PURPOSE: The purpose of this study was to explore school-based therapists’ perceptions of the 3:1 Service Delivery Model, which aligns itself with a workload approach, and to determine whether it is perceived as effective in helping practitioners to shift their practices toward a workload framework.

RATIONALE: School-based practitioners have been encouraged to reframe their job-related responsibilities in terms of their workload rather than their caseload, where workload refers to all of the activities practitioners engage in that support students directly and indirectly, and caseload refers to the number of students treated by a therapist. The American Occupational Therapy Association endorses this paradigm shift because it expands the role of the occupational therapy practitioner (OTP) beyond direct treatment to include activities that serve the larger community.

Currently, there are no guidelines for practitioners to help them to shift from caseload to workload in their practice. Furthermore, there is no research to demonstrate the effectiveness of specific service delivery models that facilitate the paradigm shift away from a caseload toward a workload approach in school-based practice. This study addresses this gap in the literature and explores therapist perceptions of the 3:1 Service Delivery Model as it relates to their workload responsibilities.

PARTICIPANTS: Upon institutional review board approval, 5 OTPs and 5 speech–language pathologists with experience using the 3:1 model in their practice were successfully recruited for inclusion in this study.

METHOD: Participants in this phenomenological study completed a demographic survey and a semistructured interview with the primary author. Interviews were recorded and analyzed for categories and recurring themes once the data were transcribed verbatim and coded.

RESULTS: Five themes emerged from the data. When the 3:1 model was used, services were provided in natural settings, the scope of services was expanded, use of the model was determined on a case-by-case basis, time management was more effective, and the negative perceptions of stakeholders created challenges to implementation.

DISCUSSION: Results of the interviews indicated that when faced with reasonable caseload numbers and when stakeholders had a positive perception of the 3:1 model, its use provided practitioners with more time to manage their workload responsibilities than a traditional model, thereby supporting their shift toward a workload approach in their school-based practice

IMPACT STATEMENT: On the basis of the findings of this study, using a workload-oriented service delivery model provides a vehicle by which OTPs can shift their practice away from a caseload model toward a workload approach. The Occupational Therapy Practice Framework and principles of best practice support this paradigm shift.

When selecting a service delivery model to guide their practice, practitioners need to be aware of opportunities that workload-oriented service delivery models present for them, such as expansion of the scope of their services. Furthermore, practitioners need to be prepared to address the potential challenges inherent in the model so that they can act to prevent barriers to successful implementation from occurring.

Dissemination of this information will support practitioners in their choice and implementation of appropriate service delivery models to manage their workload responsibilities.