OTSH 85: Facilitating Collaborative OT Services with Meghan Fox, OTR/L




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In this episode, I am bringing on Meghan Fox, OTR/L, from Wootherapy.com to talk about her transition from providing primarily pull-out OT services, to a more collaborative service approach.


Meghan shares with us why she decided to make the move and what those collaborative services look like. Also, she gets very real with us and shares what is (and is not) working during the transition.


There will always be students who need pull-out services, but there will also be students who learn best from in-class, contextually relevant services. So let's talk about how we do that.


Listen in for more and check out the show notes at otschoolhouse.com/episode85


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Episode Transcript

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Amazing Narrator

Hello and welcome to the OT School House 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

Hey there, welcome back to Episode 85 of the OT School House podcast. My name is Jayson Davies, thank you so much for being here with me today. Whether you're in your car, working out at the gym, wherever you might be. Thanks for joining in and listening to this episode of the OT School House podcast. Today we have joining us, Meghan Fox, she is an occupational therapist here in Southern California actually not too far from me. We'll talk about that during the episode. But yeah, I'm excited to have her many of you have probably already interacted in some form with Meghan on Instagram actually, that is her main platform where she does post under the name wootherapy. She is the brilliant mind behind wootherapy and the woo tape that she produces for her company wootherapy. We're not going to talk too much about the woo tape even though it is a fantastic product where you can actually it's taped that has handwriting lines on it. So you can rip off a piece of tape, add it to a piece of paper and you have a handwriting line. So we're not going to talk too much about that, you know, Meghan is just so humble, so kind. And we're not trying to sell anything, but I do want to mention it because it is such a great product. But what we are going to talk about today and I'm super excited, because we're going to be very open, very candid in this episode, and talk about how Meghan has started to shift from a pullout model of services more to a push in collaborative model service. And you know, this isn't something that happens overnight, you can't just flip a switch and turn all of your students from a pullout model into a pushing collaborative model. That's not how it works. But as you will hear from Meghan today, it does happen over time, and you can make a slow, steady shift, she is not to the point where she's at a full 100% of a collaboration pushing model. And you know what, she may never get there and that's okay. Most of us probably never will, because that wouldn't necessarily be ethical. Some kids do need a pullout model of service and that's okay. So without any further ado, let's go ahead and jump into my interview with Meghan Fox from wootherapy and talk about how she's making the shift from a pullout model to a collaborative model. I really do hope that you find our candid conversations really helpful within this interview. Hey, Meghan, welcome to the OT School House podcast. How are you doing this evening?



Meghan Fox

Hi, Jayson I am good. So happy to be here. I know. We have both been looking forward to this for a while. So excited to finally be on that OT School House.


Jayson Davies

Yeah, I'm really surprised it took us this long to get you on to the podcast. I mean, we've known each other for a little while. A few years now you live literally like, I mean if there wasn't hell in the way. Baseball? Not quite that far. But not that close. Yeah. But no, I'm so happy to have you here. I mean, you are the mastermind behind wootherapy and woo tape. Don't give me that. Look, you are a mastermind. You are awesome. Every OT, we are all awesome. So yeah, so we're going to talk a little bit about that. But first, I want to give you the opportunity to kind of share your story about how you fell into occupational therapy. And even more specifically, how you fell into school-based occupational therapy.


Meghan Fox

For sure. So I feel like I've heard this story a lot from other OTs I've heard on podcasts but it's so funny how it happens because I literally thought I was on the path to PT through college and then I get to my junior year and then they want me to take like quantum physics and like all these crazy science courses and I'm like, like pump the brakes, no not going there. And so it just kind of snowballed into talking to my advisor. What other you know, I've taken all these, I was a cornice major. So took all this human movement, all the anatomy physiology courses, like, what other realm or you know, road and path Should I go down? So she's like, oh, have you ever ever thought of occupational therapy? I'm like, No, what's that? Got more information? and funny story. She literally showed me the pamphlet of the top OT Schools and USC was on there. I'm like, I knew before college that I wanted to be out in California. So I'm like, Okay, done. Like, let's just put in the application. Hmm. Yeah, no, that's just another side story. But yeah, so that's kind of how I fell into it is, I wasn't up for taking all the coursework, not because I'm lazy, but just that wasn't my interest. If that wasn't my strength and my skill base come to find out and turns out occupational therapy is the most perfect fit for my creativity, my coping, you know, interaction with people. So, yeah, that's kind of how it happened. And then for as getting into school-based, so I ended up coming to USC, as you know, didn't even apply anywhere else should have, like, looked into it more, but I was kind of like one-track mind, I want to get out to California. So everything has worked out so far. But uh, so while I was there, I took the school-based course with Julie Bissell. And so which was great. And we've maintained a relationship still to this day. She's a great mentor to me. But what happened was, I did two years in a clinical-like sensory clinic on the west side of LA, and then decided I was going to move down to Orange County. So reached out to her for some, you know, I started applying for school-based jobs, and there was like, four available and I was like, What do you think of these? I, you know, I'm not so sure I'm familiar with these districts, and one was like, OCDE...


Jayson Davies

Orange County Department of Ed.



Meghan Fox

Yeah, sorry, jargon for those listeners don't know. And so she kind of steered me in a direction where she was collaborating with my current district to actually start an OT-PT department. They had been contracting for so many years, and not being able to keep reliable, consistent therapists in place for all the services that they were needing to provide. So she collaborated did the whole needs assessment, like, this is how many therapists you would need that this is what you would need to pay them, this is what some of your spaces should look like. And they bought, like all this equipment, it was really rad. She was very instrumental in developing our department, and then was very instrumental in helping me get the job because I didn't have any school-based experience. So she was kind of offering them, you know, my personal strengths. And, you know, so anyway, it worked out because, at the time, I think they hired in waves, and in my wave, they hired like, six, and I think I was the only one without school-based experience. So they really took a chance on me, which I'm grateful for. Because now being on some interview panels, it's like, oh, I don't know if I would take someone without experience and not disparage any listeners who are new to school-based or hoping to get into it. But it's, it's challenging. If you don't know, you know, you have to start somewhere. So obviously,


Jayson Davies

we actually do have a lot of people that listen to this podcast, specifically, because they think they're about to have an interview. And they know they need to learn some of the lingoes. And this is the perfect place for those people to be in my opinion, because we talked about IEPs. We talked about treatment. And we talked about the hard stuff about school-based OT, so I kind of want to lead you right into that you're kind of going there. But tell us about those first few years that first year, even in school-based OT what was it like and what did you learn?


Meghan Fox

Yeah, so I think I had an experience, unlike others, that I'm extremely grateful for. So because I didn't have any school-based experience, they placed me at two school sites where there was another therapist there. So we kind of I split the caseload at two sites, and another therapist was also there. So we overlapped at least one day where I could watch her treatment plan, I could watch her right IEPs, I think I sat in on a few IEPs that I wasn't a part of to understand, like, you know, kind of speak when spoken to like you know about you the areas that are relevant to you and just the dynamic of the team and how-to, we would have a lot of collaborative meetings with the whole IEP team prop you know, staffing is essentially before big meetings and stuff. So I got mentoring that I don't feel a lot of therapists get. And to me that made a lot of difference in my ability to then feel successful or confident to then keep going because I know school days can be grueling. For those that don't have any mentorship and they're just handed caseloads of 60 plus students, you know, plus, plus. So kind of piece of advice if you can, if there's anyone that you feel like you can trust or reach out to just say, hey, once a month, can I email you some questions and get some feedback, like any sort of opportunity to get some experience from someone else if you're new to school basis, kind of invaluable.


Jayson Davies

Yeah, and you know, I even found because I was in kind of that position at one point where there wasn't really any other OTs and I kind of reached out to other OTs that weren't in my district, but also to other speech therapists psychologists to, you know, they weren't OT they didn't know that side of it, potentially. But they knew about the IEP, and they knew how to get through tough IEPs and even a little bit that can help you with understanding IDEA and the laws specific to your state, just that kind of material that we don't get necessarily in school-based OT. What about actual therapy? You those first two years? What type of therapy did you actually provide? were you doing collaboration at that point? Or was it a lot of pullout pushing? What did that look like?


Meghan Fox

So it was a lot of pullouts because that's what I felt comfortable with. I didn't know the teachers, so I didn't know when was appropriate, or if it was okay for me to go into their classrooms. And, you know, it's taken many years for me there still find a rhythm with them, like, sometimes I'll schedule kids, and they're not even working remotely on something that's going to apply to my goals. And so it's just like an ebb and flow. And so yeah, those first few years, I was so comfortable with my clinical kind of experience. So I was pulling them into my room, like, so thankfully, I had a space where I could work with them. And I was kind of pulling a lot of that kind of treatment out and working handwriting in until all these different things. And I felt like I saw tons of progress. And at that time, because my district was transitioning from contracted therapists to district employed. Yeah, we saw, how do we put this kindly. We saw a lot of students getting services, maybe that didn't need the intensity, based on contractors aren't going to get paid unless they have students to service. And I'm saying, I'm trying to get it.


Jayson Davies

Yeah, no, no, let's have a conversation about that because I think it is a real conversation to be had. And I've seen it go both ways. You know, I've seen, I have worked with contracted therapists, I've been a contracted therapist. And personally, when I was a contracted therapist, the last thing I thought about was, I need to give this student more services so that I get more hours. However, that being said, when I was a contracted therapist, I was almost an in-house provider, because the entire every single person that worked at that district worked for the same contractor. And we were basically hourly employees at the school site. So it didn't matter whether or not we had 50 students on our caseload or 25 students on our caseload, for the most part, we were, it was like we were in the house. And I've seen other therapists too. I just don't think that they feel like they're personally doing that. But I can see maybe where people are independent contractors, they're their own business owners. And that does happen. And I could see that potentially being something that they think about, you know if I see the student three times a week, that's an extra two services to pick up as far as $50 an hour or whatever it might be. So I can see how that could work out.


Meghan Fox