An expert’s view on telepractice!
COVID-19 has upended our world uncountable ways, and like many people out there, I am now working from home. But upheaval breeds change, so like many of my colleagues, I have embraced teletherapy as a viable option to continue supporting the families and children with whom I work. As a speech therapist, I am lucky; telehealth has always been a valid and effective service delivery method. I just never thought it would be for me…
I am a self-identified naturalistic, child-led therapist, that recognizes the power and importance of meaningful interactions to support learning and development. I use my physical presence, a child’s sensory preferences, and the environment as tools in my clinical tool box. I was open to teletherapy, as we all have to be, but given the nature of my practical approach, I wondered how it could possibly work?
For weeks now, I’ve stumbled through different telehealth therapy platforms, software programs, webinars and journal articles. Telehealth forced me out of my comfort zone back up the steep and uncomfortable learning curve that is the experience of any nascent clinician. I’m not here to tell you how to do teletherapy or enlighten you with any life-changing teletherapy hacks. If that’s what you are looking, there are better places I can direct you. What I can share with you is what I’ve learned as a novel teletherapist, because the curve has been steep and precipitous. While I’m not sure if I am through the other side yet, I can say with certainty that teletherapy works, and there are benefits to it above and beyond traditional face-to-face therapy sessions.
Parent coaching IS therapy. As an SLP that works primarily in early intervention, I focus on parent coaching. My mantra has always been to empower caregivers and I find myself reminding families ad nauseum that children learn best in their natural environments, with their primary caregivers. Still, it can be difficult to shake a family’s expectation that as the therapist, I should be the one “doing the work” (we all know the family who at week 5 of therapy asks innocently, “when the therapy is going to start?”). In teletherapy I have no choice. I cannot just model and demonstrate. I have to articulate - clearly. Moreover, I get immediate feedback from families if they are implementing and understanding the strategies as envisioned.
The benefit of the natural environment. My home was not well-suited to this working from home culture I’ve been thrust into. But my husband has graciously gifted me the kitchen table and while it in no way feels like my natural environment, it is decidedly more natural for my clients. Our hypothetical prompt - “Try it during snack time” - takes on a whole new meaning when we’re in session on the kitchen counter during actual snack time. The power to get involved in a family’s natural routine and day-to-day activities is endless. And it’s impactful.
Technology as a useful tool! I’ve had to step back from my regular rant about the negative impact of screen time on the minds of young children. Not all screen-time is bad screen-time, the key is avoiding passive, mindless use. Active engagement through a screen - with a specific focus on contingent responses - is a valuable and useful tool to supporting both children and their parents in direct therapy. And the games! The apps! There is so much out there. I could have been saving the environment by reducing the paper resources I typically go through. Not to mention the accidental rips, coffee spills or giving away your last hard copy!
Ultimately, what I have realized is that therapy is therapy, independent of venue. The clinical skills transfer, kids surprise you with their enjoyment of the simplest activity, and perhaps most importantly, this “new” way of providing therapy has forced me out of my comfort zone in all the best ways. I’m feeling energized by the opportunity to create again. Change is hard, but it is always good. Thank you to therapists that lay the groundwork before me and thank you to the families willing to give this a try!