Teletherapy: What I’d Wish I’d Known When I Started

Guest Post:

It seems that for the immediate future, teletherapy will be the new normal. 

In addition to adjusting to social distancing and shelter-in-place, many therapists are now being asked to practice our profession using a completely new and unfamiliar delivery model. And it can be intimidating. Many therapists may be saying to themselves: “I didn’t sign up for this!”

This is totally understandable. As a current teletherapist who’s also spent my career working in a variety of settings, I know this isn’t a welcome change for everyone. However, there are some very basic strategies you can do at home to increase your comfort level and adopt quickly. 

These are a few of the things I’d wish I’d know when I started. 

1. It’s an Adjustment - But You Will Adjust

As with many things in life, keeping an open mind and being receptive to new experiences is the best attitude you can have going into teletherapy. Know that while you're venturing into new territory, this will ultimately help sharpen your craft and make you a better therapist. 

So take it easy on yourself and accept that this may be a multi-step process. It’s a tired cliche, but once you learn to ride the bike you’ll wonder why you were so nervous to start pedaling in the first place. Consider your own practice rhythm, how you operate, provide feedback, and take progress notes, and try to make the smallest changes to your daily routine possible. 

As therapists, our goals are always the same: helping our clients achieve their speech and language goals. The only thing that’s changed is the modality of communication. But remember, you’re still speaking with your clients face-to-face. You’re still practicing repetition, corrections, and cues like you were before. You’re still providing helpful strategies and exercises. And at the end of the day, you’re still you. Teletherapy won’t change this. You were a fantastic therapist before this pandemic, and you’ll continue being one during and after. 

2. Practice in Front of the Camera

Even Hollywood A-listers do several dress rehearsals before the camera starts rolling. That same principle applies to us. Practicing in front of the camera will help you feel less awkward and more natural. And ultimately when we’re comfortable, our clients are comfortable, and this leads to better, more productive therapy sessions. 

Start video chatting more with your friends and family. Do a practice run with your colleagues. And if you’re not the most tech-savvy person (like me), one way to feel more relaxed is to make sure you understand the user interface of whichever video chat application you’re using (e.g., sharing your screen, the muting feature, in-app chat features, etc). 

Speaking personally, I’m also more confident in sessions when I feel more confident. And this usually means having an air of professionalism. I often dress up just as if I was attending a typical appointment. This helps me get in the right headspace (although pajama bottoms are totally allowed). 

And finally, try to tidy up your therapy space :). Some platforms have virtual backgrounds - try them out for a fun way to engage pediatric clients in conversation, or to hide any messes in your busy home. Accessing materials will be more efficient if your space is clutter-free. Check that the windows or blinds are closed for privacy, there’s no ambient noise from dogs or kids (this one is tough), your phone is on silent, and the light is brightening your face, not shadowing it. 

3. Use Teletherapy To Your Advantage

I’m a huge proponent of parents and guardians being actively involved in their child’s speech and language progress. Many studies have explored the impact and effectiveness of “parent-implemented intervention.” One study in particular found that not only did parents have a positive impact on their child’s verbal and nonverbal communications skills, but when it came to understanding language, parents were just as effective as their therapist!

As a school-based therapist, it can be hard to get parent’s attention and ensure that their reinforcing best practices at home. We often only get a few minutes of their time in the lobby after a session, or during an annual (Individualized Education Program) IEP meeting at school. 

One of the biggest benefits of teletherapy is that it can create stronger parent-therapist relationships. Often time, the parents join the child during their session or are in the same room. This makes it considerably easier to engage parents and educate them on how they can promote communication skills at home. Establish early buy-in for families by giving positive reinforcement for any big or small wins that happen in a session!

4. Your Approach May Need Some Tiny Tweaks - But None that You Aren’t Equipped to Handle

Your cues and feedback style might become slightly more reliant on verbal instructions. Of course, many online platforms have screen-sharing and you can always provide visual cues through the camera as well. 

Tactile cues can be tricky - if you’ve got a parent on-board, you might loop them in and walk them through clear, step-by-step directions on when and how these cues can be used. Activities meant to help regulate your pediatric clients with sensory needs are great things to coach parents on - try to see if families can get ready 5-10 minutes before a session with one!

Don’t be afraid to lean on your community! SLPs love to share, and there’s a good chance that someone else out there has dealt with a similar situation. I firmly believe that, in general, shifting to teletherapy is likely to improve your clinical skills. With some adjustments (and give yourself some grace and time to make those adjustments), you might find that your clinical input actually becomes more efficient. 

About Leanne Sherred, M.S. CCC-SLP:

Leanne calls Austin, Texas home but studied Speech and Hearing Sciences at the George Washington University in Washington, D.C. and gained her Master's in Speech-language pathology from Northwestern University in Evanston, Illinois. She has worked in pediatric outpatient clinics, schools, early intervention, and home health. As many SLPs do, she found working with students, patients, and clients to be her favorite part, but dreaded the paperwork headache of insurance submissions and SO many denials. So with the combined brain power of her husband, Nick - who has experience in the healthcare tech industry - and two other teammates, the vision for Expressable was created. A telepractice company, Expressable envisions a modern and affordable way for anyone who needs speech therapy to access it - with all the superb convenience of therapy at home and without breaking the bank.



Bridget is an ASHA certified, practicing speech-language pathologist. She is passionate about providing parents with information on child speech and language development as well as provide functional, easy activities to do at home! Parents have the power to make a real difference. Follow Bridget at Facebook and Pinterest for more fun!

Author of  child language development eBook series


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