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OTSH 86: Journal Club - The Problem with Caseloads

OT School House Podcast Episode 72 journal club how much of school is fine motor anyways?

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Welcome to the show notes for Episode 86 of the OT School House Podcast.

In this journal club edition of the OT School House Podcast, we are examining the 2020 Seruya & Garfinkle article about the current workload trends in school-based OT.

We will discuss the findings from a survey of 571 OT Practitioners working in the schools just like you and talk about the real-life implications your caseload can have on your practice.

Spoiler alert: Your Caseload is likely holding you back, but listen in to hear how you are not alone and what steps you can take to move forward.

Also, stay tuned until the end for a special announcement and giveaway from Jayson.

Links to Show References:


Download the Transcript or read the episode below!

OTSH 86_ Journal Club - The Problem with Caseloads.docx
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Jayson Davies

Hey there, and welcome to this journal club episode of the OT School House podcast. My name is Jayson Davies. And I am so happy to have you here joining me from wherever you are. As you might have noticed, we're starting this podcast off like we have a few in the past where we do the intro first. And then we're going to cue that intro to the music that we all love so much in just a moment. But first, I just wanted to let you all in that this episode is a very important episode because we're talking about something called a caseload and a workload and how those differ how they're similar a little bit. And we're actually bringing in an article from the American Journal of Occupational Therapy to kind of show where we're at today, or actually where we were at in 2020, right before the shutdown of everything. But anyway, that's a different story for another time. So I'm excited to have you here this entire, this entire episode is going to lead to something bigger I have an announcement as well as a giveaway at the end of this episode. But I really want you, to listen in to this entire episode because it all comes together at the end for one big announcement that I'm super excited about and cannot wait to share with you. So let's go ahead and cue the intro. And when we come back, we're going to talk about an article titled caseload and workload current trends and school-based practices across the United States. Alright, I will see you in just a moment right after this intro.

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's your host, Jayson Davies, class is officially in session.

Jayson Davies

Alright, welcome back. Thank you again so much for being here. I want to start off by sharing a little bit of the demographics I guess you can call it the information about this article that we're discussing today. The title is "Caseload and Workload: Current trends in School-Based practice across the United States". It was published in the AJOT, the American Journal of Occupational Therapy back in 2020. So it is relatively new. And the authors who I just admire so much are Francine Seruya and Mindy Garfinkel, more on them in just a bit. The full citation can be found down in the show notes or at 86. I cannot believe we're on episode 86. This has just been a whole blur from episode one to Episode 86. And thank you so much for being along for the ride. So I want to talk to a moment about Seruya and Garfinkel, Mindy, and Francine they had been so instrumental in supporting occupational therapy practitioners working in the schools. This article as well as some of their other articles have been my go-to Resources. When it comes to thinking about what the next step in occupational therapy within the schools is. They have published articles about workload and caseloads and where we're at and maybe where we could be in the future. They've also looked at the three to one model, which some of you might know as being a model where you provide direct therapy services for three weeks and then you have that fourth week of the month to kind of do other things like maybe get into the classrooms to observe those students that you would regularly pull out and see also to maybe complete those evaluations maybe participate in some RTI or MTSS tiered intervention. So that is the type of thing that Seruya and Garfinkel have been pushing forward, almost kind of the next step for occupational therapy, how we can move from where we are today to where we can be in the future to support more students, more teachers with potential even less time. So I want to get into that. But first one last time, I want to give a huge shout-out to Francine Seruya and Mindy Garfinkel just for all the work that they have done for occupational therapy practitioners working in the schools. So let's go ahead and dive into some of the key terms some of the background information that this research article actually starts with. They identify a few things that we really need to know about in the first is caseload versus workload. They do define caseload as basically the students that are on your list of students that you have to serve. So the students that you serve, whether they're on an IEP or 504, the students that you are directly responsible for that is your caseload. We'll talk about the average caseload in a little bit. Now they define the workload as going beyond that more than just your caseload. But all the responsibilities and the time that those responsibilities take throughout your week or throughout your month, that's your workload. How many hours do you put toward RTI, toward driving, toward seeing the students on your caseload, toward maybe training teachers and working with staff, all of that is part of your workload. And as we get further into this study, you're going to see how many are using caseload but they're not using a workload approach. And when you're not using a workload approach that could potentially kind of skews what the numbers look like your caseload just simply doesn't tell the whole picture. And then they go on to talk about how this is really a paradigm shift. And switching from a caseload model to a workload model would in theory allow for occupational therapy providers to provide occupation-based interventions within the natural environments such as within the classroom. As you'll see in a little bit, most occupational therapists are using a pullout model, partially because that's what we have kind of schedule for us, you know, it's very easy to control a pullout model service, it's a little more difficult to control that push in. And therefore, it does take a little bit more time in order to actually prepare and complete that push-in model. In fact, we discussed this a little bit in the most recent episode, Episode 85, at OT School House podcast with Megan, right, we talked about how the struggles are so real when it comes to moving from that pullout model to more of a collaborative type of push-in model. And there are a lot of barriers involved in moving from that pullout, traditional pullout model to a push-in model. And one of those is that we are using a caseload-based model, that really just assumes that every student needs 30 minutes of services. And that's not always the case. And it does take a little bit more time when you have to plan to go into the classroom. And you have to figure out what time to go into the classroom. All those barriers that we talked about in episode 85, with Megan, are all relevant to what we're going to be talking about right here within episode 86. And moving from that caseload context to a workload approach. And then there's one last thing before we jump into our goals and hypothesis, and that is that the researchers know within their background of this article that while there are state guidelines, and even some district guidelines that have been published related to caseload and workload approaches, some states have even gone as far as putting a soft cap in place. But there have been no general standards implemented at the national level. And even at the state level, many of those guidelines, they're not law, and so they're not enforceable. And so you have districts kind of using them when possible feature with a cap, you know, a cap might be 55 kids, but then it says at the end of that when possible. Well, what does that mean? When possible? I mean, does that mean Oh, right. You know what, we have four therapists and we have 300. Kids? Sorry, it's not possible to keep your caseload at 55. So you all have to take on 70 kids? Well, no, that means you should be hiring someone, right? The district should be hiring. But because it's not a national law, or because it's not really enforced at even the state level, that isn't happening. And that is what is leading to some of our caseloads, continuously expanding, or maybe your caseload isn't growing, but your workload is growing, because you're getting more duties such as tiered intervention than your team wants you to be a part of. Or maybe you're being asked to be in more IEP meetings or longer IEP meetings. Well, that includes your workload, without actually increasing your caseload. Your caseload might still be 55 kids, but your workload, the time that you actually need to complete your job is growing. And so nothing related to national guidelines for that really exists. There are guidelines from AOTA and even ASHA, the American Speech and Hearing Association that say we should be moving to a workload approach. But again, they're just guidelines. There's nothing forcing that we do that. And there's nothing forcing the school districts to make us do that or allow us to do that. And so that brings us to our goals of this, this research and what the purpose of this research was by Seruya and Garfinkel, well, they wanted to reach out to occupational therapy practitioners working in the schools and find out what their caseloads were, and what activities were a part of their workloads. They didn't necessarily ask, Hey, how many hours of student direct therapy time do you have? But they did ask what do you have to do other than direct therapy time? And you know, documentation and evaluations writing up evals but also tiered intervention, all that is part of the workload. So they ask them what is a part of your workload? They also wanted to know the why behind who was using a case of the model and who was using a workload model. Why were therapists using the caseload model versus their workload model? Or vice versa? Why were they using a workload approach as opposed to a caseload model? So we'll talk about some of the data that came as a result of that. So then, let's have a look at the participants who completed the survey who participated in this. Well, there were actually 541 Occupational Therapy practitioners that started this survey. I am proud to say that I was one of them. Many of you probably also completed this. They did have therapists from all over the country participate in this of the 541 Occupational Therapy practitioners that started the survey 371 completed the survey. So what We kind of round-up, that's four out of six therapists that completed it. So that's about 66% of the therapists who started the survey also completed the survey. And in case you're wondering if the 541, occupational therapy practitioners that started the survey 479, were occupational therapists and 44 were occupational therapy assistants. There were a handful of others who are not US based, or they're not currently working, and they were excluded from the survey results. Demographics from this participation group showed that most of the therapists were working in a full-time job, meaning that they were working either 30 hours or more per week as an occupational therapist, going even a little deeper than those therapists who participated came from all over the country and had various levels of experience, if I remember, right, the most therapists came from the northeast, I think it was around 20%. And then about 20% also were within the one to five-year range. Within experience. However, there were therapists who had many more years of experience than those, who also participated in the study. So that covers the demographics of the participants. And of course, this is a survey so the word no interventions used, and the results are directly related to the survey conducted. So let's go ahead and take a look at the results. We're going to start with some key results here, and that is that therapists reported working in anywhere from one to 10 schools, and the average caseload was identified as 41-50 students, there's actually only one therapist, I think, that reported working at 10 schools, most of the therapists reported working in one to four schools. And despite having schools across the gamut from elementary to middle and high school, a majority of the therapist did work within the elementary range. Diving a little bit deeper into the caseload, I mentioned that the average caseload was 41 to 50 students. However, as we know, the average is not always what everyone has. So I want to share a little bit of the extreme. Looking at the graphs in the article, it's actually a little shocking, because you see that 10 therapists reported as having a caseload of greater than 120 kids. So 10 therapists, and more than 120 kids on their caseload, it does not identify as to whether or not they had an occupational therapy assistant, working to help them with that 120. But still, 120 is a lot, even if you do have an occupational therapy assistant working with you. Maybe if you have two or three OTAs working alongside you, then maybe that's a little bit more manageable. But that wasn't identified here. Going a little bit deeper, because we all know that 120 is a lot, but so is 80. And if we look at any other therapists who had 81 students or more on their caseload, 35 therapists or almost 9% of all respondents had 81 or more kids on their caseload. That's a lot of kids, I've been there, I've done that. That is a lot of kids, especially if you are trying to do that by yourself, it almost makes it impossible to see kids on a weekly basis, you can only see them on a console, maybe on a twice a month basis. Now, again, if you have an occupational therapy assistant, it does make it a little bit more manageable. But that is what was identified here in the research. Now with such a high caseload size, it's not difficult to understand this, but 60% of the surveyed therapist reported that their caseload was not manageable. And 55% of all of those who were surveyed noted that they were not always able to meet the mandated IEP minutes for the students on their caseload. That means that over half of us are not able to see the students that we need to see every week. That's pretty crazy. Because we are, that's our sole purpose. Even if you're going by a caseload number and you don't have any RTI going on on the side, your sole purpose of being on campus, is to evaluate students, and provide them the minutes of therapy that they need, right? That's like the basics of IDEA. And so to say that 55% of us are not even meeting the minutes that we are, "prescribing or recommending", if you want to say that, that's kind of a scary thought because we're saying these students need services, and we're not meeting those services. That's also a liability for the district. If parents knew that half of us were unable to see all of our students, can you imagine the uproar that would be happening among the parents, they'd be questioning whether or not their students actually getting the services that the occupational therapist recommended, and it might extend beyond occupational therapy might extend to speech therapy, physical therapy, adaptive physical education, who knows? Now getting beyond the average caseload, when asked to rate their most frequently used model of service delivery, 63 and a half of us occupational therapists who work in Schools rated non-integrated pullout as their most frequently used treatment model. The second most used model was integrated pushing services. So I think that was kind of expected. I think, at this point in 2021, where we're at or even 2019-2020, when this survey was conducted, I think that's the case most of us are using a pullout service as our primary model that we use as the students. Now, I do think that it is a bright point in the research though, that about 70% of therapists rated push in collaborative pushing services as being their most or second most used treatment model. That means that most of us are using a push-in service, in addition to a non-integrated pullout service, which is kind of cool, right? That means we're kind of choosing one of those two, as you get into collaboration, consultation, those numbers really start to drop, I have a lot of data. So I'm not going to go over all the data. But you can obviously check it out in your AJOT, the American Journal of Occupational Therapy, access that and you can find all the data, all the tables, and whatnot. Now, what we didn't get here that I would have liked to see is how many of those who are using a push-in model, or really any model for that case, felt comfortable using that model because I hear a lot from therapists on Instagram and in my email inbox that people aren't quite comfortable with that push and model. They don't know how to do that and be effective. They know how to go in and observe, but they don't necessarily know how to go in and actually provide therapy to the students within that context. So I would actually like to see another survey where we're able to see, do they feel comfortable with doing that. Now, another bright side to this research, in my opinion, was that about 50% of therapists reported being a part of 504 and servicing students that were on a 504 plan. I think that is awesome. I was actually a little surprised by how high that number was, I did not expect it to be at a 50% clip. Also, about 38% of therapists noted participating in some form of tiered intervention, which as you know, I'm a huge advocate for so that is also great to see. In the next section that we're about to discuss, I really consider this the bread and butter of this article. It just really shows where we're at and where we are going. And so about 46% of the therapist reported using some form of blended workload and caseload model, and 1/3 reported using only a caseload approach, about 20% noted using a workload-only approach. Now, this kind of didn't bother me. But I was a little left wanting more because I don't know what a blended program looks like. And I don't know that. Let's say Johnny over in San Demas. And Christine over in Glendora knows that their blended program looks the same. And so I think that if we're going to give an option of saying we use a blended approach, that needs to be a little bit more identified as to what that is because they kind of said that some therapists were using a blended approach, meaning that they had time for a workload, but they didn't really incorporate it. And it was, it was a little tricky to understand. But one thing that was very easy to understand is that only 1/5 20% of therapists had made the move to a full workload model. Not only that, but more than 60% of therapists reported attempting to make a shift to a workload model, but we're not successful. Despite that 77% of therapists reported being satisfied with their job and salary benefits and the therapist relationship with stakeholders was identified as the reason why therapists were satisfied with their job. So let's take a pause right there. Because I think that's a big number 60% of therapists have reported, hey, you know what, we want to make this shift to a workload. And we tried, we talked to our administrators, maybe we showed them some research, maybe you showed them this very article, but for whatever reason, the administrator said, No, we're not making the shift to a workload approach. Maybe you didn't even get that far. Maybe you just kind of wondered about it. And you're just like, Nope, I can't do it. There's no way the administration is going to go with this. I'm not going to go with it. I know that in the past, I have been just plain out shut down by an administrator saying No, I don't want to hear the term workload. We're not making the shift to a workload. We give you a caseload. You're expected to meet that caseload. Then they're also surprised when halfway through the year we're asking for help. So you know, it is hard, and I've been there done that. I've gotten through it with a few people and I've tried with others and I haven't gotten through it and I know many of you are experiencing that same exact thing. Now, as I kind of went on to say, it is nice to see that despite people still being on that caseload model 77% of therapists that reported here are happy with their job or generally satisfied with their job. And as I mentioned, the salary, the benefits, and therapist relationships with stakeholders, meaning like the teachers, administrators, were why therapists were satisfied. However, when they were asked to rank what would increase their job satisfaction. So even if you're happy, what would make you happier, or if you're not happy, what would make you happy, lower caseload numbers with the top selected option. So yes, people are happy because they have a decent salary, because they have good benefits, and they like who they work with. But they'd be even more satisfied if they had lower caseload numbers. And that information actually directly correlates with another article that I'm familiar with about where burnout is directly correlated with our workload. And the higher our workload, the more likely we are to be burnt out. But here in the schools, less than 20% of us are really even calculating our workload, because we're on a caseload model. And so we don't know what our workload is. Part of our role as an occupational therapy department is to really understand whether or not what we are doing is having an impact and who it's having an impact on, is what we are doing impacting student performance and increasing outcomes, or is it not? And also, what effect does it have on us and the entire district as a whole. Now, if we are only measuring by the number of students that we serve, that we're not measuring the impact that it has on the students, and if we're not measuring workload, then we don't know if what we're doing is actually effective with our time, maybe our time is going to IEPs for 18 hours a week. And is that really effective use of our time when we could be doing that with students. And so that's where a workload approach really can come into play because it can help us to evaluate our program internally. Likewise, if we think about that burnout rate, if we have high workloads, and we're getting burned out all the time, it's not only impacting us, but it's also impacting the district. It's really expensive for a district to hire a new occupational therapist when one leaves because they're burnt out. And so we can convey that to our administrators and say, hey, you know what, we can actually save money by decreasing our workload because that's going to save the district money in the long term because every year you're having to hire a new OT because the previous OT quit and was burned out and decided to go start a podcast or whatever it might be. So there is a reason to, to measure our workload. And it's not just for us, but it's for the entire district. Before we move into talking about some of the conclusions that the authors had related to this article, I want to let you in on some of the things that the researchers did not find because what they don't find is also just as important as what they do find the authors in this case, they tried to cross-reference some of the survey responses. And when they did that, it did not result in relationships developing between the use of a workload model and other factors such as the employment model region of the country and years of experience. I was kind of wondering if maybe the workload model would correlate with job satisfaction or even the caseload and they didn't provide that information within the survey. So I'm assuming when they made those cross-connections, nothing of significance popped up. Later in the article in the limitation section, they actually do mention that they wish they might have asked the questions a little bit differently and maybe formatted the questions a little bit because some of the questions did not lend themselves to being cross-referenced with another question. For instance, they did some ratings, right? Rate this from one to five or rate your top five reasons for being satisfied in your job. And some of those are hard to cross-reference to another question. And so that was one of the things that they think maybe they would do differently next time. And that leads us right to the author's conclusions. What did they take away from this? What do they want us to take away from this? Well, Seruya and Garfinkel, felt that OT showed that they have some control in the role, but primarily only during IEP meetings. They actually did ask a question, you know, do you feel like you have control in your role as an occupational therapist? And everyone said, Yes, or a large percentage of people said yes. But then when it came to moving to a workload, everyone said, Yeah, we tried, but it didn't work out. And so what they really gained from that was that yes, people feel occupational therapist, they feel like they have some, some authority when they're in an IEP, and they're providing the recommendation for goals and services. But outside of that IEP, they kind of feel like they don't have control, and they don't really have a role in the direction of the OT department, or the special education department as a whole, even potentially. Seruya and Garfinkel also noted that caseloads appear to be tied to job satisfaction, and because of this, they should be some form of effort from higher associations such as AOTA or maybe state organizations to advocate for national caseload or workload cap that may actually be enforced. As I mentioned earlier, we talked about this, they just were seeing that the caps that were put in place weren't really being enforced. And they thought maybe if it happens on a national level, that maybe it'd be a little bit easier to call out districts when they're not enforcing that cap. One of the barriers often identified for moving to a workload model from a caseload model is the funding. And they noted in their conclusions that therapists you know, if they are interacting, and they are participating in tiered interventions, such as RTI or MTS s, this could qualify a district for additional funding through IDE-IA of 2004. And going even further than that, this is my own part after I've learned a little bit from Dr. Bazyk, and so many others who are working in the role of the Every Student Succeeds Act, which didn't come out till 2015, and is still being a little interpreted to figure out how it really works. But maybe you would also get funding from ESSA, Every Student Succeeds Act, if you're doing more of those tiered interventions in the general education realm. Remember, IDEA is really specific to special education. But ESSA is really general, it's for all education, not special education. And so if we're supporting students, not in special education, then there are additional funding sources potentially, such as through grants from ESSA. And finally, what I think they felt like the largest outcome from this study is that therapists have a high level of interest in moving to a workload approach. Remember, 60% of therapists have tried and failed, and 20% have actually tried and made that switch to a workload model. That's 80% right there. And based on the high rate of therapists who have tried to make that shift, and were unsuccessful, they feel that more resources and training are needed to make that shift. And with that outcome, that is where I start to get really excited because I do see that happening, I do see the need to move from a caseload to a workload model. And I really have heard from you, the occupational therapist, that is working in your schools that you need help and that you want to make that shift. And so yeah, I'm just going to kind of forewarn you that the giveaway at the end of this and my announcement has something to do related to a caseload and workload shift. But before I get there, I do want to add that there were some limitations to this article. And the authors know that they pointed that out, they do have a limitation section, and the main flaw that they point out, and they knew it was that this was a researcher design study. And they knew that that could skew results. They did take measures to ensure the quality of the questions such as reaching out to colleagues before they sent it out to kind of have it proofread and check for understanding. But without using a standardized tool, there's always a question around validity and reliability. Likewise, they would like to see additional stakeholders such as parents, teachers, and administrators surveyed about similar topics, to compare that with the occupational therapist results. And now that brings us to my takeaways, which I'm kind of peppered a few in here and there. But I just first want to say I love what Seruya and Garfinkel have done here. There is something to be said about the perceptions of occupational therapists working in the schools, not just you know, how effective are we, but also what are our perceived notions about working in the schools. And what I'm hearing from all of you on Instagram and in my inbox is that you too are feeling overwhelmed by your caseload. And you want to know how you can change that you want to change and you want to know how to change. In fact, just this morning, I was messaging, an occupational therapist on Instagram. Hi, Alison, I know you listen to the podcast, and Alison and I were talking and she shared with me that she and nine other occupational therapy practitioners are responsible for more than 26 school districts and charter schools, herself has four different schools that she has to be a part of. Now four schools aren’t unheard of, but it's really difficult. I've worked at six different schools. Well, I had 12, we had two therapists, anyways, it's really hard to keep track of who everyone is, who the teachers are, who your kids are, even when you have so many schools that you're bouncing around from. And I think that by moving from a caseload approach to a workload approach, we'll start to see, you know, all that time that we spent driving, how can we decrease that time, all that time that we spend jumping around to an IEP, and then the therapist or sorry, not that therapist, the teacher or a parent isn't ready for that IEP, and we just wasted time. Now, a lot of that is changing, because we have zoom IEPs now. But still, there's a lot of things that go into a workload that just isn't accounted for in a caseload. And when you have a caseload consisting of four schools, six schools, one person 10 schools or more, that wears you down, and it's really hard to participate to your full extent, when you're trying to figure out what to do at four different school sites. I think there are two things that I can say here to kind of maybe help raise your spirits and the first is that you're not alone. 60% of therapists feel the same way according to this survey, they feel like they have too much on their plate. Remember, 55% of us can't even meet all the IEP minutes that we are responsible for every week for treatment minutes. So if you feel like you're struggling first and foremost, I want you to know that you're not alone. Right? We talked about earlier, 60% of therapists are feeling the same way according to this survey, we're feeling like we have more on our plate than we can manage. That's a lot. And 55% of us feel like we can't even meet the minutes that are required within our IEPs. That's a problem not just for us, but also for the district, as I mentioned earlier, right, the district has an obligation to meet whatever they are putting into the IEP. And if they don't, there are actual real significant outcomes that can come with that. And the districts can get penalized, right through either court or through funding, whatever it might be. So I do think that moving to a workload approach is actually a potential solution here. Likewise, another solution, I think, is that tiered intervention is something that we can provide to our schools that a lot of us are not yet providing. Only about 38% of therapists reported that they are using tiered intervention at their school, we're all using direct pullout, most of us are using pushing services. But very few of us are actually using a tiered intervention that could potentially prevent impairment or loss of function as Ida actually defines occupational therapy in Section 300, point 34, which can then potentially reduce the number of evaluations that we have to do and even lower our caseload, which ultimately, it doesn't necessarily lower our workload, but it allows us to put our time toward other aspects. Now, don't get me wrong, there will always be a need for individual occupational therapy services. I'm not saying that every student needs a push in occupational therapy service, there will be services that need to be in that pullout model. But we know that we can potentially help more kids through an MTSS model, and do that in less time than a pullout individual service. I really do wish that we had some sort of OT intervention research that showed how MTSS actually decreased the number of evaluations that were needed three years down the line or whatever it might be. Unfortunately, we don't have that maybe one of us listening out there, right now I myself can go back, get our doctorate or Ph.D. and do some research in that area. But it just isn't there. And, you know, RTI is picking up because there is research behind it. There's just not a lot of research related to RTI and occupational therapy. So that's one thing to keep in mind. And that brings me to my final takeaway, which is that we need to support each other in the shift from a caseload to a workload approach. I have been a little obsessed with Hamilton recently. And so the line that comes to my mind right now is that this is not a moment, it's a movement. And I think that's true. Right now we are seeing occupational therapists in the schools start to slowly move to that workload approach. And I think it's only going to compound and get more significant over time. And I really want to be there to support that. And that's why I am super excited today to announce that I am hosting a new course it is called Making the Shift: Caseload to Workload. And it really is a three-step process about helping you move from a caseload approach to a workload approach within your district, you yourself or you and your occupational therapy team will be able to go through this and I'm going to give you everything that you need in order to complete a time study to figure out what is going on with your time. And then analyze that and present it to your administrators in a way that hopefully, they can understand. Because we all know administrators think a little differently than we do as occupational therapists. And so I want to help you get into their brain a little bit, see what's important for them, and how we can come to some sort of an agreement that a workload approach is an approach that we need to move to in order to support our students, our teachers, our school and our community as a whole. Because it is not just for us, yes, it will benefit us as occupational therapists, but we want it to benefit everyone involved from the students all the way up to the superintendent of schools or even the county of education. We want to benefit everyone. I have been able to make the shift from a caseload approach to a workload approach. One and a half times in my career as a school-based OT. The first was for an entire small district though, I was able to move myself another occupational therapist and an occupational therapy assistant, we were all able to move to a workload approach and that allowed us to measure our time and it also allowed us to actually hire an additional occupational therapist when we were able to show that our time was really maxed out that we couldn't provide any more therapy service than where we were at. The other half-time. As I like to say that I did this was in my most recent occupational therapy job where I basically showed through a time study to my administrator, that I didn't have time to see all those students. And I was able to get help from a contractor. And then over time, we started to make more changes. Now, this was with an administrator who did not even want to hear the term workload. But through constant, I don't want to say pressuring or anything like that I didn't pressure. But I made my needs known through data, I use data to show that it was impossible to do my job. And by doing that, I was able to get the support that I needed. And that's why right now, I'm super excited to share that later this month in November of 2021, I am releasing my caseload to workload workshop making the shift. And I really just want to help you make that shift. There are so many of you out there that want to make the shift 60% have tried and have not been successful. Well, I want to take that 60% of you that want to do this, and I want to help you be successful. I want to help your district be successful. And so it is not quite ready yet. I will let you all know when it is. But right now, I want to give away access to the caseload to workload workshop for one lucky winner right now. And so all you have to do, yep, this is the giveaway point. If you fast-forward it, you're in the right spot. All you have to do is tag me in an Instagram story with you listening to this podcast. So either take a screenshot of your phone, or take a picture of your car with the OT School House podcast playing whatever it might be, and tag me in a story. And yeah, that's all you have to do. Just do that between now and Sunday, November 21. If it's November 22, or later, and you're just now hearing this, I'm so sorry. But I have to have an end to a giveaway at some point, right? It can't go on forever and ever and ever. So November 21 is the last day that you can enter to win the making the shift caseload to workload workshop by tagging me OT School House in an Instagram story. Okay, do that show me that you're listening to the OT School House podcast. And I will be happy to enter you in to be one of the potential winners for the giveaway. And with that, I'm going to say goodbye to episode 85 of the OT School House podcast. Thank you so much for being here. I always appreciate my time with you. Thank you for allowing me to be a part of your day. And I'm so excited to help you make the shift. Let's make the shift for the OTs make the shift for the students make the shift for the principal to teachers all the way up to the superintendent. Let's make that shift from a caseload model to a workload model to support everyone. I cannot thank you enough for listening. Have a great Thanksgiving. Have a great rest of your week. And I will see you back here for episode 86 Take care. Bye.

Amazing Narrator

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

Jayson Davies

Oh and one more thing if you just listen to this episode, and it is beyond November 2021. And you are super excited to make that shift from a caseload to a workload model. I want to help you go ahead and head on over to to learn how you too can make the shift from a caseload to a workload model. See you over there. Bye

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

Have any questions or comments about the podcast? Email Jayson at


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