Most occupational therapists who hit a wall in the school system face what feels like a binary choice: stay and keep grinding, or leave the field entirely and figure out what comes next.
Neither of those is the right answer for a lot of people. And neither was the answer for Barb Crowley.
Barb spent 25 years as a school-based OT. She wasn't burned out on occupational therapy. She was burned out on what the school system required her to do around it.
What the wall actually looks like
A caseload of 70 kids. Five minutes with a parent if you were lucky. A schedule built entirely around the school calendar. Paperwork that ate the hours that used to feel like clinical work.
"I did not feel like I could serve them in the way I really wanted to," Barb said about her final years in the district. "I wanted to work with families. I just didn't want to do billing and marketing on my own."
She looked into starting her own practice. She got certifications in infant massage and tummy time. She started planning the infrastructure. Then she hit the same wall every clinician hits when they try to go fully independent: the business side is a full-time job on its own.
The third option
When Barb found Coral Care on Facebook, what caught her attention was the framing: independent contractor flexibility, without the business overhead. No billing. No marketing. No credentialing maze. Just patients.
She joined. She built her caseload on her own terms — Tuesdays, Wednesdays, and Thursdays, five patients a day. She was full within six months.
That's the third option. Not quitting. Not grinding. Building a version of the work you love that doesn't require you to also run a small business or absorb a school district's administrative weight.
What this looks like for OTs specifically
The school-based OT burnout story is specific. It's not just general overwork — it's the gap between what you went to school to do and what the job actually asks of you by year ten.
You became an OT to work with kids and families. To use your clinical judgment. To see the whole child. The school system has you writing IEP goals in formats designed for compliance, not clinical clarity. It has you tracking numbers for reporting purposes. It has you managing upward as much as working down.
In-home practice closes that gap. You're with the family. Your clinical judgment is yours. The paperwork exists, but it's proportionate. And the families you work with are, as Barb put it, "the most invested people in the room."
It's not for everyone — but it's worth asking the question
Barb is the first to say that her path isn't the right path for every OT. Some people thrive in the structure of a school setting. Some love the team-based model and don't want to lose it.
But if you're a school-based OT who is tired — not tired of the work, but tired of the conditions around the work — the question is worth asking: what would it look like to do the same work, with the families who need you, on a schedule you actually designed?
That question is what changed Barb's career. It might change yours too.
Barb found the third option. 25 years in the schools, then something better.
Read her full story — then see if Coral Care could be your third option too.
