Sarah Zera, OTD, OTR/L: OT in Podcasting and more

In this episode, we will be learning about an occupational therapy practitioner in podcasting and more. Sarah Zera, OTD, OTR/L has been practicing occupational therapy since 2002. She created the Moxie OT Podcast as a place for OTPs, consumers of occupational therapy, and friends of OT to talk about the best evidence in occupational therapy. She seeks to provide evidence-based resources such as research articles, books, and online sources for OT advocates in an effort to increase their moxie. She also specializes in helping people who have had a stroke or brain injury fully participate in their life. She received her B.S. in Occupational Therapy from Eastern Michigan University and her Doctorate of Occupational Therapy from the University of Illinois at Chicago. Dr. Zera studies how occupational therapists can improve the lives of their clients by helping them get back to the activities they love to do the most. She has helped clients return to shopping, cooking, work, caring for their pets, riding the bus, and more. In her clinical experience, Dr. Zera noted how often clients were discharged from therapy but had not yet returned to the activities they cared about most in life; caring for their children, going to work, playing sports, and all the other activities that bring us purpose and meaning. While working on her Doctorate in Occupational Therapy, she studied evidence-based practices that helped her clients return to their most valued and life-affirming activities. She is currently full-time faculty at Midwestern University’s OT program.

Q & A with Sarah:

Please tell us a little about yourself and a few favorite occupations.
I've been an OT for 20 years this December. I grew up in Michigan, started my OT career in skilled nursing in Fresno, California, and then moved on to Chicago where I worked primarily in outpatient day rehab but also inpatient rehab and traditional outpatient. After completing my OTD I started teaching at Midwestern University. Most recently I started podcasting and a mobile OT practice. Some of my favorite occupations are cooking, hiking, kayaking, and spending time at the beach.

What motivated you to contribute to this podcast series?

What I always say when talking about my podcast is OTs love talking about OT. My husband can also testify to that. I love talking about all things OT.

Please describe the UncommonOT work that you do and the setting in which you work, the population you serve, and the needs that you address.

It has been very exciting to start working as a Mobile OT. I am focusing on people who have had strokes or brain injuries. The research shows that while these folks "graduate" from rehab they don't return to their previous occupations. I am hoping that through my evidence-based interventions in their home environments I can help them take those next steps back to work, caring for their families, and returning to leisure tasks. I have had so many discussions with my students about how context is so important to our practice and yet we work in these contrived clinical spaces. To be working with clients in their homes, on the thing they want to be doing has been an amazing experience. I have also started an evidence-based OT podcast. This was a passion project created with my husband to help us to connect to others in the pandemic. Our focus is on exploring how OTs are implementing evidence-based practice. There is often a gap between what the best evidence is and what we are doing in the clinic. I'm hoping that by hearing the experiences of other OTPs others will feel inspired to try something new or try something again!

What inspired you or drew you to this type of OT work?

My OTD focused on group interventions to address executive function deficits with client's who have experienced acquired brain injuries (ABI). Developing that group has been an incredible experience and I am still researching its effectiveness. But I spent all this time exploring occupation-based, evidence-based interventions and then immediately went into teaching. I wanted a way to use these skills I had developed to address the needs of this population. In that same vein, I spent several years exploring evidence-based practice to create my group and now I teach it. It's sort of always in the front of my brain. I have enjoyed teaching OTP's through CE events and the podcast is a natural extension of that.

How did you get there? Can you describe your path?

I graduated OT school with a bachelor’s degree and just assumed I would be a clinician for the next 40 years until I retired. Working in a research hospital got my mind thinking about what KIND of research I valued. I also got experience teaching other OTs there. I worked with a DPT friend of mine on a research proposal exploring executive function and falls risk. Even though we didn't win the fellowship we were applying for I learned that I was interested in research. All of these experiences led me to complete my OTD. I know my OTD project would address executive function and the needs of my day rehab clients returning to work and school. I knew it would be a group intervention because day rehab was a group model. I discovered the CO-OP approach, but it had traditionally been used in a 1on1 format with adults. So I developed a CO-OP group for day rehab. Then it's sort of history from there. I am still researching this group, OTs and patients love it. I just need to show it's better than traditional OT. I know from my findings it's at least as good as traditional OT. And like I said earlier, I developed all these skills to support strategy training and wanted to use them with clients, so I started my mobile business. (and the podcast to support evidence-based practice for other OTs)

Please describe a typical day or OT session at your uncommon setting. What OT skills do you utilize?

I use the CO-OP approach with my patients. I'm pretty straightforward with it. In the eval, we complete the COPM and in my very next visit, I ask them which goal they want to work on that day. I teach them the goal plan do check strategy and then each day we create plans and checks for the goals they are interested in addressing. Recently I worked with a client who kept missing appointments, including one with me. So he set a goal to get more organized and not miss appointments. He was using 3 different calendars. I used guided discovery or indirect cueing to help him decide to get it down to 1 calendar. He also set some daily reminders to do tasks he wanted to address regularly. He felt much more organized after that.

Can you talk about some recent highs (successes) and lows (challenges) of your current role?

That patient was a recent high. I watched him internalize the strategy in front of my very eyes. I walked into the room and he just started making plans for the 3 goals he wanted to address that day. He didn't need me anymore to walk him through the strategy each day. A big challenge is finding clients. I work in a large metropolitan city that has excellent access to health care. Physicians are going to send their clients to the large rehab hospitals for traditional rehab. I am working on creating connections with other organizations like support groups to let people know if they have goals they want to address I can support them.

How do you continue to learn in order to stay on top of things within your role?

I never identified with the term lifelong learner until recently, even though I have been growing and learning all of my life I never thought of it as something I was consciously doing. I have started volunteering for our state association and have learned so much by being involved in that organization. One of my roles is as the CE coordinator so I get to talk to people about lots of different aspects of OT. The podcast also supports my learning goals because again I get to talk to OTs about so many different aspects of OT. I find a lot of support in the entrepreneurial facebook groups. They have empowered me to do things like go out and read the medicare guidelines. If I don't know where to find an answer someone in those groups will help me find it. One reason I love being an educator is that it pushes me to stay on top of trends, the evidence, and so many other topics such as inclusion and social justice issues. Every year I am updating my courses and attempting to make them as relevant and up to date as I can. And I can't say enough about learning by trying things. Much of this started by trying to apply for a fellowship I didn't get. Each step has been a little bit more of a new challenge and sometimes I make a mistake but I learn from it and keep moving forward. I'm currently writing an AOTF grant and feel very overwhelmed by the process. But I keep reminding myself I didn't know how to do any of this a few years ago and I am learning by doing. (Just like we expect our patients to do).

Can you share a little bit about salary and compensation in this setting?  How do OT or the services you provide get funded?

One great thing about Mobile OT is that my overhead is very low. I pay for a google workspace that is HIPPA compliant, a google voice number, and things like liability insurance and learning opportunities. I hope someday soon I'll be able to also reimburse myself for things like my gas when going to visit clients. So far all of my clients have been private pay. I have recently been credentialed with BCBS of IL and Medicare. That will be my next thing to learn - how to submit those claims!

Any career advice for our followers and listeners on how to get started on this path?

You are a smart cookie, you finished OT school for goodness sakes. If you want to try something new you can do it! Find a friend or mentor to support you through the process.

What’s a common myth or misconception about your job/role you’d like to call out or demystify?

Research is just for PhD's. While it might be harder for clinicians to find support there are lots of ways for clinicians to get involved in research. I firmly believe clinicians know the research questions we need to be asking. One way to get involved is to reach out to your local university and see if students need research projects.

How do we find you, follow you, be in touch with you, and promote your unique work?

Website: www.moxieot.com/podcast

Apple: https://podcasts.apple.com/us/podcast/the-moxie-ot-podcast/id1552988131

Spotify: https://open.spotify.com/show/7fOtvTbdW02ZQuDMNFQOXe?si=lTLK-UEFQva27WQxHUZkFw&dl_branch=1

Facebook: MoxieOT, moxieotpodcast

Instagram: @MoxieOT @moxieotpodcast

Twitter: @OtMooxie @moxieot https://www.moxieot.com/about

Resources:

CO-OP Approach website: https://icancoop.org/pages/the-co-op-approach

COPM website: https://www.thecopm.ca/

My article: https://journals.sagepub.com/doi/full/10.1177/03080226211008713

My podcast: www.moxieot.com/podcast 

EBP resources I have created: https://www.moxieot.com/for-professionals   

CEU's coming soon! 

As always, I welcome any feedback & ideas from all of you or if you are interested in being a guest on future episodes, please do not hesitate to contact Patricia Motus at transitionsot@gmail.com or DM via Instagram @transitionsot

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