Episode 34 - Diving into Surf Therapy with Naomi Matanick, OTR/L
Laura: 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 a hundred percent real, you'll hear it all on this podcast, Dr. 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 Therapy in the great outdoors.
com to help you pursue your nature based therapy dreams too. Are you ready to take action on those dreams? Let's jump in.
I am so excited to welcome you, Naomi Matanick. Did I get it right?
Naomi: Got it right.
Laura: Okay, good. Naomi is the owner of Hang Ten Therapeutics. She's an OT and Hang Ten Therapeutics is a SURF Therapy business in West LA, and she's going to talk to us all about her business so it's going to be really fun. Welcome, Naomi.
Naomi: Yeah. Thank you for having me. It's always great to be able to share about it. People know what it is so that they can start utilizing it.
Laura: Yeah. I want to dive into surf therapy in a minute. Oh, no pun intended. I joked on the thing to you. I was like, let's dive in, pun intended when I wrote to you, I think. . So tell, why don't we start at the beginning? Tell us how you started, how you got this idea to do an outdoor business where you're offering surf therapy and like what it is too, cause people, it could look differently for different businesses. I think like what exactly you do.
Naomi: Yeah, absolutely. So I feel like what got me started. Was a couple of things. So I'm a surfer myself. And, just over the years have started to recognize all of these benefits that surfing and being in the ocean has not only physically, but emotionally and socially.
And then the other component was, I think I've always in the back of my head had a desire to make being outside part of my work in life. But really didn't know what that would look like or how to do that. And then in 2020 discovered that surf therapy existed and I was blown away. I'm like, this exists, this is a thing.
And as quick as I could, I reached out to the first company that I heard about, which is groundswell community project and contacted their CEO owner and was like, how do I learn about this? And so got very connected with them just learning about surfing as a therapeutic tool, but they are mental health and adults is primarily right now where surf therapy is existing.
So mental health, adults veterans, but fortunate for them and was able to really get a framework of what surf therapy is and how I might be able to implement it myself just by
Laura: learning from them. So what, when you say a framework, like I think, let's play a game. Can I guess what it looks like?
I have no idea what it looks like, but I'm wondering when I think about surf therapy, when I think about surfing in and of itself, like any activity in and of itself can be therapeutic, quote unquote, for a person, right? But I'm assuming that there's some sort of especially maybe with the mental health field or mental health kind of goals that you may be addressing.
Is there some kind of cognitive or emotional processing that happens outside of the time on the water too?
I have to have you
Naomi: maybe rephrase that question. What what would be, what are you asking, like when they're, when they leave the ocean?
Laura: Yeah. Like how, I guess how is surf, I guess the question is how is surf therapy different than someone just going surfing and getting the therapeutic benefits from that?
I could say the same thing for like, how is what we do in the woods with kids in my practice different than just. Parents taking their kids outside to play, do you get what I'm getting at? Like the therapy piece, like how does it become therapy? I think this is a question people would have when they're thinking about what you do or what we do in my practice too.
Naomi: absolutely. That's a great question. And it comes down to the individual. So I work with kids. And so typically what I'll do is I will do an assessment of the child prior to getting on the beach. So that's going to be your more standardized occupational therapy clinical assessment. And so that I see what are their specific goals and needs talking to the parents.
So then when I get to the beach sometimes we'll add. Some things at the beginning before we get in the water that are targeting their specific therapeutic goals in the water. I'm very mindful of what their goals are. So as versus if we're just going surfing and I think in surfing there's, and be this like pressure for performance and sure.
Intensity, right? Okay, let's catch a wave and let's catch another wave. And then, and and how do we catch that wave? Don't squat. That's not really serving stand up, and changing that a little bit and taking a step back and considering what the child's needs are when we're in the water and in on those specific needs.
And that's the therapeutic component.
Laura: Yeah, that makes sense. So it's interesting because I can't help but and I'm sure people listening can't help but think about their own work and how their similarities to it because it is, it's a lot of what's going on in your head and how you're modifying or changing in the moment with whatever's in front of you based on whatever that child is working on.
I've only surfed once and it was way harder than I thought it was going to be and we're going to Puerto Rico in December. Go to surf school there. So I'm super excited, but I could barely balance just on my stomach, paddling on the board. So I could see where the challenges inherent in the activity are actually really amazing for a lot of kids that we would see for OT, so yeah.
Naomi: And that's the amazing thing. Are there's already these inherent challenges that are there. And then getting to utilize those along with maybe whatever other challenges I'm trying to curate too.
Laura: Yeah. So what are some of those that you would try to curate? I'm interested when you say these things.
Naomi: Yeah, and it's so child specific, right? But for example I have one kiddo who tends to be more anxious. And so then the challenge is tuning in to what's going on in my body. And okay. I hear that you're telling me you're anxious, but we can't just stay on the shore for right.
We can start there and build up, but there's going to be a push at some point but that's right. Challenge that we know as OTs, I don't want them to the point that they're terrified and they never want to try to be challenged in or out of the water again, but I'm going to need, knowing this child's specific profile, I'm going to need to push them a little bit, but then that's the challenge, right?
The challenge of regulating them while they're participating in the sport of surfing.
Laura: Yep. That's one example among many. Yeah. I love it. And I love that surfing is like a, we're as occupied, this podcast, I should always feel like I need to say this. I just recorded a new intro for the podcast.
So it is in the intro now, but I always want to clarify that this podcast is not just for OTs. I want people who are social workers and speech therapists and physical therapists and all kinds of other pediatric professionals to, to gain benefit from these conversations, but I can't help going into OT brain for a minute with you because.
Like the idea of using something that is a, that is an occupation that many children would want to participate in as a therapeutic modality is just very OT. It's like you're, what you're doing is helping these kids be able to do something that their friends may be able to do and that they could use as a social and, physical experience for the rest of their lives.
It's really cool. Yeah. And that's what
Naomi: I love about it too. Hopefully they get this sense of something that they can do throughout life now with their friends, with their family, this identity. Yeah. So it's a skill they can carry with them.
Laura: Yeah. I want you to talk a little bit about okay, so you got your foundation started.
So I know though, that you also, I wanted to make sure to mention this cause I thought it was so cool when I saw it on your website, you also offer surf therapy for. Moms in postpartum and other I'm assuming. I don't know. Tell us a little bit about that because I think that's a really cool Thing to offer especially when you're a pediatric OT.
Naomi: Yeah, so funny to bring it up. That is something I'm hoping to offer that I haven't implemented yet Okay, which I probably also haven't put in the legwork to get that like up and out there Yeah,
Laura: and it got marketed and everybody didn't know about it.
Naomi: But I laugh because I'm like, Oh yeah, that is on my website.
But it's definitely something in the pipeline. Another surfing. Had to throw that in there. Another thing in the lineup that I am hoping to offer and that just became born out of when I'm with kids hanging out with moms whether they're like very busy. Yeah. Like very much postpartum, just like a couple of months or whether they have a five year old, recognizing how it's so hard to be connected to their own body.
And and then just talking to a colleague of mine who's a doula and realizing this need and how really some of the skills and background I have in my training with kids, particularly in sensory integration and how that can be applied to these moms.
Laura: Yeah. I love it. I love it. I think I, I think that could really take off.
I'm just thinking I would have paid to do that when I was a young mom, I'd pay to do that right now. I'm postpartum. My latest is 13 years ago, but 21 to 13 are how old my kids are now. But I just love it. I love, I think it could be a really cool symbiotic offer for your, for families to take advantage of.
Yeah. So how was it getting things started? Tell us about the early days of starting up. Like maybe, I love to hear stories too. Tell me about like the early days of starting maybe the first client you had. Yeah.
Naomi: Your early days of starting so funny.
So I don't have a business background. I just knew that I love surfing and I thought it would be so amazing for kids and the kids I work with. And, it was hard to get started, I think, because I didn't know what the first step should be. And finally, gratefully with encouragement from, other colleagues.
And friends just telling me, Hey, you just have to like, get started. You just have to do it. And so I started just telling people, Hey, this is what I do. I do surf therapy. And and I would say my very first session was rough in a, in the sense of I realized at that time it was like, okay, I know how to be a surfer and I know how to be a therapist.
But I didn't realize it would be so hard to figure out how to merge those together that you're talking about but I also Appreciated that session because it I feel like it taught me So much. I laugh because that first session, I felt like it went so poorly that I had to get into the ocean myself afterward and surf because I just needed to reset myself.
Laura: And be like, what am I doing?
Naomi: Yeah. And I don't normally get into the ocean to surf after my session. So I that was my sign that I was really like reset, right? Probably not as bad as I think we're all our own like worth critic, but but it was, it has been taken time to refine it and most beneficial and how it can become most therapeutic for kids.
And so that's where, setting expectations of what this is. Making sure I do that clinical assessment. So I'm very clear on what their actual therapeutic goals are. And then just gaining in confidence as I've had the opportunity to work with more kids and have that
Laura: be my goal. Yeah.
What did you just say? Have them be your best teachers? Is that what you said? Yeah. Yeah. It cut out a little bit. I wanted to make sure to capture that. That's a good, have the kid be your best teacher. So tell us what in your. Hindsight is 2020 kind of thinking about that first session, because this is something I really want to explore more.
I feel like a lot of times it's like what you said about, I was an OT. I love the outdoors. I didn't come from a business background. I didn't know how I was going to do this. And I just had to go for it. I think we often think that it's going to be really easy and idyllic, we think Oh, I'm just going to be surfing.
It's going to be so great, and we don't think about all the systems and all the logistics on the back end, just the communication with families and the paperwork and the logistics, the legal stuff and all of the things that we have to do to run, even if you're not running a communication.
Business per se, even if you're running an outdoor program, a lot of this stuff, like as part of a bigger business, right? A lot of this stuff is really important. And I think that's part of my mission with this podcast is to help pull back the veil a little bit on like how to do those, all of it, really the practice piece, but also the business stuff.
So what was it about that first? Session, maybe we'll get into the business stuff in a bit, but what was it about that, that first session that you feel like was like, Oh, it was rough. What do you remember about it? That was hard. I
Naomi: think, yeah, I remember several things. I feel like this one is like in my memory long
But I didn't have that relationship with the child, because it was the first meeting them. And that's such a big thing, is You know, in business and in therapy, those relationships. Yeah. And and then when you don't have the relationship with a child and you're in a very non unpredictable environment like the beach it's really hard to know how to move forward. So how does that particular child attend? How do they follow directions? Yeah. How do they understand their own body and space? And having to quickly navigate those things in a really fast paced environment, right? Because once you're in the water, now I will clarify, we don't go very deep, but there's still wave after wave coming and it's a really difficult time to try to figure something out.
You know ahead of time what to expect with that child because water, you have to be very hands on and know how and what's going to help them to
Laura: pay attention. Yep. Yeah. Yeah. Things were hard that first session then like you did you get in the water the first session
Naomi: got in the water?
and then that was also on me too was Learning how to be hands on with a kid in the water So I don't think I was quite hands on with them enough as I should have been and they were fine But I think it was just we want kids to have wins right in a challenge and I think there weren't enough wins comparatively because I don't think I was supporting the child physically enough to help them have the wins that they needed to have in that moment.
Laura: Yeah. Yeah. That's good reflection though. It's really good reflection. And you learn from it. Clearly it's embedded and you remember it and I always say we learn from failure. Although I just heard on a podcast that I listened to this podcast called Modern Wisdom. I love it. It's it's all about living in the modern world, essentially wisdom for living in the modern world, and the guy interviews really expert, amazing authors, and... People. And so he had a guy on that said it was the topic of the podcast was something like seven counterintuitive advices from this guy, some guy, I don't even remember who it was, but one of the things he said is that I just don't believe we learn from failure.
I think it's way overrated. I think people like to say that we learn from failure, but I don't think we learn as much from failure as we think we do. It's more did you learn the right lesson from failure? And I'm like, I disagree wholeheartedly. I, because I do, I just think, yes, you learn from the reflection on the failure.
If you don't reflect on it, you don't learn from it, but absolutely you learn from it to me. I don't know. So I'm expert in the world thinks I'm wrong, but I don't care.
Naomi: I know that's baffling to me too. Cause I'm like, I think if you reflect on it, you do learn. Yeah. There's so many things I've learned this year that have been maybe counted as losses that have helped propel me forward.
Laura: Yeah. Yeah. Yeah. Yeah he's wrong, we're right, Naomi. That's right. Some rich guy who knows stuff and is on some fancy podcast whatever, we don't need to listen to him. No, I'd love to be on his
Naomi: podcast. Yeah,
Laura: okay, so you had a hard first session. And when do you feel, when do you feel like you got your sea legs to use a little pun there?
Like, when do you feel like you got in the flow of things and you another pun? Oh my gosh. The puns are just all there with surf therapy. I know, so many puns. And you felt ready to dive in and Right, how long did it take you to feel comfortable,
Naomi: after that session? I feel like I, it wasn't that long after because then I got another kid I started working with and I had taken everything that I felt had gone poorly in that first session, changed it, right?
That was when I immediately made that rule, Hey, I have to actually complete this assessment in home. And then. Understanding that we can't, I think another thing that had happened in that first session was I thought, Hey, let's just get in the water right away and understanding that's actually not therapeutic at all.
And taking my time. So I would say the next kiddo I got in my caseload, I was noticing like immediate like changes and getting better and then of course, the longer I did it and now as I've started working with more kids. And, now encountering a variety of kids, right? So they have different goals and different needs.
And I guess going back to that framework, there's a certain framework that I apply for everybody. And I do that every time. And then there's. Specifics that come into the session for each kid.
Laura: Sure. Yeah. So it sounds like your intake process is like you require an assessment. I know your private pay.
We didn't really talk about that. I know your private pay. You're not taking insurance. I guess a question I would have is, are you? Are you billing this like private pay OT services to families? Because it sounds like you're writing goals, you're doing the full OT assessment. So you're like, this is OT and you're using the surfing as like a modality as a sense.
Is that accurate or no?
Naomi: Yes. Accurate. Yeah. So I am, billing it as OT and using therapeutic codes. So maybe that's motivation or therapeutic activity. So Billing it as an OT session, right? Creating an assessment, creating goals and then providing super bills for families for their insurance providers.
Yep. Yeah, I'm not putting anything related to. Surfing on there. I don't even know if there is a code for that,
Laura: but yeah, there wouldn't be. I'm
Naomi: sure. I just, yeah, I'm assuming it wouldn't get covered in a million years right now. Yeah. But that's how I'm that's how I'm structuring it.
Laura: Yeah, I think that's I think that's great.
I had a, I'm remembering an interview I did for my research last year that One of the OTs who was the most experienced nature based therapist that I interviewed, and she was just adamant about, we are our profession first. We have a license to practice your profession. We're all licensed healthcare providers.
And The place where you serve children or the techniques that you use or the modalities you use are just those things there. There's no such thing as nature based therapy. That's not a certification or there's no such thing as surf therapy. There's not a certificate. There might be. I don't know if there's a certification for it, but there's not a there's not a licensure process in place like in a legal government sense, right?
And so we're always our profession first and we're using that lens. Through we're using that lens in order to treat children and the. the ways that we choose to work in nature are just like additions to the therapeutic process. And it was just an interesting, she was really adamant.
Like I, I don't even she she multiple times in the interview when I said something nature based therapy, she's see, I don't even use the word nature based therapy. I don't think that's a thing, she was like, or she didn't, maybe she didn't say that quite that directly, but like it was, she definitely was very careful about the language she used.
And I think this is important. And it sounds like you're doing it similar to how my practice does it too, because I often tell people that when you're, even if you're a cash pay practice and you're submitting like a super bill is a paid in full invoice. If people listening don't know that, but if you're submitting a super bill, giving it to families to say here, you can, it's a paid in full invoice.
You can give it to your insurance company and maybe get a little bit of. Reimbursement back if you have out of network benefits you have to be following all the rules of your profession, right? Like you have to be ethically putting ethical codes on those things. And you're not writing that you're doing surf therapy and sending that to an insurance company, right?
You're an OT. I know a question that people have too, is Like goals. A lot of people have, I'm going to do an episode in the future about that, like from my perspective, but I'm interested are you writing goals that actually mention the surfboard in any sense? Or are you using words like dynamic surface or something like that kind of imply or are you writing mental health goals?
I don't know. Talk to us a little bit about the type of kids you're seeing in the goals that you're working on with them out there.
Naomi: Yeah. So the type of kids I'm seeing I, my specialty is in sensory integration and neurodiversity. Those might be kids with ADD, ADHD, might be kids who have what we would consider more pure sensory integration challenges.
And then some kids who are on the spectrum. And and then, all of those kids are going to have sensory challenges and motor challenges. And then subsequently emotional challenges because it's difficult. So no, my goals are, if you would read my goals, they're very tradition based goals where I'm, it might be.
Increase, bilateral integration, which is for people who aren't sure what that is using both sides of the body together. So you're going to see balance or core strength or, tolerating textures or, it's going to be things that yes, we're actually covering through surfing as a therapeutic tool.
But, I'm talking about the pure goal that I'm trying to achieve.
Laura: Have you ever had kids that you don't think are appropriate for surf therapy?
Naomi: Yeah. One thing that I, I'm still getting started and so I haven't had to educate a ton on this yet, but it's definitely happened where.
I'll have a kiddo who is like adamantly opposed to surfing in the ocean and it just like terrifies them beyond the point that I can help them like regulate or they just hate it. And those to me, even if they may physically be appropriate or emotionally appropriate, I encourage parents, if your kid is just gonna hate surfing and hate the ocean, I don't think it's an appropriate tool because I don't, there's a certain level that we can work on overcoming.
It's different if you're a little bit fearful or anxious, but if you just adamantly hate this it's really, it may not be the right. Therapeutic modality
Laura: for you. So it's not like a, it's not in some ways that's good. It's like telling the parent just because you want your kid to surf, your child might not want to.
And so it's like really tuning into the child and knowing if it's something that could be beneficial for them. Cause your job is not to teach surfing per se. Like that's not what the purpose of this is. They have to be somewhat interested in going and the same for any, I think any nature based therapy service, whether you're doing hippotherapy, whether you're doing therapy in the woods, whether you're on the beach, wherever you are outdoors doing therapy with kids.
I don't know that we've ever talked about this on the podcast before, but there probably are like some kids that are not well served by wherever you are for. Certain reasons, and that's something that we have to take into account as a therapist. I feel like that's part of the process, yeah,
Naomi: it is. And a big thing I work with on kids is self autonomy, right? And so actually really listening to them when they're telling me that something isn't feeling good for them. And that's, there is some confusion where I've had to educate that this is a therapeutic modality. So if we learn how to surf in the process, that's great.
But that's not the end goal. Yeah. And taking away the pressure of having to serve.
Laura: Yeah. How long do you often see kids? Like, how do you deliver your services? You're doing an assessment and then what are you what's the process after that? Yeah.
Naomi: So the process after I've done the assessment, this is still so new for me with seeing kids in the water that I'm still figuring that out.
Like how long do we need to be seen? Some kids they'll just continue. I had some kids work with me throughout the entire summer. And one in particular, he was doing really well by the end, but I think it was just like a nice fun summer activity to do. So they kept with me.
But I think I fall back to how I normally assess kids, right? Every three to six months, I'm considering, are we meeting goals? Where are we functionally outside of being here at the beach? And assessing in the same way I would assess. Normally, but I don't have a specific framework yet for
Laura: I love that you just admitted that and just said, I just don't, I'm still figuring this out because that's how it is when you're first getting started.
Yeah, the first few years of your business are just like figuring out what works and what doesn't work and what systems you need and how to make things more efficient. And You're figuring it out and you're going for it. It's so great. It's so cool. How many kids are you seeing now?
Like, how have you grown? I'm interested to, yeah,
Naomi: this past summer into now, even in the fall it's grown comparatively last summer I was seeing one kid and then this summer and into the fall, 10.
Laura: Yeah, that's good. Yeah. And are you doing this full time or do you have another job on this? Not full time. Okay.
Naomi: Half the week I work for a pediatric home health company. Okay. And so the idea is to slowly phase that out and then, increase my own practice. But it is starting to grow just from word of mouth and...
plugging into different resources. And so now I'm at that business juncture where I'm like, Oh no, I better get some help. Like maybe with admin or I have thought about, into next summer, if I'm going to need support in terms of other staff helping me.
Laura: Yeah. Like someone else there with you.
Yeah. That's a, that's another thing I didn't even think of. So it's just you and the child in the water. Does the parent come in the water with you or no
Naomi: parent is not in the water. Okay. It's just me and the child. So then I guess that would be the last coming, going back to that question you had asked if there's anyone that's not appropriate.
In terms of what I'm offering right now and what my company is equipped for it's, do you have to be able to follow, I would say anywhere from two to three step directions and have safety in terms of they're not a looping or they don't have maybe behaviors that can cause danger.
Yeah. Do you, it's perfectly okay if they have an aid who can help and support them. But right now I'm just not equipped for that as being like one
Laura: person. It's like a safety
Naomi: thing, the safety thing. And so for me, it is one on one in the water. Okay. Yeah. So there's only so many sessions a week I'm able to do.
And then also, the conditions of the water, right? Okay, we want it to be ideally morning to mid afternoon. So that we have great conditions in the
Laura: water. That's interesting because how do you, so this is like logistically the wheels are turning in my head because like lots of kids aren't available during the morning or afternoon and I could see where summer, that would be great, like you could do camps or things like that, or like maybe parents could figure it out to get them there midday, but how are you structuring things in the business?
With that being the best time for the setting that you use what's that look like? That's still me
Naomi: figuring that out right now. What it looks like is me working a lot because I'm having to figure out, the work I do during the work week, but then the ideal time for kids, if I want to see them in the mornings or early afternoon is on the weekends.
Yeah. So right now that's what I'm doing and I've scaled back, I've scaled back on hours during the week so that I'm, not burning out completely. And then there's one or two kids I do see during the week after school, but it just depends on the child and like what we need it works out for them.
There's certain kids that wouldn't work out for in terms of how the conditions are at that time of day. So I'm still figuring it out. That's another thing where I'm like. Whoa, what does this look like?
Laura: Yeah, it's because we have the same problem. It's like here I found, I remember because I just started the branch, the practice here in Madison.
I don't even know. I never know if people know this, but my practice is in California. I moved to Madison, Wisconsin to live near my husband's family a few years ago. And we just started the branch of my practice here. The California one's still going. So this is our second location. And I remember when I was like, deciding what time we were going to set up all the programs inside of our EMR.
And I was I saw the school schedules and I looked at it and was like, Oh my gosh, they don't even get out until three 30. Our groups can't start until four o'clock. So we are going to be doing a lot of in the dark, fun, snowy activities in the middle of December. I bet because it's going to be so dark when we're out there, from four to five 30.
So we'll find, I, constraints. Make you creative. So we'll figure it out. But
Naomi: you mean that or you haven't had a chance to try it
Laura: yet? We haven't we just started this fall. So we haven't gone through a winter yet. So yeah, it'll be fine. It's not like it's a five hour camp or anything in the dark, but but it's just, it'll be interesting because I was so used to out there.
We start our groups at 3. 30 because schools get out at 2. 50, so it's just different logistics that you have to figure out in new locations. But what do you think I'm interested if you've thought about that, maybe you haven't, and it's totally okay to be like, I don't know, but, what do you think is full time for you? Like how many kids would you need to be seen? Have you done any math around I make X number of dollars per kid. Like how many kids do you need to see to be able to leave your other job?
Naomi: You know what? I haven't really sat down and done that yet. And I think it's because it's going to sound funny, but I think the growth is surprising me.
I'm like really grateful and excited and nervous. And but I hadn't, it's going to sound so funny, but honestly, when I started this, I told someone, I was like, you know what, I started this because I was like, I want to be outside. And I think this is going to be a great tool for kids. And, it took me so long to say like my company, I would be like, Oh yeah, I'm a surf there.
I'm a therapist. I see kids in the water. And no, so I need to like, start taking it a little more seriously. I do, but not, in the sense of okay this is happening. Are you like, am I going to get on board or
Laura: not? There's another pun. There's another pun. We have all the puns in this episode.
I love it.
Naomi: All the puns. But gratefully, no, I need to actually sit down and figure that out. But gratefully I'm starting to recruit support. So I've started working with a marketing coach. Who helps launch small companies. I've had some people just continue to encourage me and push me forward.
Laura: Yes, that's good. That's good. Because, yeah, you might need people to help you. Yeah, I think so pretty soon. Yeah it's really It's really tiring work, I think, that you're doing, right? To be in the, because if you think about it, you're seeing ten kids. A typical caseload in a pediatric clinic would be like 40 probably, I don't even know, 30 at least, and that's just two minutes.
You can't see that many kids in the water every week, like the weather wouldn't even work,
Naomi: you can't physically and just like I said, like time of day of when you can't, so that's where it's like. In my head, I'm like, even physically, I think four kids would be my max
Laura: in a row, right?
In a row. Oh, for sure. Yeah. Cause do you do hour? How long are your sessions? They're about 50 minutes. Okay. So yeah. A little over 45 minutes. So you have a little.
Naomi: So it's if that's four kids a day on a weekend, that's eight kids total and that's where I would have to cap out. So you want that service. Then it's needing somebody else.
Laura: Yeah. And what do you what are you charging per session for that 50 minute session?
Naomi: Yeah. So I do go on a sliding scale, but my typical base charge is one 85. Okay.
Laura: And she's in LA. So this is we should remember this cause we charge 208 or something for our session or sessions are an hour and a half long, but like we're charging.
Quote unquote a lot. If you're listening to this. In the Midwest or, somewhere in America where the cost of living is much lower, I think we're charging like 132 a visit here in Madison. So there's a significant difference in price range, but I think it's just helpful for people to know that, like what people are charging for services, because I think a lot of times people.
I think in Madison, we did price ourselves a little too low, but new community and you live and learn and you can always raise your prices once you are full and have a wait list. But it's good to know that. And then you, and then what do you do for, so I'm assuming you don't.
You don't do like package pricing then because you're having to cancel if the weather isn't cooperating or the ocean isn't cooperating. How do you manage that? Do you just track visits one at a time and then invoice at the end of the month? Yeah. So
Naomi: I have actually done some packages. Okay. It's better to do the packages in the summer, right?
Because that's more predictable that we're going to have. Yeah. And then if we have to miss one, we just can't, we like keep track of that and then. Oh yeah. But now that we're getting into the winter time it's better to be one on one or one, one session at a time. Yeah.
And then, yeah, like I said, I bill weekly and then provide super bills at
Laura: the end of the month. Oh, okay. So you're billing on a weekly basis. Yes. So that's, yeah, that's good. That kind of gives you like a little bit of income throughout instead of waiting for a big or for parents too. Yeah.
Naomi: And I've had a couple of families pay me in a package amount and that's fine too.
It's just how to budget that differently. And having to make sure that we keep track. Yeah.
Laura: Yeah. All those systems. This is what I mean. This is, I'm so grateful. You're sharing this because it's the stuff people don't think about when they're like, I just want to work outdoors with kids. It's yes.
And also there is,
Naomi: I spent an entire Sunday, like an entire Sunday on my simple practice, which is the like client. Yeah. More. Thank you. Yeah. Yeah. Because I don't know how to do all of this. I came out of working for other right providers. Yeah. So I'm like, wait, how do I create this?
How do an entire Sunday of watching self help videos,
Laura: any new softwares like that. And I didn't encourage people to like, I think when you're first starting out, you're at the place where we just had this. Conversation inside my coaching program a few weeks ago, because I think someone had six kids or something and they were starting to feel like, Oh my gosh, it's just so much to manage in Google docs.
And I was like, yeah, you're probably at the point where you need an EMR, like it's time to invest, but when you first get started, like you can have perfectly good systems with Google, use G suite and get the BAA, the business associate agreement signed with Google, and it'll be HIPAA compliant if you're in the U S listening.
And then you can use like Google folders and docs and all of that to organize client notes. But once you get to five or six kids, it gets to be a bit much to manage, right? So when did you invest in simple practice? Did you get it recently? No, I
Naomi: actually got it a few years ago because the home health company I contract, they require it as well.
The only difference was they're doing all the billing and invoicing. So once I started seeing my own kids, that's when I had to really learn how to do the billing and
Laura: invoicing. That's good that you are at least familiar with the platform before, right? So
Naomi: exactly, but now it's helpful and now it's like mainstreamed.
Laura: Yeah. Totally. Yeah. You're on autopilot with it. Once you learn how to use it, it's makes things so much simpler to be able to send forms and just do all the back end stuff in the business. It's all in one place. It's smart to do that..
Naomi: Yeah. It's worth it for the investment to have it all curated for you.
Laura: LA is warm most of the year, but in winter, what is your plan? Do you think people are going to be less likely to? Want to come or what do you think?
Naomi: Yeah, I started to brainstorm. I feel like people will be less likely to want to come because the water does get cold.
I have a few outliers, right? I have one family that they've just told me, Hey, their son loves the water so much that they're willing to get him in a warmer wetsuit, get some booties on and go all year round, but I feel like maybe that's the exception. Yeah. So I've started to think about some different ideas.
One idea is. offering aquatic therapy. So that would essentially be covering a lot of the skills that we're doing via surfing, but in a swimming pool. And the other big one that I'm really excited to get out there is I'm getting ready to utilize a surf simulator. Which is basically a track that you put on the ground.
It's about the size of a yoga mat and then you can set any surfboard on top and connect it to a computer and then kids get to physically move the board and that will activate the video game.
Laura: That is so cool.
Naomi: I'm super pumped about that one. And so there's a variety of options for kids as we move into wintertime.
Laura: Yeah. That's, I think it's great that you're thinking about what your clients need and like how your business can meet those needs, but meet them where they're at. Because a lot of people don't want to get in the water when it's, people think California is warm all the time, but like the winter, even in LA, it's like maybe 70, right?
It's not like you're dying to get in the 50 degree water of the Pacific.
Naomi: Yeah. That's what it is. Usually 50 degrees. Yeah. Yeah. Yeah. In
Laura: the water, thick wetsuit on so yeah, no, those are great ideas.
Yes. I think we could wrap up here, but I want you to tell everyone where to find you. Do you hang out anywhere online? Where can they find your website? All the things tell people where they can find you and find out more about what you do.
Naomi: Absolutely. So if you really want the rundown on, what is surf therapy as a therapeutic modality or what other services do I offer?
You can go to my website that will have the most information. And that is. Hang tentherapeutics. com, and the 10 is spelled out, people always ask me if it's like the number 10.
Laura: Yeah. T E N. Yeah.
Naomi: And then on that website, it'll also lead you to my Instagram page, which is where I often post, the work I'm doing with kids or other informational content.
And then it has my email and my phone number and I'm happy to be reached any one of those ways. To set up a
Laura: call and talk more. Yeah. I, you might get people calling you how you called the other people saying, how do we do this?
Naomi: I know I'm happy to, I'm happy to share the knowledge.
Laura: Yeah. It's so great.
It's so well, I can't wait to see you grow. I've just, I'm excited for you and it's really cool what you've created and thank you so much for taking time to do this. I just think it's going to be a fun episode for people to learn from you. Thank you.
Naomi: Yeah. Thank you for inviting me and I hope you guys. I'm thinking about your Puerto Rico trip.
I'm so excited for you to get to surf it.
Laura: Yeah. Supposedly we have like surf, there's something, we actually had a travel agent help us because we're, my husband has certain places he needs to be for family at certain times, but then he wanted to see other things. And so she mapped everything out, but she's traveled a lot there.
So she knows some local surf school that she highly recommends. So I guess I'm doing it. Yikes! I have such poor balance. I'm like 47 now. I've always had poor balance, but man, the older you get, the more it like, you should just keep surfing forever, Naomi. Oh my gosh. I will.
Naomi: I will.
All right. Thank you so much.
Laura: You're awesome. Bye.
Thanks for joining me today for therapy in the great outdoors. If you want valuable advice, as you start or grow your nature based pediatric practice, get my free ebook, the nature based practice roadmap. It is a guide to help you focus and avoid. Mistakes as you start or grow your outdoor work with children in it.
I share the four stages of nature-based practice, what you need to focus on and common mistakes to avoid in each stage. Plus a checklist of specific action steps for you to take at each stage in the process. Get it at Therapy in the great outdoors.com/. roadmap. So until next time, get outside, connect, reflect, and enjoy therapy in the great outdoors.