Cotreating with Other Allied Health Disciplines

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Last weekend, I celebrated Easter Sunday by joining a friend from work on a mountain bike trail ride with her family.

I’m new to mountain biking and am definitely still learning. Her husband is semi-pro in the sport and their young son is definitely taking after him. She, like me, is relatively new to mountain biking and I think we both appreciated having someone else along at the same skill level. We both grew up riding road bikes which is very different from riding a biking over rocks, roots, and flora. In fact, I’m going to take the latest steed in my stable (a dedicated road bike I call Circe) out for about 20 miles after I finish this post.

She’s a certified occupational therapy assistant or COTA. I didn’t know she was a COTA at first. She thinks like me – outside of the box. We share several clients and cotreat when it’s best for the client. I know she’ll support what I’m trying to do with a client when I’m not there. I’ve learned a lot from her about helping kids use their hands differently and more efficiently. I’ve learned a lot about how to help kids (or not!) in activities of daily living when she’s not there. When we cotreat, it’s seamless for the client even though we haven’t planned anything in advance.

It’s a really good working relationship.

So, of course, we talked a little shop. It’s inevitable, I suppose. I learned that there really isn’t much financial incentive for COTAs to become OTs now, especially since everything is moving toward the Doctor of Occupational Therapy degree. She said it was only a couple of dollars per hour difference. Definitely not enough to offset the cost of going back to school for three or four more years. She gets to do the fun parts of the job without having to deal with the administrative parts of the job. I understand the appeal.

She mentioned that she’s frustrated by other OTs and COTAs practice strictly by the book and who don’t take practical needs into consideration. She mentioned that she’s frustrated by families who won’t follow through with suggestions and recommendations.

I completely understand and sympathize with her frustrations. I have the same ones.

I’ve been thinking a lot about this topic for a while now (as you can see by my posts). And, I’ve been thinking about our conversation on Easter Sunday.

Because to change things requires a change in thinking.

That’s a hard thing to do. You can provide continuing education on topics and research and intervention techniques. It’s a lot harder to “train” a shift in attitudes and connectedness.

But, I think I just had an epiphany which I’m going to type here before I lose it!

My colleague, Dr. Rihana Mason, and I recently (like last week) submitted a proposal to introduce new approaches in administrative-level DEI trainings as well as a way for individual practitioners to consider how they interact with families from CLD backgrounds. Hopefully, we’ll introduce the clinician and administrator approaches at this year’s ASHA Convention in November. We also wrote two book chapters on this exact subject and the book should be in print in time for the ASHA Convention.

It just occurred to me that maybe we’ve been too focused on simply trying to change the minds and attitudes of administrators and clinicians that we’ve forgotten to find out what our clients think about the therapy process, our roles and responsibilities, and – importantly – their roles and responsibilities.

I think I’m going to go on my ride now and have a think on this a bit more….

As always, thank you for reading and I look forward to any comments or suggestions you have!

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