Clinic among the trees: Occupational therapy master’s student blossoms during fieldwork in

Washington rainforest

When most people imagine an outpatient pediatric clinic, they likely picture four walls, splashes of
bright colors, a waiting room, and a zero percent chance of rain in the office. For Colorado State
University occupational therapy master’s student Emily Tull, this could not be further from the truth.

Tull, a Virginia native and licensed exercise physiologist, is spending her summer in Washington state
completing her required fieldwork working with Emily Bryce, an educator who practices outdoor
occupational therapy for an outpatient pediatric clinic. The outdoor sensory clinic, nestled in Bryce’s
acres of forest on the Kitsap Peninsula, provides patients aged 2 to 18 the same things a typical clinic
would.

“Clients meet us at the outdoor clinic for their OT sessions. Our day-to-day practice is child-led, meaning
children are able to engage in the environment in ways that interest them most,” Tull explained. “We do
all the same things a typical outpatient peds clinic would do, except we do it outside and nature grants
us natural affordances during therapy!”

Tull’s job as an occupational therapist in this role is to be there in order to ensure safety, provide just
the right challenge activities for therapy, and to collaborate with clients to solve problems. Her day is
always full of play, as that is most youths’ main occupation, but she and her team also work on social
participation by having groups or camps of clients, and activities of daily living such as hygiene, dressing
and feeding, emotional regulation, and more.

Path to the forest

When Tull was young, her grandmother suffered a brain aneurism. This prompted Tull to gain an interest
in therapy. “Since then, I knew I wanted to pursue some realm of a therapeutic profession,” Tull said.
While earning her degree in exercise science from Virginia Commonwealth University, Tull happened
upon a poster for an occupational therapy seminar. Unfamiliar with the field, she decided to attend and
was immediately struck by the need to learn more.

“What intrigued me most about the profession was the ability to collaborate with the clients on what
was meaningful to them in their day-to-day life,” remarked Tull.

In 2019, while working with the geriatric population as a licensed exercise physiologist in Virginia, Tull
transferred to Denver with her company. Soon after moving to Colorado, she began as a student in the
Occupational Therapy Program at CSU.

“The Occupational Therapy Program and the extensive research coming from the department is what
initially drew me to CSU. Living right next to the mountains was pretty convincing as well,” added Tull.
“My favorite part about occupational therapy is how broad it is! You can really find a passion area and
find how that can be incorporated in your practice. Occupational therapy has the potential to impact the
world beyond the healthcare system alone.”
While attending the 2021 CSU OT Knowledge Exchange, an event connecting students, faculty, alumni,
researchers, and practitioners with one another, and with cutting-edge information about occupation-
based practice, Tull noticed a discussion revolving around nature-based therapy. This piqued her
interest.

“My thesis was on outdoor occupational therapy camps, and I have a background in adaptive recreation,
so I was instantly interested and attended the talk,” said Tull. After the discussion, Tull was able to set-
up a meeting with Bryce and another interested CSU student, Emily Grieb. “The rest is history,” she said.
“Emily Bryce, Emily Grieb, and I are all here in the forest this summer providing therapy to clients
beneath the trees!”

Hands-on fieldwork

It is one thing to attend lectures and write the notes, but it is an entirely different challenge taking that
information and using it in a professional setting. Luckily for Tull, and countless other CSU OT students,
the curriculum designed by the expert OT faculty has paved the way for success outside of the
classroom.

“At CSU OT, our pediatric, adolescent, and young adult classes not only prepare us with the theory and
anatomical/neurological underpinnings of the therapy we are providing, but also emphasize the
importance of being an evidence and reflective-based practitioner,” she explained. “It has been eye-
opening to see the things we learned in the classroom and lab connect to the hands-on therapy we are
providing every day.”

As Tull notes, plenty of learning occurs while conducting hands-on fieldwork as well. Tull credits her
fieldwork educator, Bryce, for lessons she will take home from her experience. Tull cites Bryce’s desire
to continue education as one of the biggest lessons she has learned. When Bryce isn’t actively giving
therapy, she is broadening her horizon and educating herself on how to uplift, advocate, and lessen the
amount of harm in her clients’ lives. From Bryce’s modeling, Tull now feels confident encouraging
autonomy for clients to explore their environment. She also feels comfortable validating their emotions
and feels motivated to advocate for clients’ voices to be heard.

At the end of this experience, Tull will be moving back to Fort Collins to study for her NBCOT (National
Board for Certification in Occupational Therapy) exam. Upon passing the exam, she hopes to find a
pediatric occupational therapy position where she can practice outdoors, employ the use of adaptive
recreation, or work in a community-based setting.

Currently, Tull is turning her thesis into a published manuscript. She was selected to present at the
annual Occupational Therapy Association of Colorado Conference in October where she will be
presenting her research entitled The Effect of an Intensive Outdoor Occupational Therapy Camp on
Behavioral Regulation and Praxis in Children.

The Department of Occupational Therapy is a part of CSU’s College of Health and Human Sciences.

Excerpt: CSU occupational therapy master’s student has taken to the trees to research new ways to
conduct therapy.