VT Works

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

I am currently the Lead Vision Therapist at Denver Vision Therapy, where I play an active role in delivering and overseeing patient care within a developmental optometry setting. In addition to my clinical responsibilities, I am engaged in ongoing professional development through a mentorship program with James Smith. This mentorship is focused on advancing my skills in developmental optometry, deepening my clinical reasoning, and refining my ability to approach complex cases. My goal is not only to continue growing as a clinician, but also to become a trusted resource within the organization, someone colleagues can turn to for insight, collaboration, and guidance.

You’ve now been a COVT for five years. How has your approach to vision therapy evolved from when you first got certified to now?

When I was first certified, my approach to vision therapy was very structured and protocol- driven. I focused on following established programs closely and often approached treatment by addressing symptoms rather than fully integrating the underlying systems. At that stage, I was intent on demonstrating competence, which led me to rely heavily on doing things “by the book.” Over time, my perspective has evolved significantly. With experience, I’ve come to appreciate that progress is not always linear—getting from point A to point C does not always require a rigid A–B–C approach. I now prioritize understanding how visual, sensory, and neurological systems interact, and I use that knowledge to guide more flexible, individualized treatment strategies. This shift has allowed me to become a more adaptive and responsive clinician. I am more willing to explore different approaches, think critically in the moment, and tailor therapy to the unique needs of each patient. Ultimately, my growth has been in moving from strictly following protocols to applying clinical reasoning in a dynamic and patient-centered way.

You mentor multiple VT candidates each year. What separates a good vision therapist from a great one in your eyes?

In my experience, becoming a great vision therapist requires more than strong foundational knowledge, it requires genuine passion and a commitment to continuous growth. While clinical skills and procedures can be taught, what truly distinguishes an exceptional therapist is the drive to understand, adapt, and go beyond the basics. A good vision therapist can competently follow protocols and implement treatment plans. A great one, however, is deeply invested in their patients and the impact of their work. They are curious, motivated to keep learning, and consistently seek to refine their approach to better meet individual patient needs.

The candidates I mentor who stand out most are those who are not solely focused on achieving certification, but who demonstrate a sincere passion for the work they do every day. They are driven by a desire to help people and to make meaningful, lasting changes in their patients’ lives. That level of purpose and engagement is what elevates a clinician from good to truly exceptional.

For vision therapists working toward certification right now, what would you tell them to focus on beyond just passing the exam?

For vision therapists working toward certification, I would encourage them to focus on far more than simply passing the exam. Certification is an important milestone, but true clinical growth comes from developing a deeper understanding of the patient as a whole.Expand your knowledge beyond vision therapy by learning about other body systems and how they interact with visual function. Understanding the broader sensory, neurological, and physiological connections will strengthen your clinical reasoning and improve patient outcomes.

It is also essential to truly understand the why behind the procedures and activities we use. Rather than memorizing protocols, focus on the purpose, expected outcomes, and adaptability of each intervention. Ask yourself how you can modify and individualize an activity to meet the needs of different ages, diagnoses, and functional abilities. Networking is equally important. Build relationships with other professionals, seek mentorship, and engage in study groups or continuing education opportunities. Some limitations in practice are inevitable, but often the greatest limitations are the ones we place on ourselves by staying only within the minimum required knowledge. Growth happens when you remain curious, flexible, and committed to expanding your understanding beyond what is simply necessary to pass an exam.

As Lead Vision Therapist, how do you balance managing a team while still maintaining your own clinical growth?

Balancing team leadership with my own clinical growth is an ongoing and intentional process. As Lead Vision Therapist, my instinct is often to prioritize supporting my team, sometimes at the expense of my own development. However, I’ve found that a strong, engaged team actually reinforces my growth in meaningful ways. My team regularly asks thoughtful questions and challenges our clinical approaches, which fosters deeper learning and keeps our work dynamic. This collaborative environment encourages continuous reflection and growth at every level. Additionally, they are highly supportive of my professional development and consistently encourage me to pursue opportunities that enhance my clinical expertise.

Outside of the clinic, I remain committed to lifelong learning by reviewing current research and literature—not only in vision therapy, but across related sensory and interdisciplinary fields. I also participate in study groups and attend trainings whenever possible. By integrating these efforts, I strive to lead by example, ensuring that both my team and I continue to grow together while maintaining a high standard of patient care.

With a background in forensic psychology, how do you see behavior, perception, and patient response differently than someone without that training?

With a background in forensic psychology, I approach behavior, perception, and patient response through a broader and more nuanced lens. In addition to reviewing clinical history and chart information, I begin forming an impression of the patient before they even enter the clinic.

Subtle observations—such as how a patient or their parent arrives and interacts with their environment can provide valuable insight into behavioral patterns, emotional state, and overall functioning. As I engage with the patient, I pay close attention to both verbal and nonverbal communication, including body language, affect, and responsiveness. My training in forensic psychology, particularly in abnormal child and adult psychology, has equipped me to assess mental states, communication styles, critical thinking, and behavioral presentation in a comprehensive way. I evaluate the individual as a whole, rather than focusing solely on isolated clinical findings. I also recognize that perception is inherently subjective. Even when two individuals experience the same event, their interpretation, processing, and recall will differ. This understanding allows me to tailor my communication more effectively, helping patients articulate their experiences in greater detail. In turn, I am able to explain visual system function and dysfunction in a way that is more dynamic, personalized, and meaningful to each patient.

You’ve presented on complex topics like unilateral spatial inattention and egocentric localization. What draws you toward these more challenging cases?

I have always been drawn to more complex cases because they challenge me to think critically and move beyond conventional approaches. These patients require a deeper level of analysis, where I must consider not only the clinical presentation but also the individual’s unique needs and how multiple systems may be interacting. I value the opportunity to collaborate with colleagues on these cases, as it often leads to more creative and effective treatment strategies.

Complex conditions such as unilateral spatial inattention and egocentric localization push me to continually expand my clinical reasoning and adapt my approach in real time. What I find most rewarding is the ability to think “outside the box” and tailor interventions specifically to the individual. These cases rarely follow a predictable path, which allows for innovation, flexibility, and truly personalized care ultimately leading to more meaningful outcomes for the patient.

How has stepping into a leadership role changed the way you communicate with patients, parents, and your team?

Stepping into a leadership role has refined and expanded the way I communicate with patients, parents, and my team. Having held leadership positions throughout my career—including roles in retail management, as a state park officer, and as a trainer within retail and financial institutions—I developed a strong foundation in adapting communication styles to meet diverse needs. That experience has been invaluable in my current role.

As Lead Vision Therapist, I’ve made a conscious effort to foster clear, concise, and open communication within my team. I believe learning should be continuous and collaborative, and I actively encourage team members to ask questions, challenge assumptions, and explore the “why” behind our clinical decisions. This approach promotes deeper understanding and professional growth across the team. With patients and their families, my communication is highly individualized. I tailor my approach based on each person’s needs, abilities, and experiences. For example, communicating with a child who has a developmental disability requires a different strategy than working with a child in an advanced academic setting. Similarly, adults present with diverse backgrounds and conditions—an individual recovering from a traumatic brain injury requires a different approach than someone experiencing a sudden onset of strabismus. Adapting my communication in this way helps build trust, improve understanding, and ultimately enhances patient outcomes.

You’ve been involved in study groups. How important is collaboration in a field that can sometimes feel very individualized?

Collaboration is essential in a field that can often feel highly individualized. While each patient presents with unique needs, there are frequently underlying patterns and similarities that become clearer through shared perspectives. Participating in study groups creates valuable opportunities to exchange ideas, explore new approaches to clinical activities and procedures, and learn from the experiences of others. These discussions not only enhance how we manage current cases, but also support ongoing professional growth and development. Ultimately, collaboration strengthens clinical reasoning, encourages innovation, and helps ensure we are consistently providing the highest level of care to our patients.

At the end of a long or difficult day, is there something that reminds you why this work matters?

At the end of a long or challenging day, there are several things that remind me why this work truly matters. First, my team plays a significant role. They remind me that my impact extends beyond patient care. I am also helping shape developing vision therapists as both clinicians and individuals. Much of what we learn and apply in the clinical setting carries over into personal growth, reinforcing the importance of understanding and valuing each person as a whole.

With my patients, I am continually reminded of the meaningful changes this work can create. Developmental vision therapy has the power to help individuals of all ages regain confidence, independence, and a sense of identity. I’ve seen patients transform in ways that extend far beyond visual function—from a child gaining the confidence to succeed both academically and socially, to individuals pursuing lifelong goals that once felt out of reach. Some of the most impactful moments come from working with patients who have faced significant challenges, including those recovering from brain injuries or struggling with complex visual dysfunctions that have affected their quality of life. Being able to help someone better understand their experience, regain function, and shift their perspective is incredibly meaningful. Ultimately, what drives me is the opportunity to make a lasting difference in someone’s life. If I can help a patient rediscover confidence, find hope, or feel understood when they previously did not, then I know I am fulfilling my purpose as a therapist.

Closing Thoughts From Robert: A big thank you to Michelle for taking the time to complete this interview and thoughtfully share her perspective. What stands out is not just her clinical growth, but the way she has evolved from following structure to truly understanding the patient in front of her. That shift, from doing things correctly to doing them meaningfully, is where good clinicians become impactful ones.

Her approach is a reminder that vision therapy is not static. It demands curiosity, adaptability, and a commitment to growth well beyond certification. Whether mentoring others, leading a team, or navigating complex cases, she brings an intentionality that reflects both her experience and her purpose. At its core, her work highlights what makes this field so powerful: the ability to give patients back confidence, independence, and possibility. And in doing so, Michelle is helping shape what vision therapy looks like moving forward. Please join me in wishing Michelle all the best as she continues her march forward!