February 20, 2024 • 26 mins
Join Gina on Animals and Aquatics as she explores purposeful steps for occupational therapists and assistants interested in animal-assisted and aquatic therapy. From establishing legal foundations to crafting exceptional client experiences, Gina provides practical advice for navigating the unique challenges of these specialty areas in occupational therapy. Whether you're considering starting your own practice or integrating these therapies into an existing setting, this episode offers valuable insights to guide your journey. Tune in for expert tips on legal requirements, business strategies, client communication, and skills development, and take the next step towards a fulfilling career in animal-assisted and aquatic therapy.
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(00:01):
Hi, this is Gina, your host ofanimals and aquatics.
And tonight we're going tocontinue our getting started
series.
Glad to have you with us.
(00:31):
This week on animals andaquatics, we're going to
continue our getting startedseries to help you get started
in an occupational therapycareer, incorporating animals,
hippotherapy, or aquatictherapy.
In this series, we've coveredthe preparatory steps that you
can take to get started.
This week, we're going to focuson the purposeful steps that you
would take, just like in anintervention.
(00:52):
We often do our preparatory workfirst followed by purposeful or
occupation-based interventions.
So this week, we're going tofollow that same path and focus
on purposeful activities thatyou can do in the getting
started path.
If you haven't listened to ourpreparatory episode, I urge you
to go back and start with thatone.
That way you get an idea of thethree topic areas I'm covering.
(01:15):
Skills.
Business and legal.
But this week, we're going toflip it on its head a little
bit.
And we're actually going tostart with the legal stuff.
Because when we get to thepurposeful step, it's really
important to take care of thelegal stuff first.
And in some cases, some of thatmay take a little bit longer to
take care of.
So you really want to get thatdone first.
(01:37):
getting some of those ducks in arow.
Getting some of those steps donewill be really important before
you invest money in some of theother purposeful steps that you
will be taking during thisphase.
So let's get started.
In the legal phase, we want totake care of things like getting
our MPI number.
(01:58):
Now, many therapists willalready have an NPI.
One number.
That's an individual number, andyou may have that from working
at another therapy company.
But at this point, you want tostart thinking about getting an
NPI to number.
And with that, that's going tocover a group or entity.
So with this, we want to thinkabout.
(02:20):
Your business structure.
So legally, what is yourbusiness structure going to be?
And some of that is dictated byyour state.
And it's really important tolook that up and know whether
you are able to form an LLC, a PLLC.
If you're thinking about goingthe nonprofit or 5 0 1 C3 route,
(02:42):
those are things that you reallywant to tackle early on.
So in this purposeful phase,it's really important.
To figure out legally whatbusiness structure you can set
up and then begin to do that.
There are a variety of differentindividuals that can help you
with that such as a lawyer oryour state's website.
And there's also some onlineservices that can help you with
(03:02):
that as well.
But you'll be looking at gettingan E I N number.
So that's filed with the IRS andthat's going to identify you as
an employer and that will bepart of your business filing as
well.
So the legal pieces that comefirst are those business
structure pieces.
(03:23):
And because you need a lot ofthose before you can move on
with some of the other steps.
So when you get to thispurposeful phase, you're really
starting to put steps intoaction.
That is going to get you closerto your goals and you may be
thinking, well, I'm really onlyplanning on seeing a few
clients, maybe one night a week.
(03:44):
Do I really need to do all this?
And the truth is often you don'tneed to do all this.
You may not need to do that.
You may not need to do all ofyour business setup, but I do
recommend setting yourself upright from the start, because
not only does it give you thebusiness structure that you may
need, even if you're only seeingone or two clients.
(04:06):
But it also affords you somepotential legal protection in
the event that something happenswith a client, whether it's a
malpractice or just a generalliability slip falls sort of
situation.
There is a little bit moreprotection if you do have a
business structure set up.
(04:26):
Rather than if you're practicingindependently.
So, the basic legal requirementsthat you're going to have is
that you're complying with yourlicensure laws, with your state
licensure, whether you're an OTRor an OTA, and that you have
supervision in place forwhatever.
Treatment and interventions thatyou are doing.
(04:49):
So thinking about getting thosecomponents together and that
supervision component issomething that we touch on in
the business barn raisingcourse, because.
As a professor for OTA students.
There's a lot of questionsaround being able to practice
more independently while stillmeeting your supervision
(05:09):
requirements.
So I think that's somethingreally important to think about
in this legal category whenyou're getting to the purposeful
phase, you want to get thatsupervisory relationship set up.
This is think about like gettingcontracts in place, having
attorneys review paperwork.
The legal.
Purposeful side of things is, isreally starting to get things
(05:33):
together that are going to notonly allow you to be successful
in starting working in one ofthese areas, but is also going
to help you practice ethicallyand be protected legally.
Now if you are an employee.
And you are working for someoneand you want to start a program
(05:56):
that is incorporating one ofthese treatment tools and your
focusing on bringing this intoan already established.
Occupational therapy program tonow it looks a little bit
different, but there still aresome legal considerations that I
want to touch on.
If you are in an employeesituation and some of that is.
(06:19):
Making sure that you've had thediscussions with your
administration.
And if there is a legal teaminvolved at your place of
employment, that they've beennotified that you will be using
some new treatment tools andthey may need to look at
liability forms.
They may need to look atstandards and compliance for
(06:40):
accrediting bodies.
They may need to go throughthose particular components.
If you're bringing animals intothe facility, the legal team
generally wants to know thatthey may have an additional
waiver that needs.
To be created and signed byclients who are going to be
interacting with the animal.
And that could be a dog or go.
Or a bearded dragon.
Like it doesn't have to be.
(07:01):
A farm animal.
It can even be a small animal,like a bearded dragon, but
there's still generally going tobe some additional legal
paperwork that would be requiredfor you as an occupational
therapy provider to incorporatethat into your session.
So thinking about those legalside.
Legal sides of things you wantto make sure you have all of
(07:21):
your bases covered.
So, whether you're starting thisas a side hustle on your own,
and you need more of the legalcoverage.
Or if you're doing this underyour employer.
Then you want to make sure thatthey have gone ahead and checked
off all those boxes.
Make sure.
And that there's nothingexcluded from their liability
(07:43):
coverage.
And really just go througheverything to be really
comprehensive about that.
And in this purple purposefulphase.
You have that opportunity totake a deeper dive into what are
those systems that are set upand making sure that they're
going to accommodate the areathat you want to now bring into
(08:05):
your occupational therapypractice.
If that's going to be in thepool, do you need to have a
contract?
With the facility that has thepool, or do you need to have
something written up?
Maybe there's a new waiver.
That you're going to add intoyour intake packet, mate.
So this is a good time to gothrough those again, this is a
(08:26):
good time to sit down with anattorney.
And just have them go over thepaperwork.
And I especially think whenwe're in a niche area of
practice, that.
Going through that.
Paperwork phase with an attorneyis a wise decision because
although there is a bunch ofattorney reviewed paperwork out
there, it's often dealing withclinical services.
(08:48):
And when we're outside thetraditional clinic, it is often
helpful to have some additionalphrases added or there may be a
recommendation for an additionalwaiver.
And we also want to be aware ofwhat our state liability laws
may be for like an equineliability law and those vary
from state to state as well.
(09:10):
So just really.
Being very sure.
About any laws that may pertainto the particular area that
you're looking to specialize in.
And I'll give this as anexample.
In New York state is arequirement.
That anyone under the age of 18wear a helmet when they are on
(09:32):
top of a horse.
And if you are working intherapy and you have a client
with compromised head control.
And you think that maybe ahelmet would not be the best
choice for them.
Now you have an issue betweenyour professional judgment and
competence.
And the state law, and that'swhy I'm recommending again, in
this purposeful phase to reallygo over those things with an
(09:55):
attorney.
So that way they can give youguidance that state specific.
Because those types of laws dovary state by state.
So that phase, when you wrap itup and tie it off with a bow
feels really good.
It feels really good to haveyour legal ducks in a row and
know that you are really readyto look next at the business
(10:18):
side of things.
And like I said, this week,we're flipping it backwards.
Because I feel like when you'repreparing and you're in that
preparatory phase, it's reallyimportant to see if you have a
good match with a skillset andit's something that you want to
do from a work perspective.
And then you can kind of look atlike the business and legal side
of things, but once you movefrom that preparatory phase into
(10:41):
the purposeful phase, it's superimportant to really go.
The other way.
Get the legal things in a row.
Then make sure you have thebusiness components.
And again, that doesn't meanthat you're starting your own
business, even if you are goingto be seeing clients and now
incorporating in the animals orbringing clients now to an
(11:04):
aquatic environment.
That business phase of thing isimportant to look at because if
you're the employee, you'regoing to still have to show that
this is going to be beneficialto the business.
Whether it's yours or youremployers.
So now we're going into thatbusiness phase of things.
And this is where we're going tohave some money dates.
(11:28):
We're going to date our money alittle bit and look and see what
the expenses are going to be.
What we need to do as far ashaving clients and income coming
in.
And in this purposeful phase, weare.
Moving from just like marketresearch and looking and seeing
what's out there.
(11:49):
Into gauging interest, and thismight be sending out some
surveys.
Going to parent support groups.
So now we're.
Putting a lot more action behindit is I guess the way I would
describe it in this businesspurposeful phase.
We are starting to put togetherour marketing packet and
(12:10):
information.
We are starting to we'redetermining we're not starting
anymore.
We are determining what the costof our OT services is going to
be, and whether we're going tostart credentialing with
insurance, that's going tohappen in this purposeful phase.
If we are going ahead.
(12:31):
And private being private pay,we need to determine are we fee
for service?
Are we doing package pricing?
How are we putting that alltogether?
So in this purposeful phase, Itis your ability to put the
building blocks together.
And a lot of that depends onfinances again, if you are an
(12:53):
employee.
You still need to look at.
Is this going to bringadditional clients to my
employer?
Is this going to fill mycaseload?
Am I going to incorporate theanimals or the aquatic piece
into clients that I'm alreadyseeing, or am I coming on an
additional afternoon a week.
(13:14):
Where I'm going to now have newclients.
And am I bringing those newclients on or does that need to
go back to a marketingdepartment?
Like how is that all going towork?
How is that going to.
Play out.
Financially, how is that goingto play out time-wise and
managing your own time scheduleand what you need to get done?
(13:35):
So, whether you're an employeeor you're doing this as a side
hustle and maybe hoping that itwill become a full-time job,
mate, there's lots of ways to goabout this, but in the business
phase, When we're thinking.
Of being very purposeful withit.
We want to start laying thefoundation.
So that way as we move forward.
(13:58):
We're really in a good place of.
Being prepared.
Of.
Being ready to see clients,because that's going to be our
next phase.
When we moved to occupationbased that's going to be our
next phase.
And so in this business phase,And you've looked at the
financials.
You've laid that foundationdown.
Then the next thing is thatclient experience.
(14:20):
And what does it look like fromthe moment that someone
expresses interest?
In working with you, especiallyif they're working in a
specialty area, making sure thateveryone is trained in the
correct language to use andknowing what to say.
Because aquatics is not aseparate service hippotherapy,
(14:41):
is not a separate service.
Incorporating animals is not aseparate service.
They're coming for occupationaltherapy.
And so in this purposeful phase,you are making sure that anyone
who's on your team.
Is going to communicate thisinformation correctly.
If someone calls in and hasinterest, or if you're again
doing this as a side hustle, howare you going to communicate it
(15:04):
to potential families that youmight work with?
So in this purposeful phase,you're really getting together.
The way that you want tocommunicate with people.
So.
How are you going to explain?
Your specialty area.
How are you going to communicateit?
Is it going to be like an emailblast?
(15:24):
That's going to go out and youwant to make sure if you're not
writing it yourself, that youare the last one to have eyes on
it before it goes out that wayagain, you can check that
terminology and language.
Are you doing flyers?
Are you speaking again?
Are you going to speak at asupport group?
In this purposeful phase, we'retaking those next steps.
(15:46):
And thinking about.
Step by step by step.
How are clients going to findme?
How am I going to intake themlike that paperwork that we took
care of in the legal section?
How are they going to access it?
I going to email it to them.
Is it going to be part of ourEMR?
Am I going to hand it to them?
(16:06):
Paper form?
Like, what does that work flowprocess going to look like?
And then as I bring them in forservices, Just starting to get
an idea of.
What that might look like.
What are some potentialchallenges, especially if you
were really diligent in thatpreparatory phase and you spent
(16:28):
some time.
Working or observing.
Someone who was in a similararea to where you want to go,
what were some of the challengesthat they face?
What were some of the challengesthat the clients presented?
Whether that's not wanting toget in the water or not wanting
to come near a big, hairy,smelly animal, or being afraid
(16:48):
of a lizard, right?
Those could all be potentialareas.
So you're starting to thinkthrough.
Some of those challenges andalso coming up with.
Potential discussion topics withparents.
I find that when I let parentsknow what the expectation is
ahead of time, that tends towork out much better.
And if I say.
(17:10):
Most children.
Don't get on the horse until thethird session, then that really
takes the pressure off of me.
It takes the pressure off thechild and allows us to go at a
much slower pace because oftenif they're thinking.
This is occupational therapy andI'm coming to the stable.
That's their expectation is thatthe first thing you're doing is
(17:31):
getting onto the horse andthat's often.
Not appropriate.
It's often not where the childis at.
I mostly work mostly withchildren but even some of the
teens and young adults that wework with, it may take them a
few sessions or.
I may want to know how good theyare at following directions
first, before I offer to havethem get on the horse and
(17:53):
experience the movement.
And.
Building that into my intakeprocess can be really helpful.
So in this purposeful phase,you're, you're going to start
sketching that out.
You're going to start sketchingout those introductory and
welcome emails.
The packet that you're sendingto people.
What do they need to bring totheir first session?
If you are in the aquaticenvironment, like what do you
(18:15):
want them to have on hand?
Do you want the parrot to comein a swimsuit?
Do you want only the client tocome in a swimsuit?
Is it a swimsuit or a wetsuit?
Do you have any.
Guidelines as far as what typeof swimsuit it might be,
especially if you're workingwith adolescents and teens.
There's a lot of components thatmay be going into this
(18:36):
purposeful phase.
And I think there's almostsomething ironic about calling
it purposeful because you reallydo want to be very purposeful as
you're thinking through this.
So we have them in we're workingwith them, we're working towards
our goals.
Things are going really well.
What is the discharge policy?
And.
(18:58):
When we talk about specialtyareas, nature-based occupational
therapy.
Aquatics incorporating animals.
A lot of times our clients arevery invested in working with
us.
And sometimes when it does cometime to discharge, they are not
particularly ready.
(19:18):
And so making sure that we'vehad that discharged
conversation.
At the beginning and we knowwhat it is that our philosophy
is on how long we intend to seepeople and whether we're working
on a plan of care system.
So.
We may be see clients for 12weeks.
We write goals for 12 weeks andwe know that we'll be rotating
(19:39):
clients every 12 weeks.
Or if you have more availabilityin your schedule, maybe you are
seeing them on a longertimeframe, but you have some
other guidelines for dischargein place.
So we're really thinking aboutthat whole experience and N as
they come.
Like to the end of their timewith us, if they really enjoyed.
(20:01):
Being out in nature, if theyreally enjoyed being in the
pool, if they really enjoyedbeing around the animals.
What other enrichment services,what other recreational
services, what other sports canwe connect them with so that
they can keep that as part oftheir life, if that becomes a
valued occupation for theclient?
How can we make sure that theycan keep that as part of their
(20:23):
life, even when they've moved onfrom our occupational therapy
services.
So in our business purposefulphase, we're really thinking
through.
What that experience is going tobe like for the client.
And we're getting the thingsthat we need to have in place.
Our communication strategies.
Our electronic medical records.
(20:43):
If we're going that route, ifwe're not, how are we going to
document?
And you know, documentation isprobably.
A love, hate relationship formost therapist in that.
We love to know how other peopledo it, but we hate to take the
time to do it ourselves and.
Thinking about how you're goingto handle your documentation.
(21:04):
Especially when you're startingsmall as a kind of side hustle,
or maybe you're at a stable onenight a week.
And it may not make sense tohave a full EMR.
It may make more sense todocument using another system
where you're not paying for acomplete EMR.
(21:25):
So thinking that through andpart of that is that financial
side.
Again, I love like what is thebreak even point on your time
versus the cost of the EMR.
So those all come in thepurposeful phase.
It's a great time to.
Get out your notebook.
This is where you actually arewriting up your business plan.
And if you have any sort ofcapital investment, it's super
(21:47):
important to have done thatmarket research, have your
business plan written up, go tothe small business
administration or the smallbusiness support in your county
or state have them look throughit, have them give you pointers
and advice before you start toinvest a lot of money.
Now, a lot of the things thatI've talked about so far really
(22:07):
don't require a lot of financialinvestment.
So.
You're off to a pretty goodstart.
And if it's your own land, housebarn, farm facility, then you
know, that's something, that'san asset that you already had.
If you're contracting with afacility, then often that
contract is, either.
(22:28):
A chunk of time per day or aweekly contract, or sometimes
even a client or hourly contractand that means there's not a lot
of upfront investment.
And so again, that can workreally good for getting started.
So in our purposeful phase,again, we're taking action
steps.
To prepare for welcoming clientsin our new treatment environment
(22:52):
or our new specialty area.
We're thinking about anyconcerns we might have regarding
communication, terminology,intake, procedures, discharge
procedures, right?
We're really being verypurposeful to outline all of
those.
And the last part.
In this purposeful phase.
(23:13):
Is the skills and work area.
And this is where we now havethe financial commitment.
This is where we now have thefinancial investment.
Because this is where you'regoing to go to those American
hippotherapy, associationcourses.
This is where you're going to goto the HTRI and take courses or
(23:34):
get your life cardcertification.
This is where you're going toget more training on nature
based therapy, right?
This is where you're starting tomake investments.
And that's why I said, Go fromthe legal to the business and
then end at the skills, becauseat that point you're really
ready.
You're really ready to startbuilding those skills and.
(23:56):
Go ahead and make thatinvestment.
That you've got a business plan,that you've done the market
research.
You know that you're set upeither with a facility contract
or with your employer and thatyou're good to go.
And now it's okay.
You can feel confident in makingthose investments in the
training and the skill side ofthings.
(24:17):
When I'm thinking about.
Building those skills, as you gothrough those trainings.
That's a really great timebecause you're going to be kind
of double checking with thepurposeful things you've thought
about from a businessperspective and cross checking
that against the, what you'relearning about as you're
(24:39):
building those skills.
And a lot of the trainings aregoing to touch on.
Documentation, a lot of thetrainings are going to touch on
marketing and business.
Right?
They're not going to go into adeep dive often.
You're going to look, need tolook for a specific program
that's going to mentor or coachyou through that.
But they're going to give youthings to think about.
(25:02):
And so it's nice because asyou're working on that skills
phase and often this is ourclinical skills, right?
It's going to help you w like,it's like, double-checking your
work, right?
When you're taking a test.
And so it's going to help you goback and double check that work.
Before you bring in your firstclient.
And so this one of the things Ithink that's really exciting in
(25:23):
looking at it step by step thisway.
Legal and business skills,because now you get to double
check your work before you getready to open the proverbial
barn doors, or dive right in, soto speak because you now have
gotten things organized andyou're going to be out there
networking with otherprofessionals who are doing what
(25:44):
you want to do and it's going togive you a great opportunity
just to double check your work.
So today we covered the nextsteps in getting started.
We talked about the purposefulactions that we can take in
getting ready to get started ina unique area of practice like
aquatic occupational therapy.
Occupational therapy usinghippotherapy, nature-based OT or
(26:08):
incorporating farm animals orother animals into our OT
interventions.
I hope this was helpful for youtoday.
Maybe you stopped and took somenotes.
If you have any questions,always feel free to reach out.
Again, that's one of our goalswith season two is really to
make more opportunities toconnect with you to find out
what the challenges are thatyou're facing or what
(26:29):
information, what interviews wecan do that would be super
spectacular for you.
So we hope that you have awonderful week and I will see
you next week.
Hi, this is Gina, your host ofanimals and aquatics.
And tonight we're going tocontinue our getting started
series.
Glad to have you with us.
(00:31):
This week on animals andaquatics, we're going to
continue our getting startedseries to help you get started
in an occupational therapycareer, incorporating animals,
hippotherapy, or aquatictherapy.
In this series, we've coveredthe preparatory steps that you
can take to get started.
This week, we're going to focuson the purposeful steps that you
would take, just like in anintervention.
(00:52):
We often do our preparatory workfirst followed by purposeful or
occupation-based interventions.
So this week, we're going tofollow that same path and focus
on purposeful activities thatyou can do in the getting
started path.
If you haven't listened to ourpreparatory episode, I urge you
to go back and start with thatone.
That way you get an idea of thethree topic areas I'm covering.
(01:15):
Skills.
Business and legal.
But this week, we're going toflip it on its head a little
bit.
And we're actually going tostart with the legal stuff.
Because when we get to thepurposeful step, it's really
important to take care of thelegal stuff first.
And in some cases, some of thatmay take a little bit longer to
take care of.
So you really want to get thatdone first.
(01:37):
getting some of those ducks in arow.
Getting some of those steps donewill be really important before
you invest money in some of theother purposeful steps that you
will be taking during thisphase.
So let's get started.
In the legal phase, we want totake care of things like getting
our MPI number.
(01:58):
Now, many therapists willalready have an NPI.
One number.
That's an individual number, andyou may have that from working
at another therapy company.
But at this point, you want tostart thinking about getting an
NPI to number.
And with that, that's going tocover a group or entity.
So with this, we want to thinkabout.
(02:20):
Your business structure.
So legally, what is yourbusiness structure going to be?
And some of that is dictated byyour state.
And it's really important tolook that up and know whether
you are able to form an LLC, a PLLC.
If you're thinking about goingthe nonprofit or 5 0 1 C3 route,
(02:42):
those are things that you reallywant to tackle early on.
So in this purposeful phase,it's really important.
To figure out legally whatbusiness structure you can set
up and then begin to do that.
There are a variety of differentindividuals that can help you
with that such as a lawyer oryour state's website.
And there's also some onlineservices that can help you with
(03:02):
that as well.
But you'll be looking at gettingan E I N number.
So that's filed with the IRS andthat's going to identify you as
an employer and that will bepart of your business filing as
well.
So the legal pieces that comefirst are those business
structure pieces.
(03:23):
And because you need a lot ofthose before you can move on
with some of the other steps.
So when you get to thispurposeful phase, you're really
starting to put steps intoaction.
That is going to get you closerto your goals and you may be
thinking, well, I'm really onlyplanning on seeing a few
clients, maybe one night a week.
(03:44):
Do I really need to do all this?
And the truth is often you don'tneed to do all this.
You may not need to do that.
You may not need to do all ofyour business setup, but I do
recommend setting yourself upright from the start, because
not only does it give you thebusiness structure that you may
need, even if you're only seeingone or two clients.
(04:06):
But it also affords you somepotential legal protection in
the event that something happenswith a client, whether it's a
malpractice or just a generalliability slip falls sort of
situation.
There is a little bit moreprotection if you do have a
business structure set up.
(04:26):
Rather than if you're practicingindependently.
So, the basic legal requirementsthat you're going to have is
that you're complying with yourlicensure laws, with your state
licensure, whether you're an OTRor an OTA, and that you have
supervision in place forwhatever.
Treatment and interventions thatyou are doing.
(04:49):
So thinking about getting thosecomponents together and that
supervision component issomething that we touch on in
the business barn raisingcourse, because.
As a professor for OTA students.
There's a lot of questionsaround being able to practice
more independently while stillmeeting your supervision
(05:09):
requirements.
So I think that's somethingreally important to think about
in this legal category whenyou're getting to the purposeful
phase, you want to get thatsupervisory relationship set up.
This is think about like gettingcontracts in place, having
attorneys review paperwork.
The legal.
Purposeful side of things is, isreally starting to get things
(05:33):
together that are going to notonly allow you to be successful
in starting working in one ofthese areas, but is also going
to help you practice ethicallyand be protected legally.
Now if you are an employee.
And you are working for someoneand you want to start a program
(05:56):
that is incorporating one ofthese treatment tools and your
focusing on bringing this intoan already established.
Occupational therapy program tonow it looks a little bit
different, but there still aresome legal considerations that I
want to touch on.
If you are in an employeesituation and some of that is.
(06:19):
Making sure that you've had thediscussions with your
administration.
And if there is a legal teaminvolved at your place of
employment, that they've beennotified that you will be using
some new treatment tools andthey may need to look at
liability forms.
They may need to look atstandards and compliance for
(06:40):
accrediting bodies.
They may need to go throughthose particular components.
If you're bringing animals intothe facility, the legal team
generally wants to know thatthey may have an additional
waiver that needs.
To be created and signed byclients who are going to be
interacting with the animal.
And that could be a dog or go.
Or a bearded dragon.
Like it doesn't have to be.
(07:01):
A farm animal.
It can even be a small animal,like a bearded dragon, but
there's still generally going tobe some additional legal
paperwork that would be requiredfor you as an occupational
therapy provider to incorporatethat into your session.
So thinking about those legalside.
Legal sides of things you wantto make sure you have all of
(07:21):
your bases covered.
So, whether you're starting thisas a side hustle on your own,
and you need more of the legalcoverage.
Or if you're doing this underyour employer.
Then you want to make sure thatthey have gone ahead and checked
off all those boxes.
Make sure.
And that there's nothingexcluded from their liability
(07:43):
coverage.
And really just go througheverything to be really
comprehensive about that.
And in this purple purposefulphase.
You have that opportunity totake a deeper dive into what are
those systems that are set upand making sure that they're
going to accommodate the areathat you want to now bring into
(08:05):
your occupational therapypractice.
If that's going to be in thepool, do you need to have a
contract?
With the facility that has thepool, or do you need to have
something written up?
Maybe there's a new waiver.
That you're going to add intoyour intake packet, mate.
So this is a good time to gothrough those again, this is a
(08:26):
good time to sit down with anattorney.
And just have them go over thepaperwork.
And I especially think whenwe're in a niche area of
practice, that.
Going through that.
Paperwork phase with an attorneyis a wise decision because
although there is a bunch ofattorney reviewed paperwork out
there, it's often dealing withclinical services.
(08:48):
And when we're outside thetraditional clinic, it is often
helpful to have some additionalphrases added or there may be a
recommendation for an additionalwaiver.
And we also want to be aware ofwhat our state liability laws
may be for like an equineliability law and those vary
from state to state as well.
(09:10):
So just really.
Being very sure.
About any laws that may pertainto the particular area that
you're looking to specialize in.
And I'll give this as anexample.
In New York state is arequirement.
That anyone under the age of 18wear a helmet when they are on
(09:32):
top of a horse.
And if you are working intherapy and you have a client
with compromised head control.
And you think that maybe ahelmet would not be the best
choice for them.
Now you have an issue betweenyour professional judgment and
competence.
And the state law, and that'swhy I'm recommending again, in
this purposeful phase to reallygo over those things with an
(09:55):
attorney.
So that way they can give youguidance that state specific.
Because those types of laws dovary state by state.
So that phase, when you wrap itup and tie it off with a bow
feels really good.
It feels really good to haveyour legal ducks in a row and
know that you are really readyto look next at the business
(10:18):
side of things.
And like I said, this week,we're flipping it backwards.
Because I feel like when you'repreparing and you're in that
preparatory phase, it's reallyimportant to see if you have a
good match with a skillset andit's something that you want to
do from a work perspective.
And then you can kind of look atlike the business and legal side
of things, but once you movefrom that preparatory phase into
(10:41):
the purposeful phase, it's superimportant to really go.
The other way.
Get the legal things in a row.
Then make sure you have thebusiness components.
And again, that doesn't meanthat you're starting your own
business, even if you are goingto be seeing clients and now
incorporating in the animals orbringing clients now to an
(11:04):
aquatic environment.
That business phase of thing isimportant to look at because if
you're the employee, you'regoing to still have to show that
this is going to be beneficialto the business.
Whether it's yours or youremployers.
So now we're going into thatbusiness phase of things.
And this is where we're going tohave some money dates.
(11:28):
We're going to date our money alittle bit and look and see what
the expenses are going to be.
What we need to do as far ashaving clients and income coming
in.
And in this purposeful phase, weare.
Moving from just like marketresearch and looking and seeing
what's out there.
(11:49):
Into gauging interest, and thismight be sending out some
surveys.
Going to parent support groups.
So now we're.
Putting a lot more action behindit is I guess the way I would
describe it in this businesspurposeful phase.
We are starting to put togetherour marketing packet and
(12:10):
information.
We are starting to we'redetermining we're not starting
anymore.
We are determining what the costof our OT services is going to
be, and whether we're going tostart credentialing with
insurance, that's going tohappen in this purposeful phase.
If we are going ahead.
(12:31):
And private being private pay,we need to determine are we fee
for service?
Are we doing package pricing?
How are we putting that alltogether?
So in this purposeful phase, Itis your ability to put the
building blocks together.
And a lot of that depends onfinances again, if you are an
(12:53):
employee.
You still need to look at.
Is this going to bringadditional clients to my
employer?
Is this going to fill mycaseload?
Am I going to incorporate theanimals or the aquatic piece
into clients that I'm alreadyseeing, or am I coming on an
additional afternoon a week.
(13:14):
Where I'm going to now have newclients.
And am I bringing those newclients on or does that need to
go back to a marketingdepartment?
Like how is that all going towork?
How is that going to.
Play out.
Financially, how is that goingto play out time-wise and
managing your own time scheduleand what you need to get done?
(13:35):
So, whether you're an employeeor you're doing this as a side
hustle and maybe hoping that itwill become a full-time job,
mate, there's lots of ways to goabout this, but in the business
phase, When we're thinking.
Of being very purposeful withit.
We want to start laying thefoundation.
So that way as we move forward.
(13:58):
We're really in a good place of.
Being prepared.
Of.
Being ready to see clients,because that's going to be our
next phase.
When we moved to occupationbased that's going to be our
next phase.
And so in this business phase,And you've looked at the
financials.
You've laid that foundationdown.
Then the next thing is thatclient experience.
(14:20):
And what does it look like fromthe moment that someone
expresses interest?
In working with you, especiallyif they're working in a
specialty area, making sure thateveryone is trained in the
correct language to use andknowing what to say.
Because aquatics is not aseparate service hippotherapy,
(14:41):
is not a separate service.
Incorporating animals is not aseparate service.
They're coming for occupationaltherapy.
And so in this purposeful phase,you are making sure that anyone
who's on your team.
Is going to communicate thisinformation correctly.
If someone calls in and hasinterest, or if you're again
doing this as a side hustle, howare you going to communicate it
(15:04):
to potential families that youmight work with?
So in this purposeful phase,you're really getting together.
The way that you want tocommunicate with people.
So.
How are you going to explain?
Your specialty area.
How are you going to communicateit?
Is it going to be like an emailblast?
(15:24):
That's going to go out and youwant to make sure if you're not
writing it yourself, that youare the last one to have eyes on
it before it goes out that wayagain, you can check that
terminology and language.
Are you doing flyers?
Are you speaking again?
Are you going to speak at asupport group?
In this purposeful phase, we'retaking those next steps.
(15:46):
And thinking about.
Step by step by step.
How are clients going to findme?
How am I going to intake themlike that paperwork that we took
care of in the legal section?
How are they going to access it?
I going to email it to them.
Is it going to be part of ourEMR?
Am I going to hand it to them?
(16:06):
Paper form?
Like, what does that work flowprocess going to look like?
And then as I bring them in forservices, Just starting to get
an idea of.
What that might look like.
What are some potentialchallenges, especially if you
were really diligent in thatpreparatory phase and you spent
(16:28):
some time.
Working or observing.
Someone who was in a similararea to where you want to go,
what were some of the challengesthat they face?
What were some of the challengesthat the clients presented?
Whether that's not wanting toget in the water or not wanting
to come near a big, hairy,smelly animal, or being afraid
(16:48):
of a lizard, right?
Those could all be potentialareas.
So you're starting to thinkthrough.
Some of those challenges andalso coming up with.
Potential discussion topics withparents.
I find that when I let parentsknow what the expectation is
ahead of time, that tends towork out much better.
And if I say.
(17:10):
Most children.
Don't get on the horse until thethird session, then that really
takes the pressure off of me.
It takes the pressure off thechild and allows us to go at a
much slower pace because oftenif they're thinking.
This is occupational therapy andI'm coming to the stable.
That's their expectation is thatthe first thing you're doing is
(17:31):
getting onto the horse andthat's often.
Not appropriate.
It's often not where the childis at.
I mostly work mostly withchildren but even some of the
teens and young adults that wework with, it may take them a
few sessions or.
I may want to know how good theyare at following directions
first, before I offer to havethem get on the horse and
(17:53):
experience the movement.
And.
Building that into my intakeprocess can be really helpful.
So in this purposeful phase,you're, you're going to start
sketching that out.
You're going to start sketchingout those introductory and
welcome emails.
The packet that you're sendingto people.
What do they need to bring totheir first session?
If you are in the aquaticenvironment, like what do you
(18:15):
want them to have on hand?
Do you want the parrot to comein a swimsuit?
Do you want only the client tocome in a swimsuit?
Is it a swimsuit or a wetsuit?
Do you have any.
Guidelines as far as what typeof swimsuit it might be,
especially if you're workingwith adolescents and teens.
There's a lot of components thatmay be going into this
(18:36):
purposeful phase.
And I think there's almostsomething ironic about calling
it purposeful because you reallydo want to be very purposeful as
you're thinking through this.
So we have them in we're workingwith them, we're working towards
our goals.
Things are going really well.
What is the discharge policy?
And.
(18:58):
When we talk about specialtyareas, nature-based occupational
therapy.
Aquatics incorporating animals.
A lot of times our clients arevery invested in working with
us.
And sometimes when it does cometime to discharge, they are not
particularly ready.
(19:18):
And so making sure that we'vehad that discharged
conversation.
At the beginning and we knowwhat it is that our philosophy
is on how long we intend to seepeople and whether we're working
on a plan of care system.
So.
We may be see clients for 12weeks.
We write goals for 12 weeks andwe know that we'll be rotating
(19:39):
clients every 12 weeks.
Or if you have more availabilityin your schedule, maybe you are
seeing them on a longertimeframe, but you have some
other guidelines for dischargein place.
So we're really thinking aboutthat whole experience and N as
they come.
Like to the end of their timewith us, if they really enjoyed.
(20:01):
Being out in nature, if theyreally enjoyed being in the
pool, if they really enjoyedbeing around the animals.
What other enrichment services,what other recreational
services, what other sports canwe connect them with so that
they can keep that as part oftheir life, if that becomes a
valued occupation for theclient?
How can we make sure that theycan keep that as part of their
(20:23):
life, even when they've moved onfrom our occupational therapy
services.
So in our business purposefulphase, we're really thinking
through.
What that experience is going tobe like for the client.
And we're getting the thingsthat we need to have in place.
Our communication strategies.
Our electronic medical records.
(20:43):
If we're going that route, ifwe're not, how are we going to
document?
And you know, documentation isprobably.
A love, hate relationship formost therapist in that.
We love to know how other peopledo it, but we hate to take the
time to do it ourselves and.
Thinking about how you're goingto handle your documentation.
(21:04):
Especially when you're startingsmall as a kind of side hustle,
or maybe you're at a stable onenight a week.
And it may not make sense tohave a full EMR.
It may make more sense todocument using another system
where you're not paying for acomplete EMR.
(21:25):
So thinking that through andpart of that is that financial
side.
Again, I love like what is thebreak even point on your time
versus the cost of the EMR.
So those all come in thepurposeful phase.
It's a great time to.
Get out your notebook.
This is where you actually arewriting up your business plan.
And if you have any sort ofcapital investment, it's super
(21:47):
important to have done thatmarket research, have your
business plan written up, go tothe small business
administration or the smallbusiness support in your county
or state have them look throughit, have them give you pointers
and advice before you start toinvest a lot of money.
Now, a lot of the things thatI've talked about so far really
(22:07):
don't require a lot of financialinvestment.
So.
You're off to a pretty goodstart.
And if it's your own land, housebarn, farm facility, then you
know, that's something, that'san asset that you already had.
If you're contracting with afacility, then often that
contract is, either.
(22:28):
A chunk of time per day or aweekly contract, or sometimes
even a client or hourly contractand that means there's not a lot
of upfront investment.
And so again, that can workreally good for getting started.
So in our purposeful phase,again, we're taking action
steps.
To prepare for welcoming clientsin our new treatment environment
(22:52):
or our new specialty area.
We're thinking about anyconcerns we might have regarding
communication, terminology,intake, procedures, discharge
procedures, right?
We're really being verypurposeful to outline all of
those.
And the last part.
In this purposeful phase.
(23:13):
Is the skills and work area.
And this is where we now havethe financial commitment.
This is where we now have thefinancial investment.
Because this is where you'regoing to go to those American
hippotherapy, associationcourses.
This is where you're going to goto the HTRI and take courses or
(23:34):
get your life cardcertification.
This is where you're going toget more training on nature
based therapy, right?
This is where you're starting tomake investments.
And that's why I said, Go fromthe legal to the business and
then end at the skills, becauseat that point you're really
ready.
You're really ready to startbuilding those skills and.
(23:56):
Go ahead and make thatinvestment.
That you've got a business plan,that you've done the market
research.
You know that you're set upeither with a facility contract
or with your employer and thatyou're good to go.
And now it's okay.
You can feel confident in makingthose investments in the
training and the skill side ofthings.
(24:17):
When I'm thinking about.
Building those skills, as you gothrough those trainings.
That's a really great timebecause you're going to be kind
of double checking with thepurposeful things you've thought
about from a businessperspective and cross checking
that against the, what you'relearning about as you're
(24:39):
building those skills.
And a lot of the trainings aregoing to touch on.
Documentation, a lot of thetrainings are going to touch on
marketing and business.
Right?
They're not going to go into adeep dive often.
You're going to look, need tolook for a specific program
that's going to mentor or coachyou through that.
But they're going to give youthings to think about.
(25:02):
And so it's nice because asyou're working on that skills
phase and often this is ourclinical skills, right?
It's going to help you w like,it's like, double-checking your
work, right?
When you're taking a test.
And so it's going to help you goback and double check that work.
Before you bring in your firstclient.
And so this one of the things Ithink that's really exciting in
(25:23):
looking at it step by step thisway.
Legal and business skills,because now you get to double
check your work before you getready to open the proverbial
barn doors, or dive right in, soto speak because you now have
gotten things organized andyou're going to be out there
networking with otherprofessionals who are doing what
(25:44):
you want to do and it's going togive you a great opportunity
just to double check your work.
So today we covered the nextsteps in getting started.
We talked about the purposefulactions that we can take in
getting ready to get started ina unique area of practice like
aquatic occupational therapy.
Occupational therapy usinghippotherapy, nature-based OT or
(26:08):
incorporating farm animals orother animals into our OT
interventions.
I hope this was helpful for youtoday.
Maybe you stopped and took somenotes.
If you have any questions,always feel free to reach out.
Again, that's one of our goalswith season two is really to
make more opportunities toconnect with you to find out
what the challenges are thatyou're facing or what
(26:29):
information, what interviews wecan do that would be super
spectacular for you.
So we hope that you have awonderful week and I will see
you next week.
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