Feature Story

Collaborating Therapies

Brenna Hoisington and Jenny Kortuem

GO! Therapy has experienced tremendous growth since it opened in 2017, multiplying its staff and moving to a new space. Certainly the need for therapy services has contributed to its rapid growth. But the clinic’s success has more to do with breaking the therapy mold. At GO! Therapy the focus is on providing functional and innovative therapy. Its services are just as unique as the people it serves because its therapy methods are tailored to fit each individual’s needs using co-treatment and innovative therapy methods.

“What continues to fuel our growth is the need for more services for people with different abilities in our area,” co-owner Jenny Kortuem said.

Since 2017, GO! Therapy has grown to provide a wide range of services for people of all ages, from babies to adults, including speech language pathology, feeding and swallowing therapy, occupational therapy and physical therapy. Combining these therapy services with a team approach is part of what makes it so unique and allows GO! Therapy to have a whole-person approach to care.

Owners Jenny Kortuem and Brenna Hoisington are speech language pathologists who are passionate about providing their clients with the best possible care. Truly a family business, the cousins came together to start GO! Therapy after seeing a common thread in their practices. Prior to working together, Kortuem provided contracted speech therapy services to hospitals and skilled nursing facilities, while Hoisington provided speech therapy services in a school district.

Although they pursued different career paths, both women reached the same conclusion: speech therapy is only one piece of the puzzle. For example, children with difficulty speaking also may have difficulty moving their bodies safely and effectively. Now, their practice brings together therapists with different specialties who consistently communicate with one another to better understand and then treat a patient’s underlying condition.

The collaboration between physical therapy, occupational therapy and speech language pathology came directly out of necessity. Kortuem found many instances where attempting speech therapy with a dysregulated child – someone who has difficulty managing their emotional responses, including sadness, anger and frustration – was fruitless.

Kortuem and Hoisington wondered if occupational therapy could help restless children feel good in their bodies. They discovered that it’s vital for supporting kids’ sensory needs, independence and self-regulation. So they began using occupational therapy tools like compression clothing, weighted vests, swings and sensory play to help children self-regulate.

Physical therapy adds an additional perspective to the whole-person approach to care. Movement is good, but the way we move can impact our development. For example, some babies are born with torticollis, when the neck muscles are tight and their head appears tilted or twisted to one side. A baby may even begin to roll over toward the tight or tilted side before expected. Parents may think this is good, but the problem is the baby may be unable to move in the opposite direction. When infants move, they integrate both sides of their brain — so rolling in just one direction limits integration, negatively impacting development. These infants often have difficulty nursing.

“As a speech therapist working with infant feeding and swallowing, I absolutely need my physical therapist by my side,” Hoisington said.

Kortuem uses the analogy of the dandelion and orchid to describe people’s varying abilities. It has inspired their mission at GO! Therapy.

“Some people are like dandelions. You can mow them off, you can stomp them into the ground, you can even dehydrate them, and they are going to grow back and do just fine,” Kortuem said. “Yet others are like orchids. They need just the right amount of sunlight, the right temperature and the right amount of water. When their environment is supportive, they can grow and flourish as a beautiful flower.”

“Just like the orchid, there is nothing wrong with the person,” added Hoisington. “We just need to figure out how to help them flourish and thrive using their strengths.”

At GO! Therapy, patients are made to feel empowered by their strengths instead of hindered by any perceived weakness.

“On this journey, we are learning more about neurodiversity, which means understanding that people experience and interact with the world in many different ways. Our job is to help individuals identify the unique beauty they possess,” Kortuem said.

As Kortuem explained, we are not meant to be masters in all areas of life. We each have unique skill sets. At GO! Therapy, patients discover their strengths and use them as a foundation to learn new skills, focusing on strengths rather than weaknesses.

“Strengths promote empowerment,” Kortuem said. “With a strengths-based approach, we hone in on preferred activities, find that internal motivation, and connect our therapy goals in a meaningful and fulfilling way. Then it doesn’t feel like work. It feels like play. But we’re learning just the same, if not more, because we’re hands-on.”

GO! Therapy follows an innovative therapy method known as Developmental, Individual Difference, Relationship-based Model, also known as DIR®/Floortime™. For children, this child-led, play-based model encourages play as a means for evaluation and treatment. For adults, the model is tailored to their skills and interests.

Jennifer Powers has been bringing her son, Ryan, to GO! Therapy for nearly four years. Ryan is living with autism, attention-deficit/hyperactivity disorder and anxiety disorder.

“I call autism a super-secret world because no one really knows what it’s like until you’re in it,” Powers said.

The therapists at GO! Therapy understand and can adjust to a child’s varying sensory needs.

“When we first started, we had to co-treat with OT. He was just so dysregulated and overstimulated,” Powers said.

During times of transition or times when Ryan’s sensory needs have changed, an occupational therapist is brought into the session to help.

“We all have good and bad days, and when Ryan is having a bad day and he’s not super interested in any of it, they can roll with that, too, and adjust to his needs,” Powers said.

The DIR/Floortime Model at GO! Therapy was a good fit for Ryan as a method of therapy. It allowed him to take the lead, but it also gave his therapists the chance to get to know him and what makes him tick.

“Because we are child-led and play-based we are looking at what motivates that person and where their skills are, and then putting those two things together so we can have fun and learn,” Kortuem said.

This summer, Ryan was asked by his psychologist to throw out the first pitch at a town baseball game in Union Hill for an Autism Acceptance game. Powers and her husband were unsure if Ryan would do it. The therapists at GO! Therapy encouraged the family to try.

Since Ryan loves books, his therapists helped him create a book called Ryan Throws a Baseball to help prepare him for the big day. Then they held a therapy session at a baseball field, where Ryan was encouraged to read the book several times and try practicing the pitch.

“The day came that we were going to do it, and we were nervous, but he just rocked it,” Powers said.
Hoisington and Kortuem were at the game supporting Ryan, with Kortuem down on the pitcher’s mound with Ryan when he threw the pitch.

“He just did amazing,” Powers said. “We were floored. We didn’t think he would do it, but he wanted to play baseball. It was amazing.”

Through the years, Ryan has benefited from occupational therapy, speech therapy and feeding therapy. His family has also felt the benefits of GO! Therapy.

“Their goal is to treat a family. They are not just there for the child that needs them,” Powers said. “They are really focused on the family, and that was super important to me as we grew through Ryan’s diagnosis, and what his needs and wants were, and what our family needed and wanted out of this.”

The Boelter family is another great example of how combining co-treatment and DIR/Floortime therapy can make all the difference for a child.

Nicole Boelter decided to bring her son Levi to GO! Therapy after noticing his struggle with verbal communication. When his family didn’t understand what he was trying to say, he would give up and stay quiet.

“Our child was going to think that whatever he had to say was not important,” said Boelter.

Right away, Boelter noticed a difference in how they provide care at GO! Therapy.

“This was far more than a clinical session,” Boelter said. “Who would have thought he could play during his appointments? Levi was able to play (with) his favorite toys, games and whatever he was into that week.”

What began as speech therapy developed into so much more. Levi’s team of therapists determined that he would also benefit from occupational therapy. Although this collaboration isn’t the norm in most clinical settings, it has made all the difference at GO! Therapy.

“The status quo isn’t good enough,” Kortuem said. “What we are doing is looking at that whole child versus just their speech disorder.”

“We’ve changed how we work with patients. We treat the whole body,” said Hoisington. “When we can all work in collaboration together, our outcomes have been just phenomenal.”

Levi was very content to sit and play with toys but was not interested in sports (avoiding anything with a ball) and was terrified to ride a bike. He also had trouble with everyday tasks like putting on his socks. So Levi’s occupational therapist worked with him on various activities to help him gain the skills he needed for daily living and to integrate his Moro reflex, an involuntary response to stimulation.

“After a little time in occupational therapy, we thought we needed a little dab of physical therapy to make sure Levi had all the tools he needed to be successful,” Boelter said.

Physical therapy helped Levi build a toolbox of skills he could use to be successful in the activities he was becoming interested in, including sports.

It helped him gain general strength, core strength and coordination, all through fun challenges, such as obstacle courses.

During his three years at GO! Therapy, Levi benefited from a collaboration of speech, occupational, physical and feeding therapies. Watching Levi gain confidence through his new skills was the best part of therapy, Boelter said.

“Levi’s toolbox continues to grow both in his body and his mind,” Boelter said. “It’s our favorite thing to watch.”

Levi wasn’t the only one building up a toolbox of skills. GO! Therapy also stands out as an educational resource for parents and caregivers.

“What we have learned during this time is literally priceless,” Boelter said. “Our therapists taught us how to better understand Levi, how to help him succeed and how to build him up. They taught us patience and what tools we can use to help him.”

One of the foundations of DIR/Floortime is teaching parents how to connect with the kids on the floor. Therapists at GO! Therapy model therapeutic skills and teach parents how to carry over that skill at home.

This summer, Levi placed his handprint on the wall of GO! Therapy. It’s a mark of achievement for all to see and a symbol of his graduation from therapy. Although they hate seeing their patients go, the ultimate goal is for them to no longer need therapy services and “graduate.”
“You create a bond that is not going to be severed once that hand is on the wall,” Hoisington said. “You’re going to be friends with them forever.

That is what we do here.”

Staying on top of the latest innovations in therapy through education is a key pillar of GO! Therapy.

“We see the value in continuing to educate ourselves, our families, and our community to create a more accepting and loving environment for us all to thrive in,” Hoisington said.

For Kortuem and Hoisington, this includes training in orofacial myofunctional therapy. Myofunctional therapy uses exercises to train and strengthen the muscles around the face, mouth and tongue to improve talking, eating and breathing.

“We’ve been able to explore our passion for providing therapy services to nursing mamas and breastfeeding infants,” Hoisington said. “The research is in; breast is best, but what happens when it’s not going well?”

As Hoisington explains, the first stop is often a lactation consultant, who seems heaven-sent to new moms. But sometimes breastfeeding concerns are more complex and not improving. Then it’s time to look at the underlying cause. For example, if a mom is experiencing decreased milk supply, nipple pain or deformation, or difficulty with latching, or if her baby is irritable, fussy and colicky or suffering from reflux, there may be a structural concern such as tongue and lip ties.

“We’ve done a significant amount of continuing education on ties and how they may be related to feeding difficulties,” Hoisington said.

All babies are born with a fold of tissue underneath the tongue that helps to anchor and stabilize the tongue. However, for some infants, this tissue restricts tongue movement, leading to breast- or bottle-feeding difficulties.

GO! Therapy also offers therapy services for adults.

“As people age, maintaining independence can be challenging,” Hoisington said.

Medical complications related to stroke or traumatic brain injury, Parkinson’s disease, dementia and even aging, in general, can result in a lack of ability to complete daily activities like cooking and cleaning. Some adults also experience social isolation and a lack of connection.

“Our delivery model is similar with our adult population, centered around individual strengths and functional needs,” Kortuem said. “The focus is on maintaining and improving quality of life. Seeking therapy due to a loss of independence is a hard pill to swallow for any adult, but living without support is torture, in my opinion.”

For aging adults, co-treatment can be an effective method of care. Physical therapy helps people feel safe and confident in navigating their homes and the community. Occupational therapy assists in tasks of daily living like cooking, cleaning, self-care and much more. Speech and swallowing therapists may help adults who are difficult to understand, can’t think of their words, are forgetful or have poor vocal quality. Speech therapists also help adults who suffer from swallowing issues to eat and drink safely, without coughing or choking.

The next addition to their collaborative therapy approach will be in-house mental health services.

“We work very closely with many local mental health clinics and professionals. We are all collaborating more and more, but the logistics of proximity often interfere,” Hoisington said. “Building a team of professionals in-house for a more comprehensive evaluation and treatment plan is our goal.”

In a time when anxiety and depression are rising in children, an in-house mental health resource will be invaluable.

“Children aren’t naughty or behavioral, and parents aren’t to blame. There is an underlying reason the child is responding a certain way,” Kortuem said. “One of our teaching tools is an iceberg analogy. At the surface, we see a behavior or disability but understanding what is underneath that response is critical.”

Kortuem and Hoisington continue to dream big for GO! Therapy.

“We started out with just a few therapists, and we have blossomed into an amazing team,” Kortuem said. “Our ever-growing GO! Therapy family now consists of several amazing women who play an instrumental role in bringing our mission to the community.”

Therapists Amelia Braun, Dana Siefert, Stefanie Grams, Jacey Risler and Megan Rabenberg make up the GO! Therapy dream team with specialties in speech language pathology, occupational therapy and physical therapy. Office manager Abbee Blaschko leads the GO! Therapy support professionals to keep everything running smoothly.

“It wouldn’t be possible to offer these services without these wonderful people,” Kortuem said.

The dreams and goals of GO! Therapy will continue to develop in tandem with the needs of the community. Expect to see more innovative therapy methods from them in the future.

The Essentials

GO! Therapy
830 Sunrise Drive, Suite B
St. Peter, MN 56082
Phone: (507) 934-3573
Web: gotherapymn.com

Christine Nessler

A freelance writer from Mankato.