Successful Strategies for a Collaborative Team: Part 1
For many years I taught a seminar entitled "Making the Grade in School Based Therapy
." The course was designed for OT's and PT's transitioning from a hospital or clinic setting to school based services. Understanding the differences between the medical vs. educational model is critical to therapists so that we can provide provided efficient and ethical services in the schools. I always closed the course with my favorite tips for becoming a successful member of the educational team. With back to school season underway it seems fitting to include them here:
1. Establish Your Identity! Be sure teachers, parents and other school personnel (yes even the school secretary) know who you are and understand your role. We are therapists...not the Handwriting, PE, Typing (fill in the blank here of what you are sometimes mistaken for) _______ teacher.
2. Remember that OT/PT are related services. In the medical model we are used to seeing the child directly and usually 1:1. In school based practice therapy services are provided once the team determines that the child would benefit from physical and/or occupational therapy to help support IEP goals and objectives. Services may be provided directly with the student and/or also on behalf of the student (such a working on a piece of adaptive equipment or as program support/in-service training for school personnel).
3. Avoid separate goals and objectives. See #2. Therapists must learn to operate as part of a transdisiplinary team. Remember that IDEA does not call for discipline specific goals. Goals should reflect the overall student's educational targets and progress.
4. Understand the continuum model for services. This one can trip up even the most seasoned therapists. From the medical model we are used to putting a child on a regular therapy schedule (such as 1x/wk for 60 min session) and keep this kind of therapy schedule for many months and in some cases years. In the educational model, the services are provided on a continuum so services may fluctuate according to the needs of the student. For example, a child with autism beginning school may initially need weekly or more intervention at the kindergarten level when there are high needs to provide assistive technology, sensory diet suggestions and/or in-service teaching personnel. Once these initiatives are put in place successfully then the role of the therapist may shift to a more supportive/monitoring role to ensure successful implementation. If new problems arise and/or the child transitions to a different school for example, the intervention level may have to be stepped up again temporarily to address these issues. And so it goes with service provision waxing and waning according to the individual needs of the student. The type of service provision (direct, monitoring, consultation) may vary according to the needs of the student and the therapist should used best practice with team collaboration to determine what is indicated at a given time along the continuum.
5. Communicate clearly. When switching from the medical to educational model be sure your reports/narratives are in a language that parents and teachers can understand. In Hanft and Place's book entitled The Consulting Therapist they open chapter 2 with this paragraph:
"A humorous example of how a therapist's clinical perspective can obscure meaning was reported by a program director who accompanied his staff occupational therapist to a parent conference. After a long explanation of why the child needed ROM for his RUE, the mother final asked what an R-U-E was. When the therapist answered right upper extremity, the mother replied that in her family it was called an A-R-M." Need I say more?
Stay tuned later this week for Part 2 of this blog......