Speech/OT really 30 minute session?

justforfun87

Sun, Apr 22 2018, 2:33 pm

For those who are therapist whether OT, Speech, whatever. If you are scheduled to see a kid for 30 minutes do you take up the whole session with actual Therapy? Does speaking with the parent get calculated into the time or walking to the office? I'm paying out of pocket and the therapist was running late last time. The actual therapy session was a total of 18 minutes. She did chat with me for a few minutes after. Before I say something I want to know what is considered standard.

amother

Seashell

Sun, Apr 22 2018, 2:40 pm

Def not standard. Could be for an initial session. Or a parent consult that officially could be billable but that should be only once in a while and if ur paying private then not even

amother

Plum

Sun, Apr 22 2018, 2:45 pm

My clock doesn't start until I have the child in the therapy room, and it stops when the direct therapy ends. Choosing a prize, writing notes and talking to parents is not included in the session time.

That said, I've worked in therapy centers where they told us explicitly that the last five minutes of the session should be used for writing up notes and parent education. I think that's fair as well. Obviously, having 12 very expensive minutes deducted from the session is not ok.

precious

Sun, Apr 22 2018, 3:42 pm

I've seen therapists in schools pull a child out of the room and the child is back within 20-25 minutes. I obviously don't know their cheshbonos and billing details but don't think it's fair. Especially since its in school so parents have no idea what's going on.

seeker

Sun, Apr 22 2018, 4:14 pm

OP, doesn't sound right to me. 30 minutes is not a long session. It should include whatever greetings/warmup and prizes/transitions at the end, but nothing else. Running late happens, but then she should either stay late to make up for it, offer to make up the time by adding to a different session, or reduce the billing accordingly.

I'm not sure how speaking with the parent would be factored in to a private-pay arrangement. If you're getting updates every time and discussing the work that needs to be done with the child, then yes it should be included in the paid therapy time. If it's just a once in a while check-in, I don't know, personally I don't include it in the session time but that's because I work for a DOE agency and that's their policy. Though if the parent shows up unannounced and insists on staying to talk while my clock is ticking and I have other kids to see after, I'm not going to subtract that time from my session - I just do my best to encourage them to contact me at a different time.

SingALong

Sun, Apr 22 2018, 7:46 pm

In the professional places I’ve worked, I was always instructed to write my progress note the last few minutes of the session, that was part of the therapy time. So I usually had my client pick his prize, or independent therapy activity of his choice to do for the last 5 minutes while he/she was with me, while I wrote my progress note. Only then I’d walk him/her back to class.

One place even told me that walking the kid to therapy and back is ok to be included in the minutes. Advised me make getting there and back into something productive like the kid tells me where to go, they learn how to navigate their surroundings, navigate around objects/others walking in the hallway,etc but that wasn’t always applicable for each client.

Talking to a teacher quickly for 2 minb4/after each session can be part of minutes. And I documented that time as consulting with teacher. But of a phone call to a parent or teacher on the phone for a lengthy conversation no that’s not part of therapy session that I did on my free time.

amother

Burgundy

Sun, Apr 22 2018, 7:53 pm

It depends upon the setting. When I did EI I made my own schedule. We were paid an amount for our half hour session. But in my mind, it was an hourly rate but cause after 30 minutes direct therapy with the child, I would use the next half hour to drive to the next session, park, and write up a 5 minute note for the last session. If I had a particularly busy or crowded schedule, there were times I did use the last 5 minutes if the session for the note. Definitely OK and appropriate.

Now I'm in a preschool. I have half hour sessions scheduled back to back, with 2 minutes in between. On other words, 9:00-9:30; 9:32-10:04, etc. All. Day. Long. So yeah. Paperwork is gonna get done during the child's half hour. Anyone have any other suggestions? Kinda sucks tho.

amother

Babypink

Sun, Apr 22 2018, 10:23 pm

In NYC the policy is:
EI: 30 min sessions include training the parent (the entire billable session can technically be a conversation with a parent, perhaps designing a bedtime routine), but notes must be completed and reviewed with the parent after the session is complete, and signed by the parent and the therapist after the note is complete, as close to the session as possible.

DOE: it depends on the agency. I'm sure he policy is written somewhere, but I never researched it.

Private pay: you are paying for the session. You definitely can demand 30 minutes of treatment time.

amother

Dodgerblue

Sun, Apr 22 2018, 11:06 pm

When I worked privately, they said it is a 50 minute hour. That counted some documenting while the child worked and then finishing after you bring the child out. 18 minutes is definitely not 30, though.

Now, in schools, I document while we work. I count the whole time in the therapy room, even choosing a sticker or prize, but not walking the halls.

seeker

Mon, Apr 23 2018, 12:43 am

amother wrote:

When I work privately I have a WHOLE lot less documentation. I take whatever notes I personally need to keep track of the client and that's it.

When I work for a DOE agency, documentation is required to be separate from the therapy time, plus they require a lot more of it. I just swallow that as part of the job choice. So for the person who switched to working at a school with only 2 minutes per session, why not look at that the same way as the previous job - where you consider your half-hour pay as also covering the travel and documentation time?

amother

Linen

Mon, Apr 23 2018, 1:29 am

Not an OT but am a therapist. My session times are clearly written out in the consent form and have been in each place I worked. Something like: "Sessions are 45-50 minutes each. If the therapist is late, he or she will give the full time allotted. If the client is late, no extra time will be added. If the client has arrived more than halfway through the time allotted, therapist has the discretion to not hold the session. Missed sessions will be billed the full amount unless the therapist is notified 2 working days in advance...."
Notes were done either between clients or after I was done for the day. No choice, thats the job.
Did you not sign a consent form? Did you not clarify what you were paying for?
I had taken my kid for SP and the therapist cut us short. It was getting slightly shorter each time, including the prize picking... I wasnt happy and ended. If she was using MY time for notes and billing I would be upset. I am not paying for her notes. Notes are a job requirement but that isn't included in what I paid for which was X number of minutes of therapy!