and not necessarily the case. I think we can, especially as new grads are. If you're listening to this, you can consider every student or every family you're working with as just a a person who's experienced many things, and some of those things may have impacted the way they develop, and definitely has. And you don't need to have all those concrete answers to to help them recognize their strengths and be the best participation have the best participation in any environment.
Jayson Davies
Yeah, yeah, no, I. It's amazing because so we did an episode not too long ago about the occupational profile and how we should be conducting this occupational profiling, getting background on a student, and all of that. And but at the same time, if our answer is it doesn't matter, like what is the important pieces of this occupational profile that do matter? You know, is it did the student have an A score of whatever, or is it that the student has a diagnosis of autism, or is it that like what actually matters on our occupational profile then, and and even going further, what actually matters in our evaluation? And I don't know if either of you have thoughts on that particular thinking that's just going on in my brain right now.
Kristen Brokamp
Well, that's one thing we've added as a private practice to our intake questionnaire is a brief statement just about how the subjective experiences a person has in their life impacts their skills and development, and put an adapted ACE questionnaire into our intake form, so it gives us some very brief information about things that may or may not have have occurred, such as you know family separations or living with an individual who has a mental illness, or you know obviously any physical or emotional or other otherwise defined trauma. But that brings to light a little bit about what has brought them to this intake as we develop that occupational profile.
Jayson Davies
Okay, so then a follow up on that: How do you actually use that information? Do you feel like that is important within your evaluation, or do you feel like it's more beneficial to have that information when you're actually treating the student one on one or in a group, like when do you find yourself actually referring to that information?
Breanna Lynch
Yeah, I think it depends on on the person and how relevant it ends up being to their story when we do the evaluation. Even if we give it a mention in the the write up of the evaluation versus kind of just a nugget of information that we tuck into our pocket, and sometimes it depends on which of the child life events that they check. That we may tap into that more just based on our own knowledge of how some of the occupational performance skills may be impacted based on the type of trauma, but I think that's come with a lot of practice and it's a lot of nuance because I also feel we've gone back and forth about this a lot. If it's not, if it doesn't really matter, which and I think in our heart of hearts we don't think that it does. It doesn't. Not that it doesn't matter. Let me rephrase that. It matters a lot. It doesn't matter to how we are gonna like meet this person where they're at. You know, we're gonna do the intervention based on the individual that sits in front of us. And because the that adversity is so subjective, you know, when you've met one person that has experienced homelessness, you've met one person that's experienced homelessness. The same way people say that of when you've met one autistic individual, you've met one autistic individual, right? That that line works.
Jayson Davies
Can we just keep it as if you met one person, you met one person? Like, can we just exactly right
Breanna Lynch
Exactly? So I think if we get too stuck in the aces, two things in my mind. One, we get too stuck on it being black and white, and like, oh well, if this ace happened at this age, then this, and like, you'll drive yourself mad over that because every person is going to present differently, right? The second part is it also the ACE questionnaire again is only as good as the system it was developed in, and so we know so much more about adversity and how it impacts the brain and and our skill development now. The ACE questionnaire completely leaves out the systems that oppress and cause adversity to individuals, right? So if we leave out all of those things, we're really missing the mark too. When we're using a super holistic systems level lens to assess how to support a client or how to support a student or a family, so many of those are so much more pervasive in the everyday person that we work with, and so you know, it's the it's the both and it's it's great information to have as background, and we also want to take into account all the bigger things that impact a person. I think what's important to remember is that trauma impacts the way that the person sees themselves and the way that they see others and the world, right? So that's really what we're looking for. Like, how does this person view themselves, their own personal safety? How do they view trust and safety with me as this new therapist entering their world? How does it impact how they see the world, right? And when we talk about kids with dysregulation and behavior, everything is is unjust. It's not fair. It's it's me against the world. It's all you know those kinds of oppositional, defiant, all those words that you know like that. That's what we're thinking about. Like, what experiences have you had that led you to a place where you feel like it's me against the world? It feels like everybody's against me. Everything's unjust. Like I'm a bad kid, right? Like that's that's the using that trauma informed lens of just being like, wow. Like I wonder what brought you to this spot, but like we might not know. We're just at this spot with you, and then we go. Yeah.
Kristen Brokamp
and just as a school-based OT, you're sitting in those IEP meetings. You're you're writing those progress reports, right? You're sitting in those. You might be asked to consult on those functional behavior assessments or behavior intervention plans, and you just might be the only one that's wondering the big picture and not getting stuck in the this behavior is occurring talk. So just bringing to light that that you're you might be the person that is bringing the whole picture in as part of the team.
Jayson Davies
Yeah, yeah, and and man, so much so many directions we can go with this. We have so many questions that that we're not going to get to today, and that's totally fine. Brianna, like, just want to mention, right? Like you, you talked about during your background about this job that you had, where you were an OT but not an OT, like on this team, or at least not a job that was specifically made for OT.
Breanna Lynch
Yeah.
Jayson Davies
and I don't think we're going to have time to jump into that too much today, but we are going to have Nicole, your your supervisor, on the podcast in a few weeks to talk more about that that job. So we won't go into too much of that today, but I do know that that really shaped what you are doing now at Holding Space. By the way, Holding Space, great name for an OT company. I love it, especially a holistic OT company like the two of you are creating here. But I do want to jump into like what you are actually doing now, and you know, are you doing the traditional pediatric clinic where you're seeing students one on one, or is it completely you know different? And so, just briefly, can one of you mind sharing kind of what what the goal is for holding space?
Breanna Lynch
I can take it. Sure, we have our hand in a lot of pots, so I'll be brief. But so we're really actually excited that we are have just opened a small clinic here in Cincinnati. So we do have the ability to see clients, one on kids and adults. We see people of all ages in our clinic space. We're offering summer groups, so we're doing like a half-day therapy group for kids this summer, and so that's kind of like that's a small group setting versus one-on-one clients. We also do have some clients that are doing intensives with us, so we see them multiple times a week, do like a high-intensity burst of intervention. But originally, when holding space originated, we felt like we needed to fill a gap in the home and the community space. So we, for the past three years, have seen clients solely in their homes or in different community spaces, and that was out of need that we found from our student. Families, outpatient clients that really were having a hard time figuring out how to generalize the strategies that they were getting from their school-based practitioner, from their outpatient person, from their mental health therapist, from right, like it looks really good in the in the gym, and then like I don't know what it looks like at my house, or I can I can use this strategy here, but then when we go to the playground, like and these other factors are at play, like it's not really it's it's breaking down. So being able to really walk alongside clients in the places where they're finding the most challenge is where we have been for the majority of our practice at holding space. We also have a few different contracts, and so some of those are school-based contracts, and we are providing tiered wellness support is what I think is the best name for it. It's a lot of social-emotional learning support across all tiers. The majority of our work is systems level. So, what does it look like to provide wellness promotion within the entire curriculum? What does it look like to make a school building the environment, the playground, the way in which the schedule functions, the way in which the administrators address discipline? What does that look like to make sure that we're putting positive mental health and social emotional learning at the forefront of that, and then we also do some within that doing some small groups and one on one with with students there. So that's been a really cool way to kind of bridge like how we view our client practice, our one on one client practice, and some of Kristen and I's school-based experience, and bring it into schools that are looking for innovative ways to support students with the all different funds that they have.
Jayson Davies
Yeah, yeah, and obviously both of you have. I mean, Kristen, you have significant school-based experience, and Brianna, you were have a unique school-based experience, I should say. With with what was the name of that, by the way? What was the name of the team, or like what was it?
Breanna Lynch
Yeah, we were the prevention and wellness team.
Jayson Davies
Okay, so you worked on this prevention and wellness team with not just another OT, but you know the entire gamut of people who work in school-based OT. And it sounds like, to a degree, you're kind of taking what you learn from there, pairing it with what you both know about the traditional quote-unquote school-based OT role, and kind of flipping that upside down a little bit to support schools. Tell me a little bit more about what these wellness programs kind of look like. It looks like it sounds like you're supporting students at all three tiers. You talked about groups and even individuals within the schools, but I'd love to hear more about that.
Kristen Brokamp
So, on a broad level, it's environmental design, it's teacher coaching, it's staff educational opportunities, it's systems design. In that, instead of in-school suspensions, where students-and you can talk more on this, Brianna-but instead of students sitting down and completing a worksheet for an in-school suspension, there are other avenues of skills learning that the student needs to have to be successful in class. So, if you're flipping a desk, if you're right, what is the skill deficit that is missing in in that regulation, that impulse control, that right, that interoception piece for understanding what your body needs when you're angry or disappointed, and then you're reacting. So, what are those skill-based opportunities for students to learn in a newer alternative learning or discipline system, and helping reframe teachers' understanding because they are overwhelmed, they have many students, they are doing the job day in and day out, and reframing their understanding of what behavior support looks like-that's not the traditional. This student is suspended, or this discipline note is being sent home, or things like that. I don't know if there's anything you want to add to that, Brianna.
Breanna Lynch
Yeah, I think the the piece that occupational therapy practitioners bring to the table in this sector, among many, is the focus on occupation, and especially in schools, is the focus on play. And for our the programming we design, the small groups that we're doing, the individual student check-ins or sessions that we're doing, to be really as true to occupation and play-based practice as possible, which is so hard to do in the every the day-to-day of school. I think we just really try to acknowledge that. Occupational therapists have the ability to bring in some of the cognitive behavioral skills that more traditional talk-based mental health therapy that can be provided in schools has. That the place where OTs can really shine is when we can bring in the occupation and the play, and we know that lots of students just really Need that that is so therapeutic for students in a place where school especially has become very sterile, where we see like recess time being cut or used as punishment, where we see just the push for educators to be so focused on content and curriculum, and it's exhausting for the educators too. It's exhausting, and so to be able to bring a perspective of we need to meet kids where they're at. What's what do kids need developmentally? Like they need play, they need meaningful participation. And so I feel like that's where we've also gained a lot of buy-in in the way that we're designing the programs or the systems. Is like okay, yes, everyone's going to go to the cafeteria to eat lunch. Like, how do we enhance this experience? How do we think about every single experience that a student's having in the day from a wellness lens? And the same for staff, right? Again, we can only do as good as the system we function in. So students can only do as good as the staff. You know that the staff can can do too, and so the same thing for staff, right? Like everything is an opportunity for wellness promotion or to enhance prevention, and to be able to use that lens in resetting or reframing a mindset is really powerful. I think that's where our work has really has really shown itself as unique and extremely like beneficial from a from a data standpoint.
Jayson Davies
Yeah, the the in school suspension thing really like is impactful. It's like something that's come coming to thought more because my wife's an assistant principal, and I don't know. A few weeks ago, we had this whole like, she gets frustrated because teachers are sending the students up to the office to do work, and then when they come up to the office, the students are happy because there's no one really there to make them do the work, and you know they're out of the classroom, so they're happy, and she's trying to keep them in the classroom, and it's just like this revolving door of everyone's trying to move the student somewhere else because no one knows what to do with the student, and at the same time, the student is no longer in their least restrictive environment. They're no longer included in everything that's going on. People are making decisions about whether or not they should be able to go on an academic field trip, or if it's academic, so you can't miss an academic field trip. And like, but no one is trying to figure out what's actually best for the student when they are having this concern, whatever it is. So, what does this actually look like in practice?
Breanna Lynch
Yeah, yeah. This is something I'm really passionate about because I think you know the question is also if the student is so happy to come up to the office, like why, right? What is what are the the differences in the task demands, in the social interactions, in the environment that make this so much more suitable for them, right? Is it that the work demands are less? Is it that it's quiet and they're by themselves in a little study room? It like what is it about that? That's the kind of wondering that helps a team to get to to the meat of it. And so, in the project that I'm working on right now, in one of our school partners, that's what we're doing. We're just really digging into it. And so, the the term in a lot of schools is alternative learning center community environment, right? But there's very little learning happening in the learning environment, and to me, it is exactly what you just said, Jayson. It's the shuffling. It's the like teachers are like, I don't know what to do anymore, just like leave the room.
Jayson Davies
Yeah.
Breanna Lynch
students are like, just get me out of the room, right? And then, and then administrators are like, oh my gosh, we have 10 kids up here, and so it is this kind of like everyone's just in in the mix, and it's hard when you're in it to like come up for air and figure out like cool how do I reinvent and reimagine the system, and so that's the the positive of having a consultant work with you, right? But I think even be like being in the system and trying to figure out what to do is that like what about this is supporting the teacher right when they send a kid to the office what is it about that that helps them what is it about this being in the office that helps the student right like some of that wondering and putting the pieces together but making sure that it's actually still learning when we have. Students that are more than more often than not having repetitive disciplinary action things happening, we are, in my opinion, restricting their access to their education, right? And so, and I don't know that everyone really thinks about it like that, but when you have students that have repetitive behaviors or discipline, and they're up in the office or they're at a school or whatever it is. When you count up those hours, right? Like, and we're the adult educators, right? It is our responsibility to help students to stay in their least restrictive environment. So I'm not saying just everyone should stay in gen ed. That's not what I'm advocating for, but I am advocating for every student having access to an education, and so I think it's important to think about it that way too because that can sometimes like stop people in their tracks when we we're like we're not letting this child access their education, and so for the environment to hone in on skill building, right? What are the skills that this child needs to be more successful if they're coming to the office or the alternative learning center because of disobedience, disrespect, out of spot, you know all the different labels we can put on the disciplinary record. What are the skills that are are missing there that we can help to support? And then providing intervention. You know there are adults that are assigned to the disciplinary rooms or the different areas where students go, and so can those adults be supporting the learning and the skill building with the idea that we can decrease the repetition of these disciplinary actions while building skill, and that's something that doesn't take up time on caseload. Yeah, it can be something that occupational therapy practitioners can be pushing in and doing a larger group lesson or a small group lesson. Right, doesn't have to be one-on-one with a student. If there's 10 kids in the room, probably eight of them are there because of disobedience, whatever that means. So, like those are kind of the ways that we can get creative, and also have the opportunities for kids to explore what are my coping strategies, who are the safe adults here, how do I repair a situation? Right. So much growth comes in repair. So in this environment, the students have the opportunity to go through all of those things. They proactively use the calming corner with a variety of different sensory-based calming tools. They go through what their repair process for whatever the reason they were referred there is. They engage in intervention that's based in the school's existing social-emotional learning curriculum. They have body breaks, so they do different like walk outside when it's nice, and different motor breaks. They have all different types of activities, things they can do on the playground. So I think it's it's more honestly just us allowing ourselves to let it happen and not feel like oh well they are indisciplined, so they like can't smile, you know. Kids have to have to be regulated, and they have to play to learn. So.
Jayson Davies
Yeah, right. This isn't the Breakfast Club. Like, so you all put this. You you mentioned in there. I was going to ask you whether or not you use a curriculum or if you created a curriculum. It sounds like you said that the curriculum used is the school's already approved SEL program. Is that right?
Kristen Brokamp
Yes.
Jayson Davies
Okay. So then, I don't want to ask like YOT, but like YOT, like why was this something that they came to holding space, you know, collaborative to do as opposed to, you know, someone else, and then why was OT the two of you the right people to put this together?
Breanna Lynch
So I think the mind, I think the mindset is probably the answer to both of those questions.
Jayson Davies
Yeah,
Breanna Lynch
hopefully it's pretty evident if you've been listening the whole time that this kind of the way our brains work, and so I think that's part of it. It is like we are putting play and occupation and skill building at the forefront of everything that we do for students and schools from a systems level and from an individual student perspective. And so I do think that that sets us apart from the more traditional mental health practitioner agency or route, not to discredit our mental health partners at all, because because we still need them immensely. But just the the ability to have like this different holistic perspective, I think, is what brought this partnership to be in this specific instance, and what makes OT the right professional to help to enhance some of these systems that we're working to to build.
Jayson Davies
Yeah, bigger.
Kristen Brokamp
picture task breakdown, bigger picture environmental assessments, bigger picture. Education for for stuff and yeah.
Jayson Davies
Yeah and to push back though because I'm trying to obviously this is a podcast for school based OT practitioners right not former school based OT practitioners that have created a business and are trying to consult and so obviously always trying to put this back into the perspective of you know the I don't know. I don't. I would only want to say eight to five because some school-based OT practitioners are only contracted for 34 hours a week or whatever it might be. But we often hear like from OTs and going back, right? It's a system problem. But I don't have time to do something like this. It would be great, but how do I go about starting this? Do you feel that this could be? Do you feel like if you had been a full time OT at this district, this could be something that you could have pitched and put into place? I guess that even a possibility for a real school based OT.
Breanna Lynch
I think the feasibility is has to be bigger than just one person.
Jayson Davies
Okay.
Breanna Lynch
Right. So me as one individual OT being like, let's do this thing. Like I probably don't stand a chance by myself, right? I do think that, and I know you mentioned the the article that Nicole and Abe and I authored. Like I do think it takes advocacy, and there needs to be several team members at least on board, even if it's just within your building and it's not the district, you know your school-based team to get on board. I also think part of it is is the the rearranging and the building capacity. So like, let's everybody lay out on the table what's the caseload, what's the breakdown, what's the percentage of kids we do direct intervention with versus small group versus consultation, right? And maybe do doing some some jigsawing of that and figure out like, okay, who's the one person out of our three OTs in this school in these three schools that could take 10% of their time and do this type of work, or if we all rearrange this much, can we all take this little sliver? Yeah. And so I think that is more of like the realistic on a day to day school based OT way to go about it, and to also like in collaborating with your other interdisciplinary professionals, right? Like let's all sit down as a team and go through, like, okay, what is the school counselor doing? What's the school psych doing? And that's really different at every school. What are we all doing? And then, like, how can we? Right. So part of that is again having the team be interested in that change too, of just like, what's this small little thing? I think sometimes we underestimate just one tiny little change that we can make. Like you don't need to do the whole school. Start with with one classroom. If I try doing this push in lesson to co teach with a teacher about interoception, about whatever it is, like whatever top it doesn't even have to be you know mental health related, whatever topic of interest. Like, let me just try with this one classroom, right? That's my little pilot, and so I think, and that's the in. Like, do you have just one teacher that's like really interested in all the work that you do? Like, sure, they're gonna do a pilot with you if you go to them, right? They're like extra support. Okay, that's what I was
Kristen Brokamp
gonna say too. If I'm a school-based practitioner with a full caseload, and I walk in and I have 30 minutes in the morning and 30 minutes in the afternoon, and I I might eat my lunch with a teacher and try to develop that relationship and get that initial classroom push and buy-in, and a lot of that comes with developing the relationships, and or I might be saying hi to the principal as I walk in in the morning, right? And and being like, I have this buddy on my caseload today, and our goal we're doing this so he doesn't come down here, right? And then starting that conversation.
Jayson Davies
That's perfect because we don't talk to people, and that's a problem. Like we don't, we don't like. Hey, mrs. Principal, mr. Principal, like even if it's kind of in a joking manner, say you know they ask how you're doing, and you just kind of jokingly say, "Well, you know, I'm working with Johnny today. You know, we're working on this skill or whatever. Like, just make yourself a little bit more visible. I mean, that's key, and and you're opening up that communication because I was going to ask you, and obviously you're coming from the business consultant side working with this, but you had to either a find a school district that was interested in this service, or b pitch yourself to the school district to do this service, and the same thing a school based OT if they're going to do something like this, they've got to pitch it somehow.
Kristen Brokamp
Yep.
Jayson Davies
You mentioned doing a little pilot study with one teacher, but did you have to sell this to the school? Was the school already looking for something? How did that formulate?
Breanna Lynch
Yeah. So I would say our school partnerships that we have had over several years with holding. Space have were looking for wellness promotion, and they were like, "Do we do we hire this person? Do we hire this person? You know, they were just they cast a wide net, and we were connected to them, and and we sold ourselves well enough, right, to be positioned for what they needed. The school that I'm working at now, the specific project. They're part of a larger grant-funded project here in Cincinnati, and so they already knew that they had funding that was for wellness promotion, and then they were able to pick from a wide variety of agencies, practices, consultants of who they wanted to have for the job, so we did. You know, we Chris and I did have a pitch for them, but they were already interested in the work and had funding set aside for the work.
Jayson Davies
Yeah, no, but that again, it shows the importance of kind of being in tune with your school site, like beyond just the 60 kids on your caseload, and being in tune a little bit with you know what the board is talking about, what are they prioritizing? What is your principal talking about? You know, is there a does your principal have a dream for every kid on campus to complete A, B, and C by the time they leave their school campus? And if so, how can OT support A, B, and C? And knowing those larger initiatives that the school team, the district team have in place, and opens up doors for the OT to say, "Hey, I can fulfill A. I can't do anything about B and C, but I can fulfill A. I can help out there and develop a plan and an idea and pitch it. Because.
Breanna Lynch
Yeah, there is the importance of of knowing where all the stakeholders are at, and then figuring out, like, okay, I know where the stakeholder holders are at. What's the language I need to use, right? Like, OT language and education language are not always like in line. So, can I or board language or when we talk business, that Chris and I are figuring out how to talk business, right? Like.
Jayson Davies
Yeah.
Breanna Lynch
What's the what's the language, and then how do you get in there? You're like, oh, you want to decrease your in school suspension or out of school suspensions?
Jayson Davies
You figure out a plan for that.
Breanna Lynch
Let me let me say, oh, I think I could get in this way. Or you want to enhance your attendance? Okay, right. So all those you have to know what the stakeholders are interested in, yeah, and then show them your your value. You have to sell yourself on what what OT can do for them.
Kristen Brokamp
And if you're not there yet, and you're planning your fall case loads, right? And you have three students who are working on their self regulation skills. There are amazing OT driven recess and lunch programs that you can see your students in shouting out every moment counts. Look it up that you can provide your direct services in. Put it into your schedule and then make it a you know make it known to the teachers and staff and school personnel. Right, and look at it differently.
Jayson Davies
Yeah, and shout out to every moment counts, like you just did. My my wife, assistant principal, tried to implement the comfortable cafeteria program. She failed because she's assistant principal, not an OT, not a teacher on assignment. Like she has too many other hats to wear, and so it didn't work out. But she would have been happy if she could figure out a way to support the OT and the SLP working together to implement the program, rather than her having to do it as an assistant principal. Like that's not what an assistant principal should probably be doing, but it is something that an OT and SLP could be doing to prevent future referrals. It's a win-win-win situation.
Breanna Lynch
Yeah.
Jayson Davies
Man, I love it.
Kristen Brokamp
So much good stuff. Her head's in the right place, right?
Jayson Davies
Okay, we've been talking about the ALC, the the Alternative Learning Center, for a bit, and I think that's just like a perfect case example, and that's why I wanted to really dive into that one. But are there any other really cool, you know, wellness programs that either you're doing or working on or dreaming of?
Breanna Lynch
Oh, dreaming of-that's a big question. Our brain is like constantly-we're always pulling it back down. Yeah, pie-we're pie in the sky kind of people. That what-that's what keeps us going. Other things that we're doing-we're-we're definitely using every moment counts with our partners. I think the other thing that we've been pretty strong in, and again, is why why answers the question why OT is assessing the environment. I think that's a piece that other professionals sometimes miss. So really looking at how is the environment leading by example. So some of like what does the office look like when people walk in? What do the hallways look like? What do all those kinds of spaces? That's been something we've been working really hard on to make the the environments match what we're asking of students and staff. If we're asking students and staff to be regulated and to be ready to learn, then the space has to also be. Regulated and ready to ready to help learn, so I think that's a big that's a big piece that we've really been working on. That is definitely a part of wellness promotion, but maybe not always thought of in the same way that OT can bring can bring to that conversation.
Jayson Davies
Yeah, well, well, Kristen, Brianna, it has been a pleasure. I think we're out of time here. We have had such great conversations. Typically, I ask for one final like tidbit, right, to help out. But I think we've we've touched a lot. We provided a lot of tidbits between the two of you about things that school-based OT practitioners can do. And you know, listen, right, like even if you're not a consultant for a school like Brianna and Kristen are, you can do a lot of this internally, and these are things that real OTs are doing. And I can't wait to to talk with Nicole and and talk about how Brianna, you and Nicole and the rest of the team kind of did this more internally as opposed from an outside consultant type of type of business, but it's going to be amazing. I'm excited to see what you do dream up of and and do implement in the schools next because OTs have so much to offer. I'm going to kind of bring in something from my other world, which is OTpreneur, where we were in a conference talking about business and OT, and we were asking our audience members, like, why should OTs be starting these businesses? And one of the audience members like raised his hand and he said, because OTs do it better. And like, that's what you all are doing right here when it comes to these learning centers, when it comes to supporting mental well-being, when it comes to supporting handwriting skills and like all these things, OTs can do it better. We just have to find a foot in the door. Whether we're working as a consultant or working directly in the schools, we have a lot of knowledge, and we just need to kind of figure out a way to convince people to let us share it and show it, and and make progress. So I want to say thank you so much for your time and your energy and and your knowledge. And I also want to ask you, Kristen, where's the best place for everyone to learn more about holding space and the things that you guys are doing?
Kristen Brokamp
Sure, you can visit our website at www.holdingspacecollab c o l l a b.com, and then that is a good way to reach us as well. There's a form on there that you can fill out that goes directly to our email, so it's probably the best spot. We're also on Instagram and Facebook, although not our strength keeping up on that one. But we do do we do try to to do some social media,
Jayson Davies
yeah, yeah, and we will be sure to link to all that in the show notes for the episode. So be sure to check out the show notes, and yeah, one more time, Kristen, Brianna, thank you so much for being here. Really appreciate it, and we'll definitely keep in touch to find out all those things that you're dreaming of and that you put into place a year, three years, five years from now. It'll be fun. So thank you again. Appreciate it.
Breanna Lynch
Thanks for having us. Thanks, Jayson. We appreciate it.
Jayson Davies
All right, that is a wrap on episode 206 of the OT Schoolhouse Podcast. A huge thank you to Brianna Lynch and Kristen Brocam from Holding Space Collaborative for joining me today for such a rich, honest conversation about how we as OT practitioners can and should be supporting student behavior beyond the sensory lens, the work that they are doing is exactly the kind of thing that our field needs more of. Not thinking about sensory and sensory integration so much as thinking about participation and how maybe we use a sensory integration lens in order to support participation, whether that is related to behavior or otherwise, and of course, thank you to you for listening today. Whether you are a full-time school-based OT practitioner, maybe a part-time kind of within the schools and somewhere else, or maybe you're a stay-at-home parent right now just thinking about getting back into the schools, I really appreciate you being here, and I hope that today's episode gave you something to think about as you start the 2026 27 school year, or if you're listening to this later, whatever school year you are in right now. Now, if you enjoyed this episode and you want to keep going deeper on topics like this one and others, I'd love to have you join us inside the OT Schoolhouses School-Based OT Collaborative. That's our online community built specifically for school-based OT practitioners with resources, professional development, and direct mentorship from myself and the OT Schoolhouse team. And for this episode specifically, members can also get access to a slide deck that we build based on today's conversation. This is something that that will actually be able to help you kind of almost pitch to your administrators how you can support behavior within your school site. You can get all of that as a member over at otschoolhouse.com/collab. Until next time, keep showing up for your students. And keep being yourself, the amazing OT practitioner that you are. Take care.
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 otschoolhouse.com. Until next time, class is dismissed.
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