Enhancing Therapy Sessions: Exploring Alternative Treatment Spaces

 In this episode, we explore the topic of alternative treatment spaces for therapy sessions and discuss various environments such as converted barns, outdoor nature settings, and aquatic spaces. We address the challenges and considerations involved in transitioning from traditional clinical settings to these non-traditional or unconventional spaces. The episode offers practical insights and tips on setting up safe, effective, and engaging therapy environments that cater to clients' needs while being cost-effective and flexible. We also discuss the importance of community integration and partnering with facilities to make therapy accessible. Join us as we dive into the world of alternative treatment spaces and discover how they can enhance therapeutic outcomes and create novel experiences for clients.

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Transcript

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Hi. Welcome to animals and aquatics. I'm Gina, your host occupational therapist, wife. Mom of three, an outdoor enthusiast. I'm excited to share a listener. Generated question today about. What types of alternative treatment spaces can we use when we're at the stable or we're outside in nature or we're at the pool? And I think this is something that comes up fairly often when we're thinking about transitioning from a typical, more typical clinical treatment space to these alternative areas. And how do we transition some of our more traditional therapy tools into these other environments? How do we set up spaces that are safe and effective for our clients? How do we work in these environments and control some of the spaces? So. I'm excited again, to talk to you today about setting up alternative treatment spaces. And again, this was somebody's question from Instagram and I thought it was a really important one. And I've certainly been in this situation as well. Has some of the people that I have coached have set up amazing spaces and I want to talk to you and share a little bit of that process today. About exploring what alternative treatment spaces you might be able to set up in your environment, whether that's at the barn, whether that's outdoors in nature or in an aquatic environment. And when we're thinking about this, we really want to consider the needs of the clients that we're going to serve, what the environment is going to be like. And then of course, what our budget is going to be. So alternative treatment spaces are non-traditional or unconventional environments. That we're using as part of our therapeutic intervention. Or as part of our occupational therapy services. They're often very different than our traditional clinical settings. And for a lot of our clients, they feel much more relaxed. They can be more flexible for us as clinicians, and they're a much more naturalistic or home-like environment for our therapy sessions. So some alternative treatment spaces that I want to talk about would be uh, converted barns, pop-up shelters. Our outdoor nature-based settings, some of the, um, types of shelters that we've included and then some of the spaces that we've used in the pool area. So when we think about alternative treatment spaces, we want to think about accessibility. How are clients going to be able to access these spaces? And it's often when we think about, you know, an older barn. It can be hard to navigate a wheelchair in that space or somebody with a mobility impairment. When we think about some of our outdoor spaces and a person with autism, the sensory aspects might be a little bit more challenging in those areas. So. When we're setting up our alternative treatment space, we need to think about again, who we're going to serve. What their needs might be or abilities, maybe some preferences that our typical clients have. And then how do we incorporate those into the environment? One thing that we found with the aquatic environment is often it's a very large space for the pool and that's a challenge for a lot of our clients. So we have found the need for some alternative treatment spaces in the aquatic environment as well. And I love I'm going to be excited to give some examples of that. We want to consider what our budget is. So our treatment space can be. Relative set up relatively inexpensively, or it can actually cost quite a bit to set up an alternative treatment space. So we need to think about, what is our relationship at the facility that we're using? Is it our own personal property? Or are we renting a space and that can give us a lot of information regarding, whether we're going to be looking at something that's a bit of more of a permanent structure or alternative space or something that can be put up and taken down each time that we're at that facility. We can look at re-purposing an existing structure. So sometimes when we're at a barn, they may allow us to repurpose a stall or a section of the facility. For therapy services, and that can be really helpful. If we're using just a temporary setup or a community space. We need to be flexible in how we're setting that up, making sure that we're following any land use rules that may be in place. If we're at a public park or something like that and that we're able to, um, move our space around as needed. we want to make sure that this alternative space that we're using fits within our budget and isn't necessarily going to increase our costs significantly, especially if we're really trying to make our therapy affordable to our clients. We don't want to incur a lot of overhead when we're creating our space. We want to think about how the alternative space might increase our client's engagement often again, because it doesn't have that traditional clinical feel. It helps our clients feel more relaxed and as they move away from the more traditional clinical environment. They might be more likely to participate, feel more motivated, and that's often going to improve our therapeutic outcomes or OT goals in the end. Our space should be flexible and adaptable because depending on the facility, again, that we're working with, it might need to be flexible for our schedule, the session duration. And how long are we going to be in this space and our service delivery for the particular types of clients or populations that we're working with. So we want to think about how flexible is this space going to be? Does it serve one type of population really well? But maybe isn't so helpful for a different population. What therapeutic equipment can I bring? So I am a lover of suspended equipment. Give me a swing any day and make me a happy OT. But I certainly can't use a swing and a pop-up shelter, just not going to work. So thinking about, you know, how flexible or adaptable is this space for the type of equipment that I want to bring. How much is this alternative space going to require as far as upkeep or maintenance or setup and take down. Those are all really important things to consider when we're talking about alternative setups to provide our services in. Thinking about from a client's perspective, it's often a very novel experience and we want to consider. How novel is that going to be? And is that going to support our treatment outcomes or is it going to be adverse to them? So in some cases we are keeping some things familiar to the client and then often we're also allowing some of those aspects to really shine through that are different because they allow the client to have a different experience and that can be uh, sensory experience, it can be a relaxing environment as opposed to something that's a little bit more structured, like a clinical space. So departing from the norm of therapy really can help our clients feel more creative. They can help foster growth for them. So we want to think about, how is that experience going to impact the client? And then as a component of community integration, alternative treatment spaces are often out in the community. We might be again, um, at YMCA facility or. Uh, public riding stable or a nature park. And we want to think about how we can partner with these facilities. So that way therapy is accessible. It's in the community where people can access us and it really promotes awareness. So there's some great opportunities for branding with some of the alternative treatment spaces that we're going to talk about today. So. As a kind of introduction or, or getting your brain juices going and thinking about how can these alternative settings be therapeutic? Be cost-effective the accessible, engaging, and flexible. Those are all things that we want to look for when we're setting up our treatment environment, when we're in a different space, a different facility. So when we're thinking about our alternative treatment spaces. We really want to make sure in two very specific ways that we do mimic our clinical counterparts. And that is in terms of cleanliness. And safety. So certainly as we were talking about some of these environments, we want to think about how clean can we keep them and how safe are they going to be? So one of the most common environments that we might transform is the barn into a therapy space. So it might be just a stall. I have a sensory stall that I enjoy using, or it could be a portion of the bar and maybe a part of the hallway or a room that was perhaps a feed room or a tack room could be converted. And these spaces can make excellent therapy spaces, especially if there's a way to close them off and separate them out a little bit. It gives us a little bit more control of the environment. It gives us a smaller space to work in from kind of the big spaces that are part of a lot of, barns or arenas. Those spaces can be a bit overwhelming to some of our clients. So a smaller space, like a stall can be really helpful. And if we're already using the space, that's there you know, that helps to cut down on the costs that we're going to incur. So when we think about creating this area, the sensory stall, um, is what I like to call mine and converting it into a therapy space. There were definitely some challenges in putting that together. One of the main challenges was just converting the barn wall. Into something that would be therapeutic, it would be easy to clean. It would be, um, more bright, right? Because the stall itself didn't have the best lighting. It felt sort of dark. And so what we ended up using was the interior to a bath or shower paneling. And basically that's able to be glued to the wall and then you use molding on the side. The really cool thing about it is it also can double as a dry erase board. And so we can do some really, really, really super great vertical, dry erase work on this type of wall. And it wipes down pretty easy. It's also antimicrobial, so it's pretty easy to wipe down as well. So that gave us a little bit more reflection of light, a little bit brighter. It gave us a workspace on the wall rather than just having wood there. And it transformed the space a little bit to make it feel more structured. And gave us the option to keep things definitely more clean. So that was something that was really good about transforming that space. Now, most sensory, most stalls in a horse barn, or even a cowl barn, they typically have some sort of overhead beams, which are great for hanging out my suspended equipment. Of course, my favorite thing. Right. And are you going to get a lot of swing height or distance? No, you're not. You're definitely not, not in my stall anyway. But I do get an unstable surface to work on. I do get a little bit of vestibular input. I can, if I put a rotator on it, I can get some orbital input. So that has been a helpful as well. Now on the floor side of things, that was kind of a multi-step process of leveling the floor, putting down stall mats, and then on top of the stall mats, putting down foam. tiles and that gave us both, again, brightening it up because of the stall mats are very dark. So helping to brighten the space up. But then also giving us some padding that way, we have, are able to get down on the floor and work. So keeping things very flexible in that space and then using the height of the stall. Because again, there was quite a bit of a vertical height, to get therapy balls up off the floor by using a PVC, ball holder. That was an easy way to get balls up off the floor. And then just doing a, adjustable height desk, for any written or. fine motor work that I wanted to do kind of in a seated position. So the. Adjustable height, racks that you can get at home Depot work really well because, you know, I have, I work with everybody from like three year olds to 16 year olds. And so. I really wanted something that I could a. Put on the wall and take off the wall. So it didn't have a big footprint, but then also I wanted something that I could adjust in height from a small child to a teenager. So that really fit the bill, and I just, you know, keeping it about 15 inches wide was enough for a piece of paper, enough to support, the arm, but also not cutting too much into that space. So my budget was$800. The total cost ended up being around 1100 for that. And I feel like it does again, give me a pretty good space to work. I would definitely add some more sensory aspects to it. If I could. And I would definitely up the lighting in the space. But that just wasn't wasn't in the budget. And also wasn't going to work given, like I don't do electrical stuff and the facility wasn't going to support, changing the electrical and lighting set up in that space. So, those were some of the challenges that came along with that, but it does give a really nice space to work. you can close it off, you can open it up. And sometimes you just kind of need that a little bit of down space. So that's one of the types of spaces that I have really liked, on a stall is usually a space that you can use at a facility. But if there's not a spare stall, then using a pop-up shelter or a tent can be another great alternative for therapy. And the nice thing about pop-up shelters or tents is that they're super easy to move around so they can come and go with you. If you're only at that facility, maybe one day a week, you can really create a setup that is really versatile and can code to different facilities with you. So I'm at two different stables and then the pool I could actually bring my pop-up shelter. D each setting and have it all kind of packaged up. One of the setups that I've seen that I absolutely love the most was about a 14 by 14 pop-up shelter. And then they used baby gating around the outside of the poles and that same foam flooring that I've used in my sensory stall on the ground. So it gave a definition of the space. It gave a space to get out from the sun, the rain, the heat. wherever it could be set up indoors, it could be set up outside. It gave a barrier and it gave a place to work, both on the ground. And then they had, some balls, you know, therapy, balls to sit on or work on and some of your kind of traditional fine motor puzzle visual motor types of activities. So I think, most of those pop-up shelters, they have wheels on them, so you can roll them around, roll them in, set them up. Usually you can set them up by yourself, but if you have, an intern, a fieldwork student or a volunteer that can help you set it up, that can go even faster and getting it up. Most of those are fairly affordable running from$300 to$500. Pretty good budget for that. And then just the paneling to go around it. And the foam flooring. You then have a pretty good space. Where you have a defined space to work in. So the other thing I like as far as using maybe more of a tent or a beach shelter for the pool, is that they're already. Like a beach shelter is already created for the aquatic environment. It's already meant to be down on the ground to get wet, to get Sandy, to get dirty. And those can give you a nice way to kind of block off a little bit of a space. So when I think about using shelters or tents, those pop-up shelters or tents for therapy. They can be really useful in that they're very flexible. They can be used in a lot of different ways. Now, some of the downsides to it is that you're not going to get any suspended equipment. You're not going to get anything kind of heavy set up with that, but they're very late. Bright airy. You can use some battery operated, twinkle lights or something like that. Now, if you're looking for a, more of a type setting than a tent, a closed intent is definitely the way to go and they can be really helpful again, in closing off some of the sensory stimulation. If you are in a more active facility. Or an active park and you know, some of your group members may be, need to have a quiet space. a tent type of setting can be absolutely perfect for that. So, if you are working in a group setting and you have a tent, you just need to make sure that you can see what's happening inside the tent, especially if more than one of your clients is going to be in there at a time. But if you're just working, one-on-one, it's, it's a great way to have a nice quiet space. Space for a client that, you know, you can do some of your more active, gross motor work outside in nature, or getting that movement from the horse, working with some of the animals. swimming in the pool, but then when we need to bring it back to a breathe in moment and we're going to do something that's a little bit more quiet and we really need to get that a focus. Then these types of shelters for therapy can be really helpful. Now another option to consider would be a shed. So prefabricated shed can be a great alternative treatment space and they come in a ton of sizes and shapes. They come in single stories. And two stories and really can be completely customized, just like a clinic. And so sheds can be really versatile. They offer a lot of privacy. They can be customized in your colors. They can be painted with a mural. They can be finished off on the inside with dry wall. really, really awesome options. For using sheds. Now this is probably the most expensive of the options. Now a single story shed often runs about$5,000 where a two-story larger shed can run. Yeah, easily up to$25,000. So thinking about, what's your return on investment with that? Where is it going to be placed at the facility? Again, if this is property, you own them getting a shed might be a great option for your clinic space. If this is at a facility that you don't own, that you're only renting space at how are you going to move this shed? If you want to change facilities or it doesn't work out. Or, are they going to purchase it from you? If it stays there? Like what would those options be? So when you're thinking about transforming a shed into a therapy space, you want to think about, do you need a single story? Or a two-story option, with a two-story option, you do have the ability to store a lot of your equipment on that second story. Sometimes they have more of a loft style and sometimes that can be nice again for creating that kind of quiet space. If you have kids that would be safe working in that type of space. If you need a shed that is accessible for wheelchairs, looking at something that has double doors. We'll make it a lot easier for your clients to be able to come in and out. So I worked with one of my colleagues and she had renovated a shed and we called it the cottage clinic and it was an excellent space to work him. A mini split did perfect for heating and cooling worked really well. And it really did give this very sort of homey feel. It was a very. Nice space to work in. It did have good lighting. And it, it just, it felt very comfortable and the kids responded really well in that space. It wasn't too large. Like, I feel like some therapy gyms are just, they're very, very large spaces and they lend themselves to a little bit of that out of control, impulsive, running around behavior, but the cottage clinic in the converted shed was really. Nice. And it felt very supportive and there, there is, usually options for some overhead beams, as long as structurally. It can take the weight for some suspended equipment, but there's lots of options with sheds for treatment spaces. So I think those are really nice options. If you know, you're going to be someplace longterm, or if it's your property and you're looking to put that space in, there's just so many options at looking at sheds again, figuring out kind of what's your what's your budget is for that is I think one of the biggest components, but you can build. A lot into it. As far as storage privacy really having a dedicated space to work. So as we've worked through this, we've talked a lot about our nature based or animal assisted spaces, but what about creating a land-based space at the pool? So often when we're treating in the aquatic environment. It comes up with a phenomena of we're either in the water or out of the water. And. Parents often have an expectation of they're coming for aquatic based occupational therapy and, they want their kid in the pool or in the water. And sometimes the child is not ready to transition into the water we actually have a whole episode about transitions into the session when we're using aquatics because there's a process for a lot of our clientele certainly Of getting to the session Getting to the environment getting sometimes into their swimsuits and and then really getting into the session. So if you can create a land base space at the pool that is a really great way to help that transition for that client to give yourself some treatment alternatives. You know some days They just don't want to get in the water and we're never forcing a kid into the water, we're never forcing a kid onto a horse And these alternative treatment spaces really give us those options. So when we're thinking about creating an alternative treatment space at at a pool there are definitely some unique challenges of being Around the water Around the pool but outside the water and so moisture or water is just a huge concern no matter like what type of space we're setting up because everything is going to get wet You just got to figure like everything is going to get wet and how are you going to get it dry at the end of the day if you're packing up your tent Then like you have to take it home you have to have a place to hang it up and air it out or it's going to get moldy and a lot of the sensory types of things like beanbags and those nice squishy things that give a lot of input they're just totally inappropriate for the aquatic environment because they're going to get wet they're going to get moldy They're going to get yucky really fast so thinking about things that are inflatables have worked really well for us because You can inflate them. They get wet You take them home You set them back up again and re-inflate them and let them dry out so that can be really helpful. Safety Is an issue around the pool like where are you going to set this up Is there any concern with the client moving from the treatment space into the water space anytime you want to use any sort of electricity that's a safety concern around the water so you know what's battery operated that you might have as an option there's really a lot of things to consider and then often the surfaces are really hard It's concrete around the pool And Getting down like on the floor on the concrete just hurts it's not comfortable so how do we make it comfortable for our clients how do we make it comfortable for us one more one more working with our clients and Again that safety aspect if the client were to fall How do we make it as safe as possible so thinking about when we're setting up this kind of treatment space that is outside of the water but around the pool how do we accommodate for as many of these concerns as we can and again those formats give us some cushioning. we just have to make sure that they're textured as much as possible to help with any slip and fall risk So when we're thinking about setting up that kind of beach tent type of thing works best really in these environment talking to the facilities manager about where could you set it up what's the most appropriate thing is there anyone else using that space during the time that you're treating are all important questions to ask and then distance from the water how how far from the actual edge of the pool are you going to be And how is that going to impact your client kind of getting from one space to the other So whether we're at the barn outdoors in nature or in the aquatic environment we can set up alternative treatment spaces To help us bring a lot of the therapy tools that we know would benefit our client in addition to our specialty areas that we're working with whether that's incorporating animals into our session or using the movement of the horse or the therapeutic aspects of water We want to be able to have flexible treatment spaces where we are because My clients aren't going home with a horse they may not have a pool at home they may not have access to any of the therapy goats that were were using So how are they going to have that carry over well Part of my job as an ot is really to make sure that what we're doing is very functional for them to do and i a lot of times i can do that In these alternative treatment spaces so when we think about setting them up right we're looking at Is it accessible to the types of clients that we work with is it safe and easy to clean i'm gonna watch out for things like moisture mold, access if we're tracking in dirt mud from the barns things like that how easy can we clean it we want to think about What is the cost to us of setting it up want to make sure it's something that's affordable to us that will fit within our budget And then thinking about how can we create this space at whatever facility that we're at because a lot of our functional carry over is happening within these alternative treatment spaces i would love to see or space if you've set up an alternative treatment space at your facility i know there's lots of creative solutions out there for creating therapy spaces and a more non-traditional setting and i love it when people share with me what they've set up'cause they're always interesting to see and i'm certainly working on a little mini workshop about setting up alternative treatment spaces using my sensory stall beginning middle and ending So you can really see what that process looks like i'd like to thank you for listening and as we conclude this episode i really want to extend a special opportunity to you if you've been seeking personalized support and guidance i do offer one-to-one coaching sessions they're tailored to your unique needs as an occupational therapy provider Whether you're really looking to enhance your clinical skills navigate a career transition into some of these alternative environments Or work on your work-life balance or as i like to say your work family priorities I'm here to assist you can go to Epona academy to learn more about my coaching services and take the next step towards unlocking your full potential I love working with people to create a fulfilling and impactful occupational therapy journey