Ep 52: Ask-Me-Anything
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Laura Park Figueroa: Welcome to Therapy in the Great Outdoors, the podcast where we explore the business and practice of nature based pediatric therapy of all kinds. If you're an outdoor loving pediatric practitioner in the fields of occupational, physical, or speech therapy, social work, or mental health, this podcast will help you start and grow a successful nature based practice or program.
I am the ever honest, always 100 percent real, you'll hear it all on this podcast, Dr. Laura Park. My name is Laura Park Figueroa. I'm a pediatric OT with over 20 years of experience and I run a thriving nature based practice with profitable locations in two different states and multi six figures in revenue.
I also host the free online community at therapyinthegreatoutdoors. com to help you pursue your nature based therapy dreams too. Are you ready to take action on those dreams? Let's jump in.
Hello friends. Welcome to episode 52 of therapy in the great outdoors. I am on the mend after two weeks of being very, very sick. I am so sorry. I did not get a weekly episode out for you all last week because I had no voice to record even an intro for episodes that I have scheduled and ready to go. Generally when I record with an interview or record prerecorded podcast, I wait to do the intro until that actual day that I am sending it out to you all or the week before I send it out to you all. And I had no voice last week.
I told my husband, I think it is the sickest that I have ever been in 23 years of being married to him. We just had our 23rd anniversary while I was sick. So we'll go out to dinner next weekend. But I'm happy to be back here with you and recording again. Today, we are going to do an ask me anything episodes.
So I love doing these because it really helps to bring you value. And answer your questions that you may have about nature-based therapy practice or running your nature based business. So we have a good mix of therapy and businessy questions today. And I will. Let Courtney get started and take it away. Here's our first question.
Courtney: Hi, this is Courtney with Moving Mountains Occupational Therapy in Anchorage, Alaska, and my question for you is incorporating swings and crash pads and obstacle courses into your nature based practice. One thing that I really appreciated in the clinic was having our Lycra swings for the vestibular and then crash pads for the proprioceptive input.
and also the safety. Um, so I'd love any tips on portability. Are you setting them up and leaving them for the day for different sessions? Um, and tips and strategies. So, thank you.
Laura Park Figueroa: Thanks so much for the question, Courtney. This is a good one. I am. Rather a purist when it comes to nature-based therapy work. And I think that I'm hesitating because I don't want to say anything. That's going to make people mad, but.
I think sometimes. Specifically as occupational therapist and maybe this applies in PT as well, because PTs might use some of that equipment as well, but. I think a lot of times we rely on that equipment. And we think it is necessary when those are not things specifically crash pads and some of the other things that we have in our typical indoor clinics. Those are not things that a child would typically have access to in their everyday life. And so the more that we can make our nature-based therapy sessions mimic what they would typically have access to. And use the natural things that are occurring in the environment.
The better the carry over will be to their everyday life. So that being said, I know sometimes when we are using a sensory integration frame of reference, we want to be able to use some of that sensory equipment. We've never used crash pads in my practice outdoors. I think they're a little unwieldy to set up and take down, given the amount of padding that you would need to have in them. For safety, of course, but we do set up swings on, on trees and there are ways you can get that proprioceptive input. Or that Deep heavy.
proprioceptive input that we want from a crash pad. Doing different swing activities. So one of the things that we love to do in. My practice. I think one of my old employees invented this game called bounce back, which is in my book therapy in the great outdoors. But basically the child is in a swing, almost any kind of swing they can be in. And you take a big stretchy piece of fabric and two children or a therapist and another child or a therapist and another adult hold the fabric very tightly so that the child can swing on the swing, can swing into that fabric and really get that bounce back off of the fabric and give them a good little dose of proprioceptive input there.
I think we need to be thinking as therapist about ways that we can. Do things in nature that might mimic some of those activities that we have in the clinic. In a way that might be more easy to. Set up and take down as we're outdoors. So a lot of us are using spaces that are not our own property.
And so we do have to set up and take down. I know in my practice, we do have to set up and take down everything. Every session. We do occasionally have swings that we like, like ropes that we have set up for swings and we'll come and clip in different swings into them. And we'll, we will leave that rope up.
But sometimes in public places, those ropes will get taken down or people will tie knots in them. And so this is the thing about nature-based practice. You have to be very flexible. And very willing to go with the flow and just know that you are not going to have access to a lot of the things that you might in an indoor setting in a clinic.
But as I started out saying at the beginning of my pontificating on this question I do think maybe in some ways that is the beauty of nature-based therapy. That parents see that what we use are things that they can naturally do and everyday life. So what are some ways that you can. Get some of that sensory input. Outdoors with the family, with the child and the parent or with the child in a group. And then share those ideas with families so that they can do those same things at home, because I think crash pads can be mimicked at home with. Sofa and some sofa cushions.
So if that's something you want to tell parents to do, you can definitely recommend that as like a home kind of activity for them to do. And that does exist in their daily life. I feel like I'm a little, all over the place and answering this, but. I think the first main thing that I want to challenge us to think about is how necessary are those things for addressing the child's goals?
Okay. That's the one thing. And how simple can you keep your nature-based therapy session to be things that parents can do in everyday life? Okay.
Okay. I think that's it. Thank you so much for the question, Courtney. And I'm going to move on to the next question.
Okay. Christina sent in a couple of different questions because she responded to my only have two questions. So if anyone wants to submit, she was like then I'll do another one.
So her first question was, what is, she did not record these. She sent these to me via email, which was totally fine. What are your ideas and thoughts? About partnerships with local arboretums or nature centers. How does the prophet work with this? Do they take a percentage of income? I'm trying to determine how to go about presenting an offer to a local area that I know. But I wish I could realistically lease or rent the land or any land. Around, but the cost is too much and many places won't lease land to me, centers arboretums et cetera. I do not want to sell myself short and put so much effort and time into my sessions with no return profit. Any insight or personal experiences would be helpful. So Christina, you are a smart and wise person because I don't think any of us should be putting effort and time and energy in two therapy sessions and not getting paid for our services. Unless you're a nonprofit and it's Misnomer that nonprofits don't make money.
That's a total lie, like nonprofits do make money and they do get paid for services that they provide. They just can't. Use that money that they earn to line the pockets of the owners of the nonprofit. That's that a nonprofit does not mean you can't make money. That being said. Even nonprofits need to get paid for their services.
And I think one mistake that a lot of people make when they start out in nature-based practice is. They're not thinking about making a profit, they just want to serve everyone. Like we all are these bleeding heart therapists. And. I want to remind you as Christina is reminding us with this question, because it's a wise question. Your business needs to be profitable, or you will not exist to serve more people in the future.
So I want us to be thinking about profit when we start our businesses. Even as we're serving people and. And providing therapy for children okay. There's a lot to unpack here. I think you need to reverse engineer this. So what are you going to be able to charge for your services? What do you need for yourself to pay yourself a living wage?
So this is something I am reading a book right now about. Business finances. And one of the things I took away from the book was that you need to be paying yourself a living wage, like whatever. A market wage would be for you as a therapist from your business, because you're basically in your business, not going to be able to see if your business is profitable, unless you're paying yourself a market based salary.
Okay. You have to be doing that because eventually you're going to need to replace yourself in your business. And you need to be paying yourself that market based salary, like what you would make on the market. So whatever a therapist would be paid in your area, you need to be paying yourself at least fat. For providing the services in your business. You're reverse engineering.
What you can afford to pay an Arboretum or a nature center or a private land owner, something like that.
Looking at your total amount that you will charge for the service. So I'm going to use a very like straightforward example here. And say, let's say you're going to charge a hundred dollars for a therapy service. I hope that everyone is charging more than a hundred dollars for a therapy service. I just saw the other day that a handyman from ACE hardware cost $180 an hour. Y'all were fair at best.
Okay. So you should be charging more than this, but for sake of an easy example, an easy math, I'm going to say a hundred dollars. So let's say you're going to make a hundred dollars on your therapy service. And let's say a going wage in your area for an OT. Salary is, let's say it's $50 an hour. Okay.
So $50 an hour. Is that might be high, but I'm again, easy math here. So you need to pay yourself half of what you're bringing in, and that's a pretty good metric to say that you need to spend you, you should be spending. Or maybe not should, but you usually in a therapy practice are spending about 50% of the income on the payroll for the people providing the service. So that's a good kind of, this is a good kind of example with these numbers.
So you're going to pay yourself $50. You're going to have to account for taxes on top of that. So I'd add another 15 to 20% for taxes. So let's say $70 that leaves you with $30 left. Okay. You also need to account for supplies and time that you're spending planning and things like that are outside of the direct therapy session. So you can see very quickly how. $100.
Isn't enough to charge for a therapy service. But also how that money quickly abs away. And you don't really have a lot of money to pay to lease land. I would suggest something that is by the amount of time that you're using the land, rather than a flat fee, of course, because that will save you some money.
If you're only doing an. Using the land for an hour. And I think you need to also consider. What is the benefit of partnering with this facility? So if they're going to do some marketing for you, you might be willing to pay a little bit more for the service for the land, for renting the land from them. But if they're look. Sorry, my, I forgot to set my phone on silent.
So you might want to also consider if they are doing any marketing for you or anything like that, then you may be willing to pay a little bit more for the land, but. You have to reverse engineer this and make sure that you're not selling yourself short. Like you said, Christina. And make sure that you're not charged, you're not paying too much for the land.
I think. I think working with these larger centers is sometimes hard because they often have their own programming.
Looking for private landowners. I had good luck finding private land in a Facebook group for local moms, where I just asked if anyone knew of anyone who might have land, that they would allow us to use. And so we use a combo.
We did for a little bit. I'm going to go down some rabbit holes here. Y'all. We use private land for a little bit here and Wisconsin where I live. And then we also used public land at a local park. And we decided to move all of our services to the local park one, because it was more affordable.
Like we're talking about here and to the land was just bigger. There was more space for us to use and more space to roam and explore. It, it depends on the land that you're using. So maybe you could find private land where there's a ton of acreage and that would work for you, but. I think just being aware, I realized I'm not giving a direct answer about, you can pay 10% of what you make. I'm not giving a direct answer because there's going to be so much involved in making that decision, but just do not sell yourself short, make sure that you can afford it and make sure that you are getting what you're paying for.
There's always going to be a cost to land for the most part, even if you're renting land from a public. Place there's going to be a cost that you have to pay to rent the space or to pay, to use the public park or to get the permit, to do your program outdoors at the public park. So there's always going to be a cost. But I also. Want you to think about. Making your rates so that you can afford that cost.
So that's the opposite of, it's. It's reverse engineering a little bit, but then maybe when you reverse engineer, you realize that, oh, I need to charge more for my service. And that might be what you need to do in order to rent the land at a cost that would be amenable to the facility or the landowner as well. Okay. Next question also from Christina. I had an inquiry about providing OT services.
One-to-one. The mother stated her son has an IEP and has an OT at school, but she'd like a second opinion because she feels he's probably not getting the right services. He needs. She reached out and asked an array of questions. One in particular was collaboration with other therapists and observing the child in school. What are your thoughts on this?
Have you come, have you had this come up with your one to ones? She also wanted to know how she would be able to see if my nature OT would have a difference or not, which brings me to another question. How do you provide one-to-one OT with the parent involved? I was always going to have the parent involved in the treatment sessions, but has there ever been any time when you would not have the parent involved in the session? So there's really three questions here.
So let's just go through them in sequence. The first one is what are my thoughts on collaborating with other therapists and observing the child in school. And have we had this come up with our one to ones? Or individual sessions. I think of course it'd be great to collaborate with other therapists and observe the child at school, but remembering that you need to be paid for your time to do that. And one thing that I think is really important for nature-based practice is to think about is growth and scaling. So there are things that you can offer, like going to a school to observe a child. When you are smaller and you don't have a large caseload, or you're not seeing a lot of kids, you're not really busy and you can fill your time doing things like that. But those things are a little bit difficult when you go to scale and you're trying to make sure that you can pay everyone for their time.
If you. If you choose to do this, if you choose to go offer school visits, in addition to your nature-based therapy. Then I think the wise thing to do is make sure that you can have a system around it. And that you limit the amount of time that you have to visit the school because that's a lot of time on your part. And that you're making sure that you're getting paid for all of the time that you are visiting the child in the school.
So again, reverse engineering. What do you need to charge for that in order to make it. Worth it for you to spend your time driving to the school and spending time there. Driving back home and all of that.
I think phone collaborations or zoom collaborations are also a good in between for maybe the parent to pay you to meet with the therapist for 30 minutes or something. Separate outside of the session and then you just bill them separately for that.
So that's something that could maybe scale a little bit more easily than doing school visits, to collaborate with therapists at the schools while you're also providing the nature-based therapy as well. Okay, the next question was, how will the mom asked, how will she be able to see if the nature OT has a difference or not? I think this comes down to writing really good goals. I did do an episode on writing great goals and nature-based therapy. That was episode 36. I'll link it in the show notes. So basically. When you write really good goals, you will be able to tell the parent. One, my answer to that question would be. First of all, we want to be making a difference on the things that really matter to you and your family and to your child.
And so the first thing that we would start with to make sure that we can see. If a difference is being made or not in those areas. Is, we're going to sit down and we're going to write goals together. I'm going to really talk to you about what matters to you. And we're going to have some very specific goals.
Now I'm saying goals because with an individual child, you can have more than one goal with groups. Generally. I only write one goal per child because it becomes a lot to manage five kids in a group with four different goals. Each you can't, you just physically can't do that as a human being. So I'd tell the parent that we're going to write goals and that we will be monitoring every single week.
We're going to be writing the progress on those goals. And she's going to get a copy of those notes and the progress that we've made. And then we're going to have a check-in at a specific time.
So that depends on how you've set that up in your practice.
So if you have eight week sessions or 10 week sessions, or maybe you go a semester, That's what you would tell the parents. So we're going to do this. Check-in on these goals. And you will know whether or not we've made a change in the areas that really matter to you.
So I think a lot of answering that question for the parent just involves really reassuring them.
That what we are doing is skilled therapy. We are assessing, we are writing goals. We are documenting and we are reporting progress. That is. How we know if we've made a difference is when we do all those steps really well. And that's what skilled therapy is, right? So it's reassuring the parent that we're going to be monitoring and checking on those goals and working on things that are very important to the family themselves.
Okay. And then the last question about, do you provide one-on-one OT with the parent involved? Yes, that is. The standard practice in my practice is that we require the parent to stay for the therapy session. And the reason being just that helps with carry over into daily life at home. It helps the parent know what's going on.
It helps the parent really be the one that is. The. One co-regulating with their child, the one being connected with their child, the one understanding their child and really giving them. Insight into what you're saying as the therapist with the child. And allowing the parent to see what's going on in that session and be really involved.
Has there been any time that we would not have the parent involved in the session? Yes, but one thing that I am huge on is that in an outdoor setting, you always need to have the parent nearby. If you're doing an individual session. For safety. And that is even if the parent is not going to be. Co-facilitating this session with you and really involved in the session, which I think it's rare that they shouldn't be, but I'll talk about that in a minute. But for safety, if you are alone with a child in a wild nature setting. That is not a safe situation to be in if an emergency would happen.
Our rule. And my practice is if the parent for whatever reason is not going to be directly involved in that session. Then they have to be within earshot. Of the therapist and the child. They have to be able to hear. If the therapist or child yells for them. And that is our kind of Rule in my practice.
So regarding the parent. Not being involved in the session and when that might not be the case. We all know as therapists that therapy is really complex and. Sometimes there are challenging dynamics going on with relationships between a child and the parent. And so I would say that the goal should always be to get the parent into the session. But that maybe you start off with small. Bits of the session and then move towards the parent being in the session the whole time.
I think I would like some input from our community on this one. So I'm gonna throw this out there. As a. Question. Related to this podcast in the therapy, in the great outdoors community. And I want to see what other therapists in the community would weigh in and say, Because I'm having a hard time right now, articulating. The reasons why a parent would not be involved in the session. And this is a question that I would love to hear what other therapist. Have experienced and what they would say. We don't do a lot of individual services in my practice. We mostly do groups. So I may not be the best person to answer this question. So I'm going to throw it out to the community. And if you're listening to this and you have thoughts, go to therapy in the great outdoors, the community and. You can weigh in on the question and share your expertise.
Cause I'd love to hear what you think.
Oh, my voice is shot. Y'all I realize now that I am still on the mend, because I haven't spoken. For 30 minutes straight in two weeks.
So I'm signing off, but before I go, make sure you stay for the outro because I have a brand new freebie that you are going to want to get. It is going to be so helpful to you and I am so excited to be offering it. So stay tuned for the very last minute of the podcast. See you next week.
Laura Park Figueroa: Wait a second, don't go yet. Do you want 120 ways that you can take your pediatric therapy work outdoors into nature? I wrote the free big huge list of nature based therapy activities just for you. The big huge list will give you quick ideas for nature based sessions. In the big huge list there are activities for gross motor, fine motor, visual perceptual, executive function, balance, group collaboration, and team building.
social, emotional, and self regulation skills, as well as speech and language, and a whole section just for swing activities. So go on and get your free big huge list so you can get started taking kids outdoors or have some new ideas if you've been doing this a while. You can download your free copy at therapyinthegreatoutdoors.
com slash list. So until next time, get outside, connect, reflect, and enjoy therapy in the great outdoors.
