Occupational therapist Stacey C. is a San Diego native. She’s been a practicing teletherapist since 2012. Stacey is the mother of a 13-year-old boy and a 12-year-old girl, both doing virtual schooling. And she’s an amateur scuba diver—with her husband, she’s done scuba dives all over the world.
My husband and I were married four years before we had kids. Scuba diving was our life then. I have two children—a 13-year-old boy and a 12-year-old girl. We’re having fun with both of them in middle school, both doing virtual school right now while I am in another room doing my virtual therapy. We had an advantage since I have done virtual therapy…this is my fifth year. I do have some tech knowledge to help them figure their things out.
What inspired you to become an OT?
I initially had wanted out of high school to go into marine biology because I was very interested in the ocean. I changed my mind because I damaged my ears when I was doing some free diving so I couldn’t get into the ocean as much as I wanted to. I started on a different path at this point. I was searching and my cousins who are twins and live in Ohio were both occupational therapists and they said “You’ve got to check this profession out. We think it would be great for you.” I had a chance to go to Ohio, observe them, and that’s the direction I went. I became an occupational therapist.
What made you want to be a teletherapist with PL?
It was a little bit by accident, a little bit because of need. Back before I became an OT, after looking at the profession itself, one of the reasons I chose OT was because I knew there was a way I could be home with my own kids eventually when I had them, more so than in another profession. So that was part of my decision to become an OT anyway.
I did a lot of hospital-based rehab. I was the director of a rehab hospital at one point. Then I was working in a community-based, brain injury reentry program. I have a friend who is a speech therapist. She used to work with PresenceLearning. She told me about what she was doing with teletherapy. I was already really comfortable with computers and it intrigued me. I thought “Wow, this is going to be the best of both worlds. I can still do my occupational therapy and now I am home more with my kids.” She told me all about PL and how things work. Even though she wasn’t an OT, she was able to mentor me on the platform side—she let me know what she did and how she worked with students. That launched me into teletherapy in 2012.
What do you enjoy about being a provider with PL?
My favorite thing with teletherapy itself is I feel like I connect with families and not just the student. I hear this in general. Even now since we’re all forced to be in this virtual world, more therapists are realizing they are getting more communication from parents and they’re able to actually train parents more than when they were at the school. Even teachers are getting more out of therapy because they’re more focused on what you’re doing versus in the classroom when they have everybody else running around. Teletherapy does open up a lot more learning opportunities, not just for the child but for the caregiving team.
Does this new form of connection with parents have any impact on the continuity of care, and progress and reinforcement.?
I think it’s huge. I’ve not only seen it myself, but the parents are starting to communicate with me even during IEP meetings. I hear things like “Wow, we had no idea what OT was about.” Speech is pretty easy for them to understand but they’re hearing from me directly now how to position their child, what kind of paper to use with their child, what kind of activities will strengthen their child. Previously, they had no idea that these things were happening in school—they were getting progress reports and some information from the teacher, but now they’re getting a whole new perspective and they’re having positive things to say about the new interaction.
What were you most surprised about when you made the transition to be a teletherapist?
I was surprised by the fact that it worked. I think I learned how creative you could be to still do all the same things you would do in person with a student but you just had to do it in a different way. It was helpful because I realized how much more independence I was actually giving a student sometimes because I wasn’t there to help them more, physically.
I tell this story sometimes. When I first became an OT and I was working with patients, I remember this one time when a patient was trying to button their shirt. I was standing behind them. They were struggling and I was back there switching foot to foot because I wanted so much to go in there and help them, but was working hard to hold myself back. I was being so obviously impatient. They finally asked me, “What’s wrong?”
Hands off for an OT is actually so important, and it’s a learned skill when we first start as therapists. We can’t go in and do it for them. With PresenceLearning, doing teletherapy forces you to have to use your words to communicate to teachers and parents how to set up for success, and how to help the kid struggle a little bit—you still want to have just the right level of challenge. It’s really cool to see how working with a student via teletherapy gives the student a little more push to work because they don’t have someone right next to them to pick up the pieces.
What do you find most challenging about being a teletherapist?
It’s not a challenge with every student. The positive note is we do get more engagement with parents but the negative is that sometimes we get a lot less engagement. I think from some parents’ perspectives, they see school as: the student is now over there in school and I’m over here. So sometimes it is a big challenge to get parents to understand the importance of sitting with their student during therapy. Not all students need that. But that is one of the challenges…to help parents understand that when I am sitting with your student, I’m not just teaching your student, I am teaching you as well. So your student is going to go from 20 or 30 minutes of OT and then leaving, to now strengthening OT all the time because the parent can support the concepts and strategies that we went over in a session.
Parents have a lot of things they are used to doing and need to do outside of sitting with their student. I try to work with them on scheduling—by gently helping parents see the advantage and work with them so they don’t feel so stressed. Usually I start with some emails to let them know what their student is doing. I might write something like, “Hey, they just did this amazing thing. I’d love for you to come to the session and see their new skill.” Sometimes I have to call them. Some parents are really responsive to emails, some to calls, some to texts…I know pretty quickly which parent is going to respond to what. I try to use all three most of the time. I will work with the parent and will adjust to their communication preferences, whether that be email or a quick phone call.
When I tend to get stuck, where I am not really seeing that the parent wants to buy in, I will engage the case manager and the IEP team. Usually if the student is having speech therapy as well, the SLP and I will talk with each other. Sometimes one of us is having more success with a parent coming than the other and we’ll play off each other—for example, we’ll see if it is a challenge with the scheduling. Some parents are really uncomfortable being on camera. In speech therapy parents can sit off to the side more. In OT we want parents to be more hands on. It’s hilarious. It will be like this: here’s the kid on camera and I know there’s a parent because I hear their voice and I see their hands but I don’t see their faces. I’ve had a lot of parents though who eventually get comfortable, even if they don’t have their morning face on.
How did your practice change during the COVID-19 crisis?
Students I used to see at school with teachers and teacher’s aides initially had difficulty with the concept of school at home. Parents were also a little overwhelmed at first and not sure how to set up schedules and an appropriate environment. I helped by providing guidance on movement activities to “get the wiggles out” before sitting to focus. And I’d provide guidance on how to minimize distraction. But once everyone got into the groove, it has been wonderful seeing parents more aware of their student’s abilities and how to bring out the best in them academically. Parents are learning so much more about Occupational Therapy and our interventions and techniques. I am also learning more about my students as parents share more about home life and students get a chance to show me their activities at home.
How have you been helping parents and caregivers who are now acting as the primary support person with their child?
I think the most important advice I’ve been giving parents is the fact that students thrive best with structure—structuring the “school day” and the student’s environment. I’ve also let parents know that providing opportunities for movement and fun within that structure to motivate and help with focus is just as important as the academic lessons the students are completing.
Could you walk us through your daily routine? A “day in the life of a PL therapist” if you will?
This is my day in the life of COVID-19 because I have my two kiddos in middle school who are home. I’m trying to get really good by doing an exercise routine when I get up. It definitely helps wake my brain up. I have a little breakfast and coffee and a little quiet space. I think I do better in the morning prepping and calming myself than I do at night. Then I usually go and make sure my kiddos are set up, that everything is charged, and they can log into their classes.
Then I go into my office and check my schedule. I just set up a new office. I set up a standing desk so I’m not always sitting. I usually see students starting between 7:45 and 8:30 am. I try to schedule breaks and I always try to carve out lunchtime, although as a therapist we have to fit in meetings sometimes. Sometimes lunch is a meeting and a bite.
I’m so impressed with the content PresenceLearning puts out via a weekly newsletter to the Providers in the PL Care Network. A recent article referenced voice care and how to avoid vocal fatigue. Even though I’ve been a teletherapist for a long time, I feel like my schedule is more stuffed than it used to be and I am talking a lot more. Yesterday at the end of the day I was really feeling it. So I am trying to pay attention to what I can do for self care. Standing is my self care thing. I am going to try to do some things for voice care so I am not hoarse at the end of the day. Usually when I am done with students around 3, I’ll take time to do as many notes as I can so I don’t get behind. I try to keep on top of notes so I don’t get to Friday and have 30 notes. I’ll look over emails.
I try to turn everything off around 4 pm. I walk out of my office and try to spend time with my kids. Even though I’m popping in and out with them during the day, we’ll have a deeper conversation. I’ll ask them questions like “How did your school day go? Do you need help with classes?” Then I do my cooking. I’ll prep our dinner. We often pick a show to watch. We’re big sci-fi fans. We like The Mandalorian. I use puppets some time and I actually have a baby Yoda puppet. We have our dinner and clean up.
I do come back to my office after dinner is over and just make sure whatever I really had to do is done, whatever I really need to prep for the next day is done. So I spend about 30 mins or an hour more making sure that everything is good, everything is shut down. Then I just chill and try to get to bed before 10 pm. That’s my day.
What age range/student population are you currently serving? Please include demographic information.
I am serving Kindergarten through 12th grade, mild to moderate and moderate/severe population. Disabilities include Autism, Emotional Disturbance, ADHD, Down’s Syndrome. My students are all in California now. I do have a license in South Carolina. I was seeing kiddos in South Carolina two years ago so I did have a different time zone for a while. At that time, it worked well for me because I could see students before I had to drive my kids to school. Then I could see more kiddos and I had time to go pick my kids up. So I was able to start my day a little earlier being in California. Today, my schedule is working well with all California kids.
What tips do you have for other providers getting started with telepractice?
My best advice is to reach out to the veteran telepractice providers who have already navigated the challenges of transitioning to providing virtual therapy service. Most importantly, take time to practice with them. Getting comfortable with your platform functions and all of the features you can use for instructing your students will go a long way in helping a new telepractice provider move smoothly through therapy activities while making it fun and engaging for their students.
What approaches have helped you to reach out? What helped you to find practice partners and set up practice times?
I’ve connected with everybody in the PresenceLearning Lounge. I have also reached out to our CAMs or the people in the different districts. My one friend who was with PL was able to connect me with different therapists. It’s really great that PL is having a lot more office hours. Even as a veteran, I appreciate going in and seeing fresh ideas. The same thing I recommend for new therapists, I still recommend for veterans too.
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