ep 58 - Live Coaching Call with Marianna Ayers Sordille
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Laura Park Figueroa (2): 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 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.
Welcome everyone back to therapy in the great outdoors today I have a special guest because I've known Marianna because I taught in her OT program way back when she graduated like four years ago now. So it's really exciting that you're here for a live coaching call to help you with your business.
So introduce yourself to everyone and just tell them a little bit about. Where you're at in your nature based practice
Marianna Ayers Sordille: Yeah. Thank you, Laura. I'm super happy to be here. My name is Marianna Ayers Sordille. I am in the process of starting my own outdoor therapy clinic on my own property. So it's actually going to be outdoors. And indoors I'll have the sensory integration clinic right now I rent space at a private practice clinic.
It's wonderful. And so they're super flexible there about transitioning here for however much I want to. I do I love it there. I love the space. My colleagues there and I love the collaboration. I actually get some mentoring as well I don't think i'll ever want to leave there 100 percent I just I like fear that i'm like, oh my gosh, I never would have been by myself.
But so that's I think that piece will always Be there, but I certainly want to transition like most of my caseload Here.
Laura Park Figueroa (2): outdoors. Yeah. And at your home site. Yeah. Okay. So In six to 12 months, what would your dream outcome be in your nature based practice?
Marianna Ayers Sordille (2): To have I would say 80 percent of the clients that I see here and then within that and this is a question I'm on here for today, but like majority of those kiddos to be kids I'm seeing for intensive therapy. So at least two to three times a week. Cause I mean I have other further plans like providing camps for spring and summertime, but yeah, six months to a year, I would say that's actually pretty ambitious. Maybe Yeah, maybe, let's say 80 percent of my case load here at my house.
Laura Park Figueroa (2): Okay. How much is that? How many kids is that when you say 80%? Like how many kids are you currently seeing? And are you pulling those kids from your, is this okay with your employer that you're taking kids to your practice? Are you meaning like all new kids
Marianna Ayers Sordille (2): totally,
Laura Park Figueroa (2): you would be at?
Marianna Ayers Sordille (2): yeah, so all new kids, so I actually, I have my own practice already. I rent space, so I have, I'm like, running my own business, all that but I pay for the space that I rent there weekly, but I also do get, I'm sorry, not weekly, per session but I also do get referrals through that clinic as well, they're like more established,
Laura Park Figueroa (2): sure.
Marianna Ayers Sordille (2): And, but I also, I have a medical contract as well, so I do get some of my own referrals and I just recently started getting, for the little bit I've put out into the world on my website, it's nowhere close to being done, I have started to get a little bit of traction there And that's, that's something that I work out with the space that I rent from as well they're flexible and it goes both ways, but my medical contract clients would certainly come here no matter what unless they didn't want to stick with me, but the referrals I have from them would most likely stay there unless they There's someone who lives super close and they're like, and I would probably like,
Laura Park Figueroa (2): Okay.
Marianna Ayers Sordille (2): pay or something to have them come here.
It's just, If they, really wanted to stick with me. But
Laura Park Figueroa (2): Okay. So you're talking about, you're talking about basically, I just want to be clear on what our goal is here. So you're doing the exact same thing I did when I started my nature based practice. And I was basically able to take, I was renting space at a clinic for my own clients that I was responsible for booking and scheduling and all of that.
And I was just renting space at the clinic. And then when I decided to take my work outdoors, I basically just took those kids with me because they were my clients. So that's a lot different. Then what I was thinking, you were like an employee at this clinic and they were supporting you and so it's much easier and cleaner the way you have it is that you're renting space through your clients and you're gonna move, right?
So is your thought that you would move? Those are some of those clients coming with you. I'm trying to get a number for how many kids we need, to have you hit this goal that you have of having 80 percent of the, of your caseload be at your property, at your own property.
Marianna Ayers Sordille (2): yeah. Thank you for that. So a couple of things. I rent space there. Right now I have time. Monday's Wednesday's and Friday's and Wednesday's is just like a half day And then you know, it has been a challenge to get clients in the morning time. So right now I have about 15 clients and that actually feels really good for me I don't think I'm ever gonna be someone who wants to have 40 clients a week because as we know, there's so much other work that goes into it, but also just for me and my health and what feels comfortable with family and work balance that seems like a really good number for me right now.
And then when we throw in like intensives, that number might be a lot smaller.
Laura Park Figueroa (2): Yeah. Yeah, exactly. So what, why would the people from the clinic not just follow you to your property?
Marianna Ayers Sordille (2): so because some of them Some of them are referred, they were referred directly through the clinic that I work at.
Laura Park Figueroa (2): Okay. So you're being respectful and continuing to see them there.
Marianna Ayers Sordille (2): Yeah. Yeah. And then, we're starting to talk about transition date for, the days that I will stop there and onboarding them to someone else or changing their schedule.
Yeah. So it just, it really depends, I think, on. My end, the availability of other clinicians there whether they're over the takeover and then of course the family's availability to come here and if it's like feasible because it is a little bit different in terms of Geographical location.
Laura Park Figueroa (2): Okay. Yeah. How far away are you from the clinic?
Your location where you live?
Marianna Ayers Sordille (2): I am 30 minutes without traffic, but typically like 45, 50 minutes depending on the time of
Laura Park Figueroa (2): that's,
Marianna Ayers Sordille (2): Yeah.
Laura Park Figueroa (2): that's going to impact, especially with time of day, right? That's going to impact cause a lot of kids are coming after school hours during rush hour. So that will impact you might actually have a situation where you do need to build new clientele for your practice on your property because it's the distance is just too much.
I know Bay area traffic and it's just that's what we didn't really say that like you're near where my practice is, but probably gosh, Clayton is like probably an hour from where my
Marianna Ayers Sordille (2): If not more from where I live, I think it's a
Laura Park Figueroa (2): maybe even more with traffic. Yeah, so we're
Marianna Ayers Sordille (2): like an hour and a half. Yeah,
Laura Park Figueroa (2): So I know the area where you are is all I'm saying in the context of this conversation. So what is getting in the way right now? And that's what I want to spend the bulk of the time on this call on what is getting in the way right now, or what challenges are you having with getting to that goal of having the number of clients that you want in your practice within the next six to 12 months?
Marianna Ayers Sordille (2): First off, like the bathroom and things here, like physical things that I need here and then like safety considerations, there's things that have to be done here. Also I do have some things lined up for getting my own clients starting to talk with local preschools, and I actually have a meeting this afternoon with a neuropsych office.
I've been in communication with some Pediatrician office offices. And so I have that stuff in mind. I'm like, okay, you know We can start getting more referrals from there. I also have a Medical contract with Kaiser and I'm also going to be starting soon I'm going to start seeing feeding feeding clients with Kaiser as well.
Things are picking up in terms of being able to get some kids here. But for me, I'm really trying to nail down what is like really my niche? Definitely, I know that having the outdoor space is like a huge niche, right? But and then having, and the sensory clinic I'm just like, I know some of the clients that I see I don't know how they would do right away outdoors.
Some of them really need that, hands on, super close support. I really want to market it like I really love being able to work with families twice or more a week I really enjoy Being able to work with families in a more short term like intensive model.
Laura Park Figueroa (2): Okay.
Marianna Ayers Sordille (2): I know that it's done like STAR and ASI clinics do it a lot. And then figuring out how to, because , I really think I'm preferring to just do the private pay model. And so understanding how to do either like packages or for intensives am I just charging per session?
And then also. How do the package options work in terms of setting goals? So are we setting goals? per therapy package. And then, yeah, so I've thought about having having a payment system, like something like a firm or something where families can use because, it's a big investment, especially for intensive financially Which is, ends up being like the same, right? For the longer term clients who are seen less frequently. But then also thinking about too okay, if I see a child for 20 to 30 sessions in a few months are they going to be ready to completely discharge or am I going to, hold that space open where I'm like, Oh, I can still see them weekly.
To continue tidying up on this or that. But, and then, so yeah the feeding thing, which, so feeding and typical OT, I just, I don't want to do too much. I for me, feeding is we're not billing for time in the gym, but for me, , it's a necessity to support a child's feeding is to be able to have that movement and sorry, I don't know why I started talking about that, but I'm just thinking like trying to narrow down where to start in terms of like how I want to market myself.
Laura Park Figueroa (2): Yep
Marianna Ayers Sordille (2): Does that make sense?
Laura Park Figueroa (2): Yeah, so we have bathroom safety reaching out to preschools reaching out to pediatricians offices You have a contract with kaiser and you have feeding clients You want to do short term intensives outdoors. There's questions around packages for intensive goals for intensives and how people are going to pay for your services.
So I think this is a great example of how there is so much to organize when you are starting a nature any business really, but a nature based service, right? There's no way we're going to cover this all in 30 minutes. Like we know this, right?
I do think focusing in on the question of your niche and what exactly are you going to offer and some of the questions around marketing that and how people will pay for it and setting up the system around that.
You have to have those in place. Because you can't market if you don't know your niche, you can't market if you don't know what you're communicating to families, like you have to get that dialed in to start any business, right? So I think I wrote a little note here while you were talking. Like just to myself, because I think it's an interesting thing to think about that more and more people are starting nature based practices, right?
Like you don't have a guarantee anymore. Like it used to be like 10 years ago, it was like, if you were a nature based practice, that was a niche, my practice was so innovative when we started. And now it's who cares? Everybody does that, it's just, it's there are so many.
Therapist entering nature based work now that you do not have a guarantee that is going to be a niche, right? That is going to be enough of a niche to actually make you stand out. So I love that you're thinking about this idea of intensives because the nature piece plus the intensives, right?
That's a niche, like that's really a thing that really sets you apart, right? Because there might be other nature based practices in the vicinity, like my practice that isn't going to do intensives. Like we don't operate that way. All of our systems are set up the way they are, and we're not going to change that to, to do something totally different right now.
And so I do like the idea of. Pairing those two things together, like you having the outdoor space and then also having the intensive model at the same time, a niche also needs to be focused on a specific clientele, right? So I've heard you talk about the feeding clients do you Want to see all feeding clients or is how much of your caseload would you like that to be?
Or is that even part of your niche? Talk to me a little bit about that
Marianna Ayers Sordille (2): Yeah. Thank you for that. It's so tricky because I feel like even my kids who I'm not seeing for feeding and don't have feeding goals with it always comes up. It's always part of the conversation. And I don't know, maybe it's not maybe I'm not marketing like, feeding therapy, but I'm just like, that's one of the areas we cover, you know what I mean?
So it's in the package for OT, right? We can address some feeding but there are a lot of extra resources and different things that come with feeding, right? Like the, Yeah, it's definitely something I'm trying to figure out and, based on the feeding therapy experience that I have so far.
I'm like, wow it's different. For OT, it's it's a lot of behind the scenes work too, right? Like collaborating with other professionals and like building those like home programs and but it's, I guess a lot of the sensory diet piece sometimes is super similar.
But then when it comes to like mealtime strategies and those type of small like nuanced things, it's different.
Laura Park Figueroa (2): Yeah, I think you need to really think about because you're right. Just listen to you talk I'm, like there's a lot that's different about feeding therapy and it's not that you can't do, you could do feeding therapy outdoors. You could have feeding groups, you could have feeding sessions, like you could totally do that.
And I think that's a really great that'd be a really great niche to do, but also I always want to encourage us to think about is our niche too small because you'll hear these like big entrepreneurs online. You watch people on Instagram, whatever. If you're interested in small business content, then Instagram will start to throw all the business people at you, in your feed.
And a lot of times I hear. Like entrepreneurship advice. That's you can't have a niche. That's too small. This one lady does, all she does is artistic paintings of Chihuahuas or something, like just some kind of random, like totally random niche, but the reality is that with a practice a therapy practice where you are providing services to direct services to people. It's very different than a lot of the entrepreneurship stuff that you're going to hear online, which tends to be driven honestly towards online business owners. And so your niche can be too small, especially if you're a private pay practice, you're doing intensives, you have the outdoor model, like the more you add to that, the more you're going to narrow your base of people who would even be able to come to you for services.
So I just. I don't know that we need to make a decision about this on this call or that you need to, but but I do think making sure that your niche is broad enough, like that you can communicate exactly who your services are for on your website is really important. And I'm not sure if the feeding niche with the other things that you want, I feel like it would maybe be too small.
That's just my gut. I don't know. I would have to do some market research in your area, really honestly, to determine if it is. Maybe there's wait lists a hundred people long at some private clinic that you know of, and you just know that there's a niche there. Maybe there is. But I want you thinking towards growth too.
Like I know right now, you only want 15 clients. But you've probably heard me say this on other live coaching calls too, that if we don't think about growth from the very beginning, we are forever going to be working more and more in our businesses. And we'll totally burn out even in nature based practice, which is so idyllic and you love being outside and all of that.
But thinking about. Building a practice that is actually sustainable and gives you income, even when you're working part time as the owner, this is like what I want to help people do, right? And the only way to do that is to hire people down the road. I just want you to make sure that your niche is big enough for the time at which you potentially decide that you would like to hire someone and have more kids coming to your practice.
So I don't think it would be. My general advice when people are at where you are is to pick one thing and do that one thing really well and then branch out, right? So maybe that's that you start with feeding clients and then you branch out to kids with whatever other issues you want to work on, right?
Whatever other diagnoses or like specific areas that you'd want to work on in development, like you, you start to add that later. Okay. Or maybe the opposite is true where you set the feeding aside for a minute, just for, just to get started and then you broaden it a little more broadly, maybe to kids with sensory processing disorder or something like that, where it's like a broader kind of maybe it's mental health challenges.
I don't know what you like to work with but giving it a broader feel so that then Your marketing reaches a broader kind of number of people. And then when you add other services in the future you have more people are more aware of your business in the community, so just some food for thought on, on niche. I don't think we need to drill down into it here but just thinking about. Your marketing, especially as you're getting started, has to be very specifically targeted to exactly who you want to work with in order to attract the right people to your business.
Marianna Ayers Sordille (2): It is like I love feeding and I think that it's so interrelated with OT like It's
It's all the same in terms of like motor challenges and typically like sensory things going on, but I don't think I ever want to do just feeding. Like I, I think that's, yeah. When you're saying that I'm like, Oh no, like I wouldn't want to do just feeding.
So there's that. Yeah.
Laura Park Figueroa (2): so listen to that. That's your gut telling you. I think a lot of times as therapists, are constantly thinking how can I serve more people? How can I help everyone? And if your gut is telling you I don't want to do just feeding, you should not start with just feeding then that is like a very clear indication.
If your gut was like I don't want to do just feeding, then don't start your business with just feeding. Because that's a fast path to burnout. Again, like you're going to be doing something that you don't want to be doing all the time. I think one of the hardest things for entrepreneurs is picking one thing and sticking with it.
Because therapists, we have all these interests, all these things we could do emotional regulation, we could do feeding therapy, we could do aquatic therapy, we could do hippotherapy, we could do outdoor groups, we could, there's all these things we could do. And yes, some very large practices are successful at having all of these programs, but they did not start there.
They did not start there, right? So picking what you want to do first, what you feel like you would enjoy doing for 15 clients a week is the key. key thing. So think on that. You don't have to decide right now. Let's talk a little bit about I'm I want to be mindful of time here. Let's talk a little bit about packages and goals for you had some questions around packaging for intensives and goals for intensives and I wrote down while you were talking, I was just jotting down notes so I could have an outline here.
And one of the things that I think you absolutely need to put in your marketing is, we choose to do these intensives because they give you faster progress for your kid, right? That needs to be All over your website. The reason we offer our services this way is because it gives you faster progress when you come multiple times a week than when you come once a week.
That's just logical, right? Like we, we know that's the case. If a child comes to therapy and has more intense intervention they obviously would make progress more quickly. When you create packages, you need to make sure that you are that you are accounting for every minute that your brain is thinking about that child in the process.
Marianna Ayers Sordille (2): So I was thinking about that because oh my gosh, so much time right now just for individual sessions. Like it's I've just had a 45 minute call this morning with the psychologist who's working with my clients and I'm like,
Laura Park Figueroa (2): Yeah.
Marianna Ayers Sordille (2): Do I feel for that? You should, but So I was thinking for the packages, I feel like it would give me more room for that too.
So cause the home programs and like consults, usually we just, Oh, at home programs, I don't usually charge extra for, but for parents , or I'm like, we really need to talk, for an extended amount of time. Can we book 30 minutes or whatever? That's usually added on, but I feel like I wanted to hear your thoughts on having a package for, 20 sessions and then, cause it's so hard to tell from the beginning how much time you're going to need to spend with the family.
Like sometimes families are with it. They're like, Oh, I get it. I understand. And we do this. And then sometimes I totally read families wrong where they're like, super invested in doing all these things, but it's just harder for things to click. And so I end up spending so much more time, but I'm like, okay, if we do 20 sessions, then we can, maybe in three weeks, we'll just have two sessions.
Together with the client and then one of those will be with the family. So I can say this many sessions, but we can use them for consult as needed. I don't know.
Laura Park Figueroa (2): yeah. So I'd, yeah, I like the way you're thinking of this because you're thinking towards paying yourself for all the time that you're spending that is unpaid time when we don't set up the expectation in advance that it's going to be paid. None of us would ever hire a lawyer for that.
and expect that they were just going to talk to us for 45 minutes for free on the phone and we weren't going to be paying for it, right? So some of that is like industry expectations, right? But as therapists, there's no reason why we should expect parents to assume that they were going to get us on the phone for 45 minutes or get us to talk to another professional about their child for 45 minutes without being paid for that time.
So you're thinking, The right direction. I think what saves a lot of the uncomfortableness on our part of charging for those things is when we have it set up in advance, it's part of the package. You get this is what you pay for. And then there's a lot of clarity. So it works with kids too, right?
Like kids need to know what to expect in a session. That's why we do our little visual schedule or whatever with them, or we just tell them what's coming. Same with parents, give them a visual and help them understand what your services include and why. Why it's included. So that will help you stand out as well, because you are going to be able to put on your website all packages at whole child, pediatrics include XYZ and list out the things that are included in that package.
So if you're gonna do like you said, a session, I don't know if I would do 20 to start Okay. I feel like that's a lot of visits to start. That's if you're in doing intensive, it's not that many. Is it's like,
Marianna Ayers Sordille (2): weeks if you do
Laura Park Figueroa (2): would it be? You're doing twice or three, three times a week.
Marianna Ayers Sordille (2): that's something I think I should I think yeah, I Right now I'm familiar with doing twice a week
Laura Park Figueroa (2): Okay.
Marianna Ayers Sordille (2): and That feels good But I think for someone like the younger kids who are pretty you know Who have more severe challenges? That's when I think Maybe three would be better.
And maybe that's something I've been reaching out to star I would love to talk to somebody I know their model is a little different because people are actually like there when they get their intensive in terms of like they're usually visiting from out of town. So I don't know where I'm going with this, but yeah,
Laura Park Figueroa (2): I don't know. I just don't know. I think you need to think about I don't care what star does because you're right. It's a totally different model than what like people aren't traveling from out of town and staying in a hotel while you see their kid, right? So you don't have to worry about I think what they do is valuable and stuff.
I'm not trying to diminish it. But I think for us as nature based therapists, we have to think about what does our Current clientele in our community need. And one thing that came to mind and think as you were talking about three times a week, I was thinking like, okay, what do I know about people in the Bay area? What do we know about parents in the Bay area?
Marianna Ayers Sordille (2): They're really busy. They're stressed
Laura Park Figueroa (2): really busy.
Marianna Ayers Sordille (2): Yeah.
Laura Park Figueroa (2): Stressed out.
Marianna Ayers Sordille (2): And part of this, and I totally forgot to mention part of what mine, what I want my niche to be is to be towards the younger kids. So
Laura Park Figueroa (2): Okay.
Marianna Ayers Sordille (2): two to six. And that's because I really enjoy working with that population, but also for my goals,
Laura Park Figueroa (2): That's a niche, Marianna. That's a niche.
Marianna Ayers Sordille (2): Okay. But also I don't want to be working until 6pm. Like I want to see my kids in the morning at their optimal time, my optimal functional time, honestly, that's really big for me. I feel like when I start my day late and end my day late, I'm just like, okay. Because I'm up early, I have a child, a young child yes, so thank you for helping me. Remember that's also a part of what I want to focus, okay.
Laura Park Figueroa (2): But that's a niche because that's like a very clear niche. Two to six year old kids or zero to six, whatever you're one to six, whatever it is. If that's on a website, like outdoor intensive occupational therapy for children ages two to six. That is very clear. When someone lands on your website, if that is the tagline underneath whole child pediatrics, it's whole child, right?
Am I'm remembering this
Marianna Ayers Sordille (2): yeah, that's right
Laura Park Figueroa (2): I was like, for a minute, I was like, wait, am I saying that wrong? But if that is there, then those people who land on your website, if they have a 10 year old they're just going to be like, okay, this practice isn't for me, I'm gone. But if they have a two to six year old, Like that is where they need to be, right?
And so they know right away. So that's a, I think that's a good niche. Like the pre K kids, that's a good niche, like broad enough, better than feeding therapy and outdoors and intensive. That's a little too niche, but it's a good, I'm glad you brought up the age range because that's another way to niche down, right?
Like what age range do I want to work with? And that's that means you can work with. Any kid that's two to six years old in the entire Clayton and Walnut Creek area, that's a ton of kids. So that's an example of a good niche
Would be broad enough, What were we talking about? Packaging. So when you package your services thinking about in your dream world, like the way you start with it is like in your dream world, what would you want to provide to families? And in your dream world, what would you be able to pay yourself to provide those service to families?
And then you just figure out how much time it will take you. You add a little bit of extra time or extra money, or maybe pay yourself a little more per hour than you would maybe think, and then come up with the pricing for your services. I know some people do different levels of packages for like different levels of services.
I think sometimes that can get a little bit confusing to families. So I would say if you're starting out to, to Try to keep it as simple as possible, right? Like it's 20 visits, which is 10 weeks of services. And the dates start on this date, they end on this date. And within that time, we have two parent consult calls and you get a assessment at the beginning and a report at the end and it's X number of dollars or whatever it is.
So you're grouping all those services together and then you're charging families a rate that will pay you for all your time involved in that. So for example, a progress report. If you are going to spend three hours writing a progress report for that child at the end of the session, at the end of the session of services then that progress report should cost 600 or whatever, I'm assuming, 200 an hour for a therapist in the Bay Area is not 600 an hour.
Is like a going rate essentially. So I'm just like using numbers that are in my head to estimate. But so just really accounting for your time and that will free you up as you run your practice and grow your practice, that will free you up to not feel like you're working for nothing, like you're not getting paid for tons of hours of time.
Yeah,
Marianna Ayers Sordille (2): Yeah. Thank you for that. I didn't think about adding in The discharge report or progress report as part of that's a great idea. Cause then
Laura Park Figueroa (2): you can, that's what, yeah,
Marianna Ayers Sordille (2): Because, I just wouldn't feel right to end that and then not give anything formal to say oh, this is where we are with this.
, I should certainly factor that in. That was another point.
Laura Park Figueroa (2): And I wouldn't go ahead.
Marianna Ayers Sordille (2): The eval part too, which I think is part of the whole like digital intake thing that I'm working through right now is a whole nother thing. I, right now I spend way too much time on reports and I want to try to minimize that.
Like there, I, the standardized test are super helpful, but maybe I don't need to do like everything. And just it's, I think I've heard you say you use like less of the the standardized whole test, right? I mean it I'm like, I know there's no way that everyone spends so this much time on their assessments
Laura Park Figueroa (2): You have to think too about okay, so it's, What type of practice do you have, right? My practice does not do intense, big, huge assessments where we do 17 standardized assessments on a kid that Star Center might do, or some sensory integration clinic that's doing research might do, or something like that.
The purpose of our services is not to do this super comprehensive look at the child's entire neurological system, right? Our services are group services for the most part in my practice. And so for that reason, we do a light, like we call it the AOTA codes for assessment or whatever.
There's like min,
Marianna Ayers Sordille (2): low. Huh
Laura Park Figueroa (2): maximum or whatever, complexity. So we bill our assessments as low complexity assessments because the kids that are coming to our services have to be ready for a group model of therapy. Okay. So that's the first thing we know that there can't be intense needs there because most kids who have really need of a high complexity evaluation, they may not be ready for a group service.
So we do assessments that are related to what we treat in our groups. And so I think that's something that we as therapists. Need to think more about is we shouldn't just be doing assessments because OT says we should do this assessment or people we knew in peds say that they do all these five assessments or whatever.
We should be assessing what we want to treat. And so if you're going to do feeding therapy, this is another example of how niching will help you get systems in place in your business. For example, if you were going to do feeding therapy, but you also are going to do kids with sensory processing challenges who are two to six years old, and those might overlap a little bit.
We know this, right? Ultimately, not all of those kids that are in the sensory processing group are also going to have feeding challenges. So you need separate systems. For both of those services, right? So you need specific assessments you do for the feeding kids and specific assessments you may do for the sensory kids.
So I, it's a good example of how state keeping it simple and focusing on one thing as you get started is very helpful because. You get better at creating systems as your business grows. But even now in my practice, I love systems. I love creating them. It's like one of my favorite things to do, but I have hesitated to expand my practice to like other professions, to like speech and PT, to be a multidisciplinary practice.
Because of the systems involved in setting all that up, like whole new intake process, whole new assessments that we need to get, whole new, so it's easiest to just stay OT and stay the focused on OT, so yeah, I don't think that you'd, I'm not a proponent of doing a million standardized assessments, but again, individual therapy is different than group therapy too.
So if parents, and that could be part of your tiered Packages. If you wanted to do tiered packages, you could do there's a, like a light assessment or I don't know what you'd call it. We'd have to think up some name to give it. But cause I don't think I would tell people it's a min mod or maximal complexity evaluation or low, medium or high.
I wouldn't call it that, but You could outline some sort of two different packages where maybe one package includes up to four standardized assessments, but the other lower priced package only includes two standardized assessments because it won't take as much of your time
right? So there's ways to make the packages tiered in that way to like account for some of the more challenging cases that you may bring on that might actually need the higher level assessment. And you can use like an intake call or discovery call with a family to help them know what is right for them. You could say like on this call, we are going to talk about which assessment package would be right for your child and if we're a good fit to serve your family's needs or whatever And then that gives you a frame on the call to say well based on what you've shared with me in this call I really do feel like we need to do The higher complexity evaluation because i'll need to I can already think of four standardized assessments that I want to do or whatever You know, you could use that language to tell the family what you're anticipating will be needed And another thought I just had too was keeping your assessment separate from the make that a separate package, than the intervention, because Those packages for intervention may not always need an assessment at the beginning.
They might come in with an assessment from someone else. They may have been assessed by you previously, and you really don't need to assess more than every year in my opinion, but
Marianna Ayers Sordille (2): No, it's that I love that. We, right now we have an option at the place where I rent space to offer like just scores only. So it's you get, the standardized scores but you're not going to get like A full write up on what everything means and give recommendations and sensory diet recommendations So maybe the lower tier one is just like here's the scores Because I think especially too for this age like families want and need those You know for going into school or trying to get reimbursement or medical based That is a big need.
But okay. Yeah, maybe, I actually just learned recently that there's a therapist that does assessments like her own assessments and it's true, right? Like with practice, like you typically can see a child's challenges without doing the standardized tests. But I know that there is a therapist that exists that does her own assessment, doesn't give the family anything, and then creates the goals from that, but doesn't physically.
Laura Park Figueroa (2): Sure.
Marianna Ayers Sordille (2): And I was like, Oh wow. That's like removes a lot of time, but, and puts a lot of confidence in yourself and just like creating those goals from the start. I don't think I'm interested in doing that, but it was just like, Oh wow. In
Laura Park Figueroa (2): I think you have to be careful because I think I would, I do think there is a lot of value in going through an assessment process. There is clinical reasoning that needs to be done in order to understand how best to provide therapy to any given child. And that assessment process, like I don't mean that the standardized test should do the thinking for us, but I do think the assessment process of having some sort of standardized measure we use in order to help us think through why might that be happening?
Why are the results like this? And how can I explain that? And then what are evidence based ways to address the challenges the child may be having? But along those lines, even if you did do standardized assessments and you are going through an assessment process and you are doing the assessment, you're meeting with the child and you're interacting with them and you're forming an assessment, right?
The idea that you just said of not giving the written report but doing some sort of give the parents the results and talk with them about that and come up with goals from that, I think that could be a way to save time. On your end, you could even do something like with that package level where you don't get an extensive written report because our reports for OT, at least, I don't know how speech or PT or mental health counselors could be, but our reports for a kid with sensory processing disorder, that's five years old, that report can be 10 pages long sometimes.
It is a lot of content to get through because we're looking at their whole like picture of their life. So it's a lot. So I hear you with wanting to save families some money if they don't want to pay for that report to be written, but what you might do is do the scores, right?
Cause all of our online assessments now have click and give the print out of the scores or whatever, give the scores to the family. And then maybe part of the package is a 30 minute zoom call with you to go through the scores and establish goals. The family can record that. If they want to and have that on record. So they have like documentation essentially, of your conversation. So you're recording it. So there is documentation. You could even save that in your files and use AI to make a transcript and save that as your documentation of the process with the family.
Marianna Ayers Sordille (2): I've been thinking about AI so much. I'm glad you brought it up because I'm being HIPAA compliant, there has to be a way we can take advantage of this technology for these 10 page reports that we write. But, maybe we just leave all client information out and then it's like very, yeah, Sounds, general, and then we just, attach the child's name
Laura Park Figueroa (2): Yeah, I think sometimes we overthink HIPAA too. HIPAA is like protecting people's privacy. So as long as you're, as long as you're making sure that the platform you're using is secure, now don't, I'm not a lawyer, so don't take my advice on this, but I think we overthink HIPAA. Essentially, like if you were to take that video and publish it on your social media, obviously that's a HIPAA violation, right?
Or if you're to take that video and store it in a place that's not secure and someone got access to it. Yes, that's a HIPAA violation. But if you have an EMR and you're storing that content in the EMR, that is a HIPAA compliant platform, right? Most EMRs now have a video conferencing tool that I bet you could record in.
You throw that into a, you just get a transcript of it. It's. Any AI service can do that for you. And most video platform services can give you a transcript, right?
As long as we're protecting people's health information, I don't think there's anything wrong with using a video conference or anything like that to communicate with families.
Like therapists do this all the time. I do think it's a way that you could save time though. If you can keep the call to the 30 minute. Deadline, which I am clearly not good at doing because we're at 47 minutes and 55 seconds right now So we need to wrap up on the
Marianna Ayers Sordille (2): Okay.
Laura Park Figueroa (2): using a call to 30 minutes.
So Yeah, but I do feel like that's a way you could save some time And you could map out if you want the report, it's gonna be another 500 because it's my time to write the report, right? But if they don't want the report it's cheaper because they meet for 30 minutes with you on Zoom and you talk to them and then you have a documentation of that call,
Marianna Ayers Sordille (2): Yeah. No, I love
Laura Park Figueroa (2): takes 30 minutes of your time, not, or whatever.
Marianna Ayers Sordille (2): love it. Cause it, and then, yeah, I feel like a lot of times too you put so much into that report, the written report, and going through all these ideas, but it's just way too much for the family to digest. And then you're saying all the same things for the remaining time you're with them anyways, you're like, Oh yeah, remember this thing.
And It's yeah, oh my gosh. Yeah,
Laura Park Figueroa (2): it's overwhelming to them. You're right. I hadn't even thought of that, but giving them a 10 page report is overwhelming, but some people want that. Some people want to give it to their psychologist or want to share it with the IEP team or whatever that may be. So if they want it though, they need to pay for your time to, to write it, which is usually pretty extensive.
And you will get faster, I think, as you go, but I definitely think Are some of our ways. I think we need to be thinking outside the box about how to really help families and some of the ways that we currently provide services. Like for example, like giving a 10 or 15 page report, whatever it is you're right.
It's totally overwhelming to them. Okay. On the topic of overwhelm, let's help you not be overwhelmed. I want you to tell me like your top takeaways from today and what you're going to do right after this call.
Marianna Ayers Sordille (2): ooh Top takeaways are really just like being okay with that niche like yes This is what I want to do. And this is what I'm gonna market and then also the packages like the specifics of the packages and how to Also within that account for the extensive time that I typically spend on like reports and collaboration.
Maybe that's something I put in there too is I'm happy I love collaborating with other professionals, but we're gonna account for that in the package. Yeah, I feel like there's more in my notes here, but those two things pop out right now.
And friends. I regret to inform you that this is where the recording ends. I am so glad that the glitch in the software that I was using to record happened right here, right at the end, because at least Marianna got to tell us her top takeaways. And we could not get the recording to work again after that.
And I just had to call it a day. I had to say, okay, we are done and I'm going to record a little outro at the end to explain to our dear listeners that the recording cut out. So you're not going to get to hear me say to Marianna thank you so much for coming on the show. And being vulnerable. I always say that when people come on the show to do a live coaching call, because it can be. A very vulnerable thing to share with everyone publicly what's going on in your business and the things that you would want advice or input on.
And I think the mark of a good business owner is being able to publicly share those things and be transparent about the things that are hard and to be open to feedback and getting that feedback publicly. I guarantee you that if you do that you are more likely to be successful as a nature-based practice owner.
Anyways, if you want to do one of these episodes with me, they are totally free. I offer them for the time being, I should say this because podcasts are weird. They live forever online. If you, if I don't take them down, which I very rarely do. But right now I am offering them for free. There's no reimbursement given for them.
I, people don't pay me to do these. I do them for free to offer value to you, the listeners and to the person who volunteers to come on and be vulnerable. Like I just said, if you'd like to do one and get some help in your business. For me, you can message me inside of the therapy in the great outdoors community.
So there is a little. Chat. Icon at the top right of your screen. If you are on desktop and on mobile, I believe it's across the bottom. Maybe. But, it's the little speech bubble. And you just click it and you find me and you can send me a DM there and I will get back to you and send you the link to schedule. Time to record. That's it for this week and I will see you guys next time.
Bye.
Laura Park Figueroa (2): 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.
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