What is cash-based therapy?

Pivot is a cash-based practice, meaning we do not accept insurance. However, you can pay for services through a qualifying HSA/FSA/HRA. Under this model, the therapist and client enter a contract of payment and provision of therapy services that can uniquely meet the needs of the client. Cash-based therapy allows the therapist to focus energy on patient care without constraints of insurance. This allows for transparency in pricing, a more personalized treatment plan, and flexibility in care that the therapist can provide.

How long will appointments last?

The initial evaluation will be about 1 hour. The evaluation will include a review of your relevant medical history and presenting condition. The therapist will collect a variety of objective measures as a part of the evaluation and for ongoing assessment of your progress. Follow up sessions will be approximately 40 minutes, but may be a bit longer or shorter depending on your needs on a given day.

What is dry needling?

Dry needling is a manual trigger point release technique used to address painful, taut bands of muscle that can restrict movement, decrease strength, and contribute to pain. Skilled used of the needle can release the tissue and be hugely helpful in the therapeutic process. Often times, clients can quickly feel if dry needling has been helpful to them, with many reporting decreased pain or increased movement shortly after application. It may take multiple sessions of needling to achieve maximal benefit.

What is fee-for-service dry needling?

Fee for service dry needling is designed for a client who does not need a full OT plan of care, but would like to come for needling ONLY. The therapist will conduct a formal evaluation to get to know your needs, to confirm that you’re a good candidate for dry needling, and to ensure that your condition does not require further medical intervention.

Do I need a referral for therapy?

No! Occupational Therapy (OT) is direct access in New Hampshire, meaning you can be evaluated and treated by a therapist without a referral/prescription. Therapists do not diagnose, but are experts at evaluation and can treat many orthopedic issues. Direct access is shown to decrease unnecessary health spending on doctor visits and expensive testing. If your issue it outside of the therapist’s scope of practice and/or you’re not showing improvements within the first 25 days of treatment, your therapist will be sure to refer you to an MD for further assessment.

What’s the difference between Physical Therapy (PT) and Occupational Therapy (OT)?

In an orthopedic setting, OTs and PTs are quite similar! However, OTs are more commonly the upper extremity specialists, with OTs holding 85% of Certified Hand Therapist credentials. OT focuses on your occupations. Occupations aren’t just your day jobs - they include self care tasks, household chores, caring for your family, attaining restful sleep…and your sports and hobbies! OT uses your meaningful activities as means for rehab to ensure you can return to what’s important to you. OTs have considerable skill in task modification, adaptations, and activity analysis to determine which specific components of a task must be addressed relative to your condition. OT also takes into account psycho-social factors in treatment, meaning that we treat the whole person, not just a body part.

What is a Certified Hand Therapist?

According to the American Hand Society Association website, “A CHT is an OT or PT by profession with at least three years of experience, plus 4,000 hours of hand and upper extremity therapy practice (upper extremity rehabilitation). A CHT must have passed a certification examination that demonstrates knowledge of all areas of hand and upper extremity therapy before being granted the right to use the CHT designation. Hand therapists must renew their credential every five years through continued education and participation in hand and upper extremity therapy to continue using the CHT designation”.

Historically, the CHT exam pass rate is near 50%, meaning those with the CHT credential are true experts of all things upper extremity and have put in the time to understand this intricate and necessary body system.

Where are you located?

Pivot is located downstairs in the Portsmouth Athletic Club at 95 Brewery Ln #5 in Portsmouth, NH. Parking is available onsite.

Is there an accessible entrance?

The main entrance to the Portsmouth Athletic Club/Pivot has stairs to enter. There is a ground-level entrance with a 1.5 inch threshold near the Southwest corner of the parking lot. Please contact therapist directly if you will need to utilize this entrance.