What I Wish I Knew Before Working In Schools
September 14, 2021
Contributed By: Rochelle Hemperly MS OTR/L
Being a school- based therapist was not initially part of my OT career plan. I entered graduate school with the notion that I would be working with older adults, as I had the most experience with this population. However, my second fieldwork affiliation altered my path. After years of saying I didn’t see myself in a pediatric setting, my school- based fieldwork assignment at a residential treatment facility taught me otherwise. I genuinely enjoyed working with my students, planning fun treatment sessions, and being a part of their team of support.
This setting has turned out to be a good fit for me, but there are definitely some things I wish I knew before working as an occupational therapist in the schools. If I’m being completely honest, even though I’ve been practicing in this area for over eight years, I just recently learned some of these things during my shift into the public school setting last year.
Differentiate between clinic and school-based practice
If I were to do some things over, being more aware of the distinction between practice in the school and the clinic is the first thing that comes to mind. More specifically, I would have made more of an effort to learn about special education laws and policies and how they would apply to my every day practice.
Even the difference between states and settings are important to note. This year I quickly discovered that there were significant differences between how OT services could be provided in the State of Washington. I remember being frustrated that my out of state experience didn’t count toward the Educational Staff Associate (ESA) certificate needed to work in Washington state schools. The truth is, I am actually glad that I had to take the class. I learned so much about how to correctly participate in the evaluation process and Individualized Education Plan (IEP) in my new state.
It’s also important to get clarification when in doubt. As someone who cares about following procedure, I have found that I spend a lot of effort actively seeking out answers relating to proper procedure when different scenarios arise. In my personal experience, this has been one of the more stressful parts of being a therapist in the schools. The take away message is that it’s important to be aware of theses policies that vary by state and district and to actively seek answers when in doubt.
Enhancing a student’s ability to access their education is the ultimate goal. The amount of time spent directly with students is different in the school model versus clinic model. To clarify, it’s more about making sure a student can participate in school compared to rehabilitation that may be done in a clinical setting. There is an emphasis on accommodations and implementing them successfully which requires collaboration and carry over. Coordinating with teachers, paraprofessionals and the entire special education team is vital to creating positive outcomes.
Long story short, fostering positive relationships with team members will make your life in the schools much easier. Is it wrong to admit that I might use my “therapeutic use of self” with staff and team members as much as I do while treating students?! Most importantly, good team work ultimately helps your students. For example, school- based OT often includes providing assistive technology, which can be complicated. Students may require assistance to correctly implement and adjust to using both high- and low-tech equipment. As OT’s we are often spread out across multiple schools and students so it’s not possible for us to be there all the time to help. This is when it is really valuable to be able to work collaboratively with teachers and paraprofessionals. I know that I feel much better issuing equipment when I have a good working relationship with those who will be using it with the students.
Be Flexible
Flexibility is key, especially when it comes to scheduling and work-space. Setting up your initial schedule feels like a game of Tetris. Collaboration with team members also comes into play because you will need to be aware of who you “share” the student with. In other words, be aware and try to avoid “stealing” other therapists’/specialists’ time. I say this from experience and because it doesn’t help foster those positive work bonds. Honestly when I started, I didn’t even think about how my schedule impacted other specialists. So that’s just a small thing to note, but again I wish I had known.
Next is the work space issue. Sometimes it is hard to find a treatment area in your school. A specific room with all the therapy tools available may not be a reality in your building. OT sessions are often active and can require more space. However, I find that sometimes being limited in this way may actually foster using the natural context of the school and pushing into environments where the student needs more support. It is good to be aware that available space may be in high demand and you may have to advocate for yourself and your students when it comes to asking for a work space.
Be Efficient and Intentional
Lastly, when I think of any other to anticipate, it’s caseload management. When I recently switched into the public school setting, my caseload was significantly higher. I learned (by the end of the year) that I could’ve set things up to be better and to me more time efficient. It’s something that may be easier to problem solve once you are already working and can see what works best. However, I think it is helpful to know this going in and to try to be intentional about the way you use your time.
These are the areas that came to mind when considering the things I wish I knew before starting in the schools. While thinking of my personal experience, I became curious about what my peers in this area of practice think. I did a very informal poll by asking some previous co-workers and past grad school friends about their perceptions. I was relieved to find that many of the same areas were mentioned by my fellow school-based OT practitioners. The three most common answers included knowing state and district education policies, being aware of the difference between school model and medical model, and the importance of team collaboration for effective outcomes.
In reviewing the areas I listed, I realize that the issues that come to mind often relate to the more difficult components of the job. Essentially, they are things I learned the hard way and wish I knew before hand to make things easier. So please keep in mind and do not feel discouraged if you want to try out this setting! In noting this, I feel that I forgot to mention a few of the most important things. So here they are, the final three things I wish I knew.
I wish I knew there would be moments where it doesn’t feel like work because you’re having so much fun with a student and helping them at the same time.
I wish I knew that so many of the people I would meet at work would motivate me professionally and become some of my greatest friends.
Last but not least, I wish I knew how amazing it would feel when a student meets their goals!
In conclusion, the school can be an amazing place to practice and I hope this provides some clarity about what occupational therapists can expect if they choose to adventure into the school setting.
