Caseload vs. Workload: Why Your Therapy Schedule Needs Both Numbers

"How big is your caseload?" is the question therapists ask each other, and it's the wrong one — or at least, half of one. Eighteen children in a two-mile radius with standing morning slots is a lighter job than twelve scattered across a county with three IFSP reviews due. The first number is caseload. The number that predicts your Tuesday nights is workload — and professional associations across OT, speech, and school-based practice have been pushing this distinction for years, because caseload-only thinking is how reasonable-sounding assignments produce unreasonable weeks.

What workload actually counts

Workload is everything the caseload generates:

• Direct sessions — the visible part: frequency × session length per child.
• Drive time — for home-visit therapists, routinely 25–40% of the working day, and completely invisible in a caseload count. Two identical caseloads with different geography are different jobs.
• Documentation — notes, progress summaries, the backlog you're pretending isn't there (we wrote about that too).
• Meetings and evaluations — IFSP reviews, team meetings, assessments: hours with no session attached.
• Coordination — the texts, the reschedules, the "quick question" calls.

Compute your real number once

The exercise takes twenty minutes and reframes everything. For one honest week: sessions delivered × average length + actual drive time + actual documentation time + meetings + a fair guess at coordination. Divide by five. If your workload day is 9.5 hours against an 8-hour job, the gap isn't a personal efficiency failure — it's arithmetic, and arithmetic is what you bring to a supervisor when the caseload conversation happens. "I have 18 kids" is a shrug; "my current caseload generates 47.5 hours" is a case.

Where the recoverable hours hide

You can't compress a 45-minute session, and you shouldn't compress a note. The two big compressible pieces:

Drive time — the same visits in a smarter order can return 30–60 minutes a day; it's the largest lever most therapists never pull because sequencing five houses around naps and windows is miserable to do by hand. (The math of it: how many clients can an EI therapist see in a day?)

Recovery time — cancellations, reschedules, and the pacing scramble at month-end are workload with no client attached. The cancellation playbook is workload reduction wearing a scheduling costume.

This is precisely the layer Casedaisy works on: it plans each day as a driving route rather than a list of times, paces authorizations so month-end doesn't spike, and turns cancellations into two-tap recoveries — attacking the workload while leaving the caseload (the kids, the care) exactly as big as your heart wants it.

FAQ

Is there a "correct" caseload size for EI or pediatric therapy? No universal number survives contact with geography. The honest answer is workload-based: the right caseload is the one whose generated hours fit the job you're paid for.

How do I track workload without making tracking itself a workload? Byproducts beat diaries. A session log with times and a mileage log (free tracker here) already contain most of your workload data — you're just choosing to read them.