Purposeful Preparation: Steps for Success in Animal-Assisted and Aquatic Therapy

 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. 

Transcript

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Hi, this is Gina, your host of animals and aquatics. And tonight we're going to continue our getting started series. Glad to have you with us. This week on animals and aquatics, we're going to continue our getting started series to help you get started in an occupational therapy career, incorporating animals, hippotherapy, or aquatic therapy. In this series, we've covered the preparatory steps that you can take to get started. This week, we're going to focus on the purposeful steps that you would take, just like in an intervention. We often do our preparatory work first followed by purposeful or occupation-based interventions. So this week, we're going to follow that same path and focus on purposeful activities that you can do in the getting started path. If you haven't listened to our preparatory episode, I urge you to go back and start with that one. That way you get an idea of the three topic areas I'm covering. Skills. Business and legal. But this week, we're going to flip it on its head a little bit. And we're actually going to start with the legal stuff. Because when we get to the purposeful step, it's really important to take care of the legal stuff first. And in some cases, some of that may take a little bit longer to take care of. So you really want to get that done first. getting some of those ducks in a row. Getting some of those steps done will be really important before you invest money in some of the other purposeful steps that you will be taking during this phase. So let's get started. In the legal phase, we want to take care of things like getting our MPI number. Now, many therapists will already have an NPI. One number. That's an individual number, and you may have that from working at another therapy company. But at this point, you want to start thinking about getting an NPI to number. And with that, that's going to cover a group or entity. So with this, we want to think about. Your business structure. So legally, what is your business structure going to be? And some of that is dictated by your state. And it's really important to look that up and know whether you are able to form an LLC, a P LLC. If you're thinking about going the nonprofit or 5 0 1 C3 route, those are things that you really want to tackle early on. So in this purposeful phase, it's really important. To figure out legally what business structure you can set up and then begin to do that. There are a variety of different individuals that can help you with that such as a lawyer or your state's website. And there's also some online services that can help you with that as well. But you'll be looking at getting an E I N number. So that's filed with the IRS and that's going to identify you as an employer and that will be part of your business filing as well. So the legal pieces that come first are those business structure pieces. And because you need a lot of those before you can move on with some of the other steps. So when you get to this purposeful phase, you're really starting to put steps into action. That is going to get you closer to your goals and you may be thinking, well, I'm really only planning on seeing a few clients, maybe one night a week. Do I really need to do all this? And the truth is often you don't need to do all this. You may not need to do that. You may not need to do all of your business setup, but I do recommend setting yourself up right from the start, because not only does it give you the business structure that you may need, even if you're only seeing one or two clients. But it also affords you some potential legal protection in the event that something happens with a client, whether it's a malpractice or just a general liability slip falls sort of situation. There is a little bit more protection if you do have a business structure set up. Rather than if you're practicing independently. So, the basic legal requirements that you're going to have is that you're complying with your licensure laws, with your state licensure, whether you're an OTR or an OTA, and that you have supervision in place for whatever. Treatment and interventions that you are doing. So thinking about getting those components together and that supervision component is something that we touch on in the business barn raising course, because. As a professor for OTA students. There's a lot of questions around being able to practice more independently while still meeting your supervision requirements. So I think that's something really important to think about in this legal category when you're getting to the purposeful phase, you want to get that supervisory relationship set up. This is think about like getting contracts in place, having attorneys review paperwork. The legal. Purposeful side of things is, is really starting to get things together that are going to not only allow you to be successful in starting working in one of these areas, but is also going to help you practice ethically and be protected legally. Now if you are an employee. And you are working for someone and you want to start a program that is incorporating one of these treatment tools and your focusing on bringing this into an already established. Occupational therapy program to now it looks a little bit different, but there still are some legal considerations that I want to touch on. If you are in an employee situation and some of that is. Making sure that you've had the discussions with your administration. And if there is a legal team involved at your place of employment, that they've been notified that you will be using some new treatment tools and they may need to look at liability forms. They may need to look at standards and compliance for accrediting bodies. They may need to go through those particular components. If you're bringing animals into the facility, the legal team generally wants to know that they may have an additional waiver that needs. To be created and signed by clients 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. A farm animal. It can even be a small animal, like a bearded dragon, but there's still generally going to be some additional legal paperwork that would be required for you as an occupational therapy provider to incorporate that into your session. So thinking about those legal side. Legal sides of things you want to make sure you have all of your bases covered. So, whether you're starting this as a side hustle on your own, and you need more of the legal coverage. Or if you're doing this under your employer. Then you want to make sure that they have gone ahead and checked off all those boxes. Make sure. And that there's nothing excluded from their liability coverage. And really just go through everything to be really comprehensive about that. And in this purple purposeful phase. You have that opportunity to take a deeper dive into what are those systems that are set up and making sure that they're going to accommodate the area that you want to now bring into your occupational therapy practice. If that's going to be in the pool, do you need to have a contract? With the facility that has the pool, or do you need to have something written up? Maybe there's a new waiver. That you're going to add into your intake packet, mate. So this is a good time to go through those again, this is a good time to sit down with an attorney. And just have them go over the paperwork. And I especially think when we're in a niche area of practice, that. Going through that. Paperwork phase with an attorney is a wise decision because although there is a bunch of attorney reviewed paperwork out there, it's often dealing with clinical services. And when we're outside the traditional clinic, it is often helpful to have some additional phrases added or there may be a recommendation for an additional waiver. And we also want to be aware of what our state liability laws may be for like an equine liability law and those vary from state to state as well. So just really. Being very sure. About any laws that may pertain to the particular area that you're looking to specialize in. And I'll give this as an example. In New York state is a requirement. That anyone under the age of 18 wear a helmet when they are on top of a horse. And if you are working in therapy and you have a client with compromised head control. And you think that maybe a helmet would not be the best choice for them. Now you have an issue between your professional judgment and competence. And the state law, and that's why I'm recommending again, in this purposeful phase to really go over those things with an attorney. So that way they can give you guidance that state specific. Because those types of laws do vary state by state. So that phase, when you wrap it up and tie it off with a bow feels really good. It feels really good to have your legal ducks in a row and know that you are really ready to look next at the business side of things. And like I said, this week, we're flipping it backwards. Because I feel like when you're preparing and you're in that preparatory phase, it's really important to see if you have a good match with a skillset and it's something that you want to do from a work perspective. And then you can kind of look at like the business and legal side of things, but once you move from that preparatory phase into the purposeful phase, it's super important to really go. The other way. Get the legal things in a row. Then make sure you have the business components. And again, that doesn't mean that you're starting your own business, even if you are going to be seeing clients and now incorporating in the animals or bringing clients now to an aquatic environment. That business phase of thing is important to look at because if you're the employee, you're going to still have to show that this is going to be beneficial to the business. Whether it's yours or your employers. So now we're going into that business phase of things. And this is where we're going to have some money dates. We're going to date our money a little bit and look and see what the expenses are going to be. What we need to do as far as having clients and income coming in. And in this purposeful phase, we are. Moving from just like market research and looking and seeing what's out there. Into gauging interest, and this might be sending out some surveys. Going to parent support groups. So now we're. Putting a lot more action behind it is I guess the way I would describe it in this business purposeful phase. We are starting to put together our marketing packet and information. We are starting to we're determining we're not starting anymore. We are determining what the cost of our OT services is going to be, and whether we're going to start credentialing with insurance, that's going to happen in this purposeful phase. If we are going ahead. And private being private pay, we need to determine are we fee for service? Are we doing package pricing? How are we putting that all together? So in this purposeful phase, It is your ability to put the building blocks together. And a lot of that depends on finances again, if you are an employee. You still need to look at. Is this going to bring additional clients to my employer? Is this going to fill my caseload? Am I going to incorporate the animals or the aquatic piece into clients that I'm already seeing, or am I coming on an additional afternoon a week. Where I'm going to now have new clients. And am I bringing those new clients on or does that need to go back to a marketing department? Like how is that all going to work? How is that going to. Play out. Financially, how is that going to play out time-wise and managing your own time schedule and what you need to get done? So, whether you're an employee or you're doing this as a side hustle and maybe hoping that it will become a full-time job, mate, there's lots of ways to go about this, but in the business phase, When we're thinking. Of being very purposeful with it. We want to start laying the foundation. So that way as we move forward. 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 occupation based 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 foundation down. Then the next thing is that client experience. And what does it look like from the moment that someone expresses interest? In working with you, especially if they're working in a specialty area, making sure that everyone is trained in the correct language to use and knowing what to say. Because aquatics is not a separate service hippotherapy, is not a separate service. Incorporating animals is not a separate service. They're coming for occupational therapy. And so in this purposeful phase, you are making sure that anyone who's on your team. Is going to communicate this information correctly. If someone calls in and has interest, or if you're again doing this as a side hustle, how are you going to communicate it to potential families that you might work with? So in this purposeful phase, you're really getting together. The way that you want to communicate with people. So. How are you going to explain? Your specialty area. How are you going to communicate it? Is it going to be like an email blast? That's going to go out and you want to make sure if you're not writing it yourself, that you are the last one to have eyes on it before it goes out that way again, you can check that terminology and language. Are you doing flyers? Are you speaking again? Are you going to speak at a support group? In this purposeful phase, we're taking those next steps. And thinking about. Step by step by step. How are clients going to find me? How am I going to intake them like 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 our EMR? Am I going to hand it to them? Paper form? Like, what does that work flow process going to look like? And then as I bring them in for services, Just starting to get an idea of. What that might look like. What are some potential challenges, especially if you were really diligent in that preparatory phase and you spent some time. Working or observing. Someone who was in a similar area to where you want to go, what were some of the challenges that they face? What were some of the challenges that the clients presented? Whether that's not wanting to get in the water or not wanting to come near a big, hairy, smelly animal, or being afraid of a lizard, right? Those could all be potential areas. So you're starting to think through. Some of those challenges and also coming up with. Potential discussion topics with parents. I find that when I let parents know what the expectation is ahead of time, that tends to work out much better. And if I say. Most children. Don't get on the horse until the third session, then that really takes the pressure off of me. It takes the pressure off the child and allows us to go at a much slower pace because often if they're thinking. This is occupational therapy and I'm coming to the stable. That's their expectation is that the first thing you're doing is getting onto the horse and that's often. Not appropriate. It's often not where the child is at. I mostly work mostly with children but even some of the teens and young adults that we work with, it may take them a few sessions or. I may want to know how good they are at following directions first, before I offer to have them get on the horse and experience the movement. And. Building that into my intake process can be really helpful. So in this purposeful phase, you're, you're going to start sketching that out. You're going to start sketching out those introductory and welcome emails. The packet that you're sending to people. What do they need to bring to their first session? If you are in the aquatic environment, like what do you want them to have on hand? Do you want the parrot to come in a swimsuit? Do you want only the client to come in a swimsuit? Is it a swimsuit or a wetsuit? Do you have any. Guidelines as far as what type of swimsuit it might be, especially if you're working with adolescents and teens. There's a lot of components that may be going into this purposeful phase. And I think there's almost something ironic about calling it purposeful because you really do want to be very purposeful as you're thinking through this. So we have them in we're working with them, we're working towards our goals. Things are going really well. What is the discharge policy? And. When we talk about specialty areas, nature-based occupational therapy. Aquatics incorporating animals. A lot of times our clients are very invested in working with us. And sometimes when it does come time to discharge, they are not particularly ready. And so making sure that we've had that discharged conversation. At the beginning and we know what it is that our philosophy is on how long we intend to see people and whether we're working on a plan of care system. So. We may be see clients for 12 weeks. We write goals for 12 weeks and we know that we'll be rotating clients every 12 weeks. Or if you have more availability in your schedule, maybe you are seeing them on a longer timeframe, but you have some other guidelines for discharge in place. So we're really thinking about that whole experience and N as they come. Like to the end of their time with us, if they really enjoyed. Being out in nature, if they really enjoyed being in the pool, if they really enjoyed being around the animals. What other enrichment services, what other recreational services, what other sports can we connect them with so that they can keep that as part of their life, if that becomes a valued occupation for the client? How can we make sure that they can keep that as part of their life, even when they've moved on from our occupational therapy services. So in our business purposeful phase, we're really thinking through. What that experience is going to be like for the client. And we're getting the things that we need to have in place. Our communication strategies. Our electronic medical records. If we're going that route, if we're not, how are we going to document? And you know, documentation is probably. A love, hate relationship for most therapist in that. We love to know how other people do it, but we hate to take the time to do it ourselves and. Thinking about how you're going to handle your documentation. Especially when you're starting small as a kind of side hustle, or maybe you're at a stable one night a week. And it may not make sense to have a full EMR. It may make more sense to document using another system where you're not paying for a complete EMR. So thinking that through and part of that is that financial side. Again, I love like what is the break even point on your time versus the cost of the EMR. So those all come in the purposeful phase. It's a great time to. Get out your notebook. This is where you actually are writing up your business plan. And if you have any sort of capital investment, it's super important to have done that market research, have your business plan written up, go to the small business administration or the small business support in your county or state have them look through it, have them give you pointers and advice before you start to invest a lot of money. Now, a lot of the things that I've talked about so far really don't require a lot of financial investment. So. You're off to a pretty good start. And if it's your own land, house barn, farm facility, then you know, that's something, that's an asset that you already had. If you're contracting with a facility, then often that contract is, either. A chunk of time per day or a weekly contract, or sometimes even a client or hourly contract and that means there's not a lot of upfront investment. And so again, that can work really good for getting started. So in our purposeful phase, again, we're taking action steps. To prepare for welcoming clients in our new treatment environment or our new specialty area. We're thinking about any concerns we might have regarding communication, terminology, intake, procedures, discharge procedures, right? We're really being very purposeful to outline all of those. And the last part. In this purposeful phase. Is the skills and work area. And this is where we now have the financial commitment. This is where we now have the financial investment. Because this is where you're going to go to those American hippotherapy, association courses. This is where you're going to go to the HTRI and take courses or get your life card certification. This is where you're going to get more training on nature based therapy, right? This is where you're starting to make investments. And that's why I said, Go from the legal to the business and then end at the skills, because at that point you're really ready. You're really ready to start building those skills and. Go ahead and make that investment. That you've got a business plan, that you've done the market research. You know that you're set up either with a facility contract or with your employer and that you're good to go. And now it's okay. You can feel confident in making those investments in the training and the skill side of things. When I'm thinking about. Building those skills, as you go through those trainings. That's a really great time because you're going to be kind of double checking with the purposeful things you've thought about from a business perspective and cross checking that against the, what you're learning about as you're building those skills. And a lot of the trainings are going to touch on. Documentation, a lot of the trainings are going to touch on marketing and business. Right? They're not going to go into a deep dive often. You're going to look, need to look for a specific program that's going to mentor or coach you through that. But they're going to give you things to think about. And so it's nice because as you're working on that skills phase and often this is our clinical 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 go back and double check that work. Before you bring in your first client. And so this one of the things I think that's really exciting in looking at it step by step this way. Legal and business skills, because now you get to double check your work before you get ready to open the proverbial barn doors, or dive right in, so to speak because you now have gotten things organized and you're going to be out there networking with other professionals who are doing what you want to do and it's going to give you a great opportunity just to double check your work. So today we covered the next steps in getting started. We talked about the purposeful actions that we can take in getting ready to get started in a unique area of practice like aquatic occupational therapy. Occupational therapy using hippotherapy, nature-based OT or incorporating farm animals or other animals into our OT interventions. I hope this was helpful for you today. Maybe you stopped and took some notes. If you have any questions, always feel free to reach out. Again, that's one of our goals with season two is really to make more opportunities to connect with you to find out what the challenges are that you're facing or what information, what interviews we can do that would be super spectacular for you. So we hope that you have a wonderful week and I will see you next week.