VT Works

For the benefit of our readers, can you explain how you are involved in Developmental Optometry?

Well, I do seem to have a few hats in this wonderful field we work in. First, I am a therapist and see patients at Mountainview Vision Therapy in Yakima, Washington.   Unfortunately, due to my other duties, I only get to see patients one day a week.  Secondly, I am a mentor for OVDRA and currently serve as the Chair of the Mentor Committee.  This is such a privilege.  I enjoy assisting other therapists in completing their certification journey.  Then I am an educator for OVDRA and have been co-teaching the VT 101 course at our annual OVDRA meetings for the past few years.  Finally,  I am one of the partners of Emergent.  We manufacture and provide vision therapy equipment, therapist and doctor education, and consultation on starting or improving your therapy practice.  This has been a wonderful experience and I have had opportuntity to train therapists in 25 different countries all over the world. 

You’ve been a vision therapist for many years and became certified in 2015. As you look back, how has your role in vision therapy evolved since your early days in the field?

Wow! What a great question.  I never dreamed that becoming certified would open so many doors and opportunities for my career as a therapist.   I wanted then and still hold as the priority that further education was to benefit my patients, to whom I owe my best.  That being said, certification has allowed me to reach a far greater audience and help so many people I would never have had the opportunity to otherwise.  It has led from therapist to lead therapist, to multiple clinic liaison, to mentoring, lectureing and worldwide involvement.  Best of all, it created in me a lifetime longing for more knowledge concerning vision therapy. 

Your colleagues often describe you as instinctive in patient care. How did you develop that intuition, and how do you believe it shapes the patient experience?

I do not know if I can answer how I became instinctive or intuitive as a vision therapist.  I live in a very musical family and have often asked my wife and son how they hear the various notes in a chord.  They always respond that they do not know how, they just do.  I do not know how, but if I were to surmise,  I would say that I try to really listen to my patient, not just their words, but also their body posture, adaptations, and persona.  I try to experience each activity through them.

When you meet a new therapist for the first time, what qualities tell you they’re going to grow into a great clinician?

I have often told therapists, doctors, and administrators that I can teach anyone the protocols and concepts of vision therapy, but what I cannot teach is passion, compassion, and curiosity. To be a good or great clinician, you must like people; we serve people, and people have flaws, so you must be able to look past the flaws to the person and connect to them.  Next, you must love to learn.  Our field is ever-changing and growing.  The amount of information is growing exponentially, so you must be willing to put in the work to keep up.  Then you must love what you do.  We have to important position to do it with a lackluster halfway attitude.  If someone is not 100% into being the best they can be, they should look for something else.  For their patients’ sake and also for their own.   I have had a co-worker tell me that not everyone is as passionate about VT as I am.  I can accept that, but you should be as passionate about VT as you can be. 

In your work training vision therapists across multiple clinics, what do you see as the biggest gaps in VT education, and how can we bridge them?

I have been so blessed to have the opportunities I have.  First, I had Dr. Benjamin Winters as my first Doctor.  I was hired on a Tuesday, and on Friday, we headed to a seminar where WC Maples spoke.  So much of the information went over my head, but it was the start of me recognizing how much I had to learn and that I could not just skate by in this career field.  Second, along with the many educators that came to our office and going to COVD, back in the day, I was also given access to books and resources to do my own research and study.  Dr. Winters made education a priority for his therapists, so it became a priority to me personally. 

As to what we can do, well, we must ask ourselves what the end goal is.  Do we want playground supervisors?  Therapists who can observe activities and ensure they are completed, yet do not know why the activity is being done.  More importantly,  they do not know if the activity is working for the patient.  Remember, it is not the activity, but the action of the patient’s brain while doing the activity that makes the difference.  We should want Professional Therapists who are competent in understanding all aspects of the what, why, how, and when of each concept and protocol in vision therapy.  

Once we have clarified what we really want, then we will provide the necessary resources for each therapist to succeed to their highest potential. 

You’ve become a respected leader within OVDRA. What does that role mean to you personally, and how has it shaped your view of the profession?

I am thankful for the opportunity to serve within the collaborative efforts of OVDRA.  I still feel that I am striving to learn more and do better.  Along with that, I have been given the opportunity and a voice to lift those around me and to try to advance this profession.  What can be better than to love what you do and then to have the chance to pass that love on to those who are entering the profession?  I see this profession as a career choice and would love to see that the education level and the compensation received would allow therapists to do what they love to do for as long as they can. 

Vision therapy can be emotionally demanding work. What have you learned about keeping your own energy grounded so you can show up fully for every patient?

Let’s face it, we are all human.  If I have seven to eight patients in one day, the quality of therapy in the last session is unlikely to be as good as in the first session.  What I did was make sure my plan was in place and recognize that it did not mean I had to have 4-5 different activities for all 8 patients, but maybe 4-5 activities done in 8 different ways through loading and unloading, depending on the patients’ level.  If I mastered my activities and then knew how to adjust them to the patient, it left me with more bandwidth to use to be connected to the patient and their needs.  Lastly, I kept in mind that I worked for that patient, not their parent, insurance company, or even my doctor.  When I looked across the table at a 7-year-old and saw them as my boss, it helped me to remember that they deserved my best. I try to keep this practice to this day. 

With the next generation of vision therapists, now including one very special member of your own family, what qualities or perspectives do you hope they’ll grow into as they begin their journey in this field?

I see great days ahead for the field of Behavioral Optometry, and especially in the Vision Therapy realm.  I was privileged to hire my son, Reagan.  It was amazing to see that, through the training courses now available, he was seeing patients and had a far broader base than I did all those years ago.  Just as each generation stands on the shoulders of those who have preceded, with knowledge now so readily available on the internet, new therapists have access to decades of valuable information previously confined to a few. 

You’ve had a front-row seat to how VT changes lives. Is there a particular patient story that still stays with you? One that reminds you why you do this work?

Oh My!!! There are so many stories.  Often, I will look into the eyes of my patients and say, “ What are you going to teach me today?”  The younger ones will laugh, look at me funny, and remind me that I am the therapist.  To which I will reply, “But it is your brain, and I cannot see into your brain. So you are going to make me a better therapist, and what you and your brain teach me today, I will be able to use to help others.”

I do remember a young lady, 15 years old, whose dad, with tears in his eyes at the end of therapy, told me, “You have given me the daughter I always thought I had.”  This young girl made such remarkable strides that, after being in Special Education and IEP classes all her life, she tested out of them at the end of vision therapy. 

After years of teaching, mentoring, and changing lives in the therapy room, what does it mean to you now, personally and professionally, to be a vision therapist?

Again, this is such a great question.  So, let me ask a question in return. Many of our patients come to see us once a week for any wher to 45-60 minutes.  During that time, they are performing their weekly VT activities.  Do we believe that doing this will change their lives and their futures?  Of course, we do,  we have all seen and have our own stories of lives that have been changed by Vision Therapy.  Now think of how long we are in the therapy room as therapists.  Some of us are working 4-5 days a week, 25-40 hours per week.  We participate in the activities and the process.  So if we believe that one hour a week will change a life, how can we not believe that it will change our own?  I am not the same person I was when I started or even 10, 5, or 1 year ago.   I love who I have had the opportunity to become, but I am more excited about who I am yet to be.   Then I will be able to help someone so much more effectively than I can now.   That is what excites me. 

Lastly, Emergent has an exciting surprise in store for the upcoming OVDRA Annual Meeting. What can you tell us?

I love OVDRA and the gathering of so many passionate people and highly accomplished professionals.  But we cannot always attend every session, and most sessions do not lead to interaction or collaborative learning. So at the Emergent booth, we are going to solve that.  We have set up half of our booth as a therapy room, where Robert and I will demonstrate some of our core activities.  Everyone is welcome to come and join us.  We will learn together ways to make these sessions more effective in our therapy rooms. Plus, as a bonus, you will get to meet Reagan, the next Smith to fall in love with Vision Therapy and all of you. 

Closing Thoughts From Robert: A great thanks to James for taking the time for this interview. His insights reflect not only a lifetime of experience in vision therapy, but a genuine passion for the people we serve and the profession we continue to build. Beyond the roles, the teaching, and the global impact, what stands out most is who James is at his core, a clinician who listens, a mentor who lifts others up, and a lifelong learner who continues to evolve. It’s been a privilege to not only learn from him, but to call him a friend. Wishing James and his wonderful family continued health, happiness, and many more years of inspiring the next generation of vision therapists.