Telehealth Therapy

Telehealth technology and telerehabilitation have been used since 1998 with their pervasiveness increasing over the past two decades as research demonstrated telehealth’s effectiveness in several types of clinical settings. Many common conditions generally diagnosed in the mental, occupational, speech, and physical therapy categories have been successfully treated through telehealth technology.

While telehealth technology provides benefits to the clinician and client, successful telehealth sessions are dependent on factors such as client use and acceptance as well as technological reliability and constant iteration to keep current with new advances and practices and the changing tastes of consumers.

Advantages of telehealth technology

From a clinical perspective, excellent client outcomes are always a great motivator for the adoption and continuous use of telehealth technology. For the past few decades, clients have generally embraced teletherapy and treatment.

According to one elemental therapy study, client response to telehealth sessions was generally positive.

“It’s splendid once you grow into it,” one marriage and family telehealth client stated.

“When you go to an office, it’s a bit intimidating … with telehealth we have stayed in a known environment which makes therapy a bit less overwhelming,” another client noted.

“I love the fact that I do not have to go into any particular building physically in order to have a soulful discussion about my issues and challenges,” one participant said.

This sentiment is reflected in a separate Harris poll from 2021 which indicated that 84% of U.S. patients prefer a telehealth option and that offering online access and telehealth could be the key to patient and client loyalty for practitioners.

In addition to a client’s willingness to utilize and enjoy new technology, therapists may be further incentivized on the business/operations side to use telehealth technology as it can grow their practices. With telehealth technology, therapists can expand their service area to remote or rural areas and reduce cancellations and no-shows – a common issue with in-person visits.

Additionally, a HIPAA-compliant video conferencing platform integrated with an EHR can keep administrative tasks at a minimum while providing group practices and solo practitioners the chance to offer telehealth technology to their clients without a major financial burden.

Concerns with telehealth technology

While the advantages of telehealth technology seem clear to most therapists and clients, some have expressed concerns about the potential lack of privacy and technological reliability.

“Sometimes, it can be hard to communicate with the therapist when there is lag time or connection issues,” one client participant commented during a study.

The good news is relatively simple steps can be taken to address these concerns. With a reliable, secure, and HIPAA-compliant video conferencing platform, updated personal equipment, and the application of a few best practices, you can ensure a smooth teletherapy session with your clients.

Video conferencing vendors

While numerous teletherapy tools are available on the market, not all of them guarantee the same level of efficiency or security. When vetting the best solution, you’ll need to understand the technical requirements (ie., minimum Internet speed) and whether clinicians need to download software to a computer or from the cloud. Another important factor is whether the video conferencing program is HIPAA compliant.

While these questions establish a solid foundation for choosing a vendor, we cover this topic at a deeper level in our telehealth technology class.

Technological reliability and privacy

When it comes to reliability, both the client and clinician need to be aligned in using solid technology for an optimal experience.

Recommended equipment for a smooth telehealth session includes:

A newer computer
Updated browsers
A fast Internet speed
- Minimum download 10 MB/sec
- Minimum upload 10 MB/sec
- Latency: Ping of 25 or less
A built-in or external webcam
A built-in or external mic

Therapists and clients can also apply best practices to ensure a hassle-free experience each time.

Avoid using other internet applications, devices, or streaming devices on the network during the session (e.g. avoid streaming music or movies, having multiple Web pages open at the same time, downloading large files, or updating a computer.) Even other individuals on the same WiFi network using bandwidth may affect the video call.
Use a wired connection. Connect a wire directly to your router modem instead of using a WiFi connection.
Ensure your cable for the wired connection is properly connected and not loose or damaged.
Disable the WiFi if you connected the wire from your computer to the router. On Mac OS, even if you connect wire, by default the WiFi is used for the connection.
Disable or remove unused WiFi. On Mac OS, if there are other existing connections set up on the computer, it will try to connect which will cause temporary disconnection from your current network which will affect your session.
Move your computer closer to your router if you must use a WiFi connection. Ideally, your router should be in an elevated position (not on the floor) and not blocked by walls or other devices, etc.

If these prevention tactics don’t work, you still have a few options. Most immediately, you can restart your router or restart your computer or remove any sources of interference.

Hardware requirements and best practices along with audio, video, or troubleshooting tips can be posted on your practice’s website or shared via email or text before your sessions. Also, encourage testing the connection about 10 minutes before each session and informing clients of a backup plan such as a phone call or chat in the off chance the technology falters.

Client engagement with telehealth technology

While telehealth technology is a convenient and safe way for providers to connect with patients, it also offers some other advantages such as the ability to boost engagement through features like screen sharing. Screen sharing gives access to clients on an as-needed level and allows clients to manipulate a game online, for example.

Not all video platforms offer this type of technology. TheraPlatform allows for this type of critical interactive therapy while other EHRs allow clients to only see what the therapist is sharing on the screen. This type of technology is especially helpful for speech therapy where clients can play games, do puzzles and follow verbal directions. Occupational therapists can use this therapy to work on visual tasks.

In-session whiteboard options and in-session video play are other features used to engage clients, especially when it comes to therapeutic exercise. Utilizing an interactive whiteboard can be useful in mental health therapy, for example, in that it allows therapists and clients to work together in mapping out thought processes, connecting feelings to the thoughts that precede them, and identifying patterns.

Collecting feedback for continuous improvement

While initial patient buy-in and properly implementing technology can provide a smooth session, collecting feedback from the client is another layer in improving your sessions and outcomes. The Telehealth Usability Questionnaire assesses the telehealth technology experience including reliability specifically around error messages and the ability to recover quickly if a technical error occurs. It can be sent out via a survey or completed as a worksheet and can be used as a foundation for assessing telehealth services and iterating based on need. The TUQ assessment or other similar assessments specific to telehealth can also provide ease of use, usefulness, and satisfaction data around teletherapy.

Telepractice or the use of video or telecommunications technology to deliver speech therapy to a client in another location, has spiked in popularity over the past several years.
Telepractice was approved by the American Speech-Language-Hearing Association (ASHA) as an appropriate method of service delivery in 2005 and was added to its directory of special interest groups (SG-18) (2011.)

“Telepractice is an appropriate model of service delivery for the professions of speech-language pathology [and audiology]. Telepractice may be used to overcome barriers of access to services caused by distance, unavailability of specialists and, or subspecialists, and impaired mobility”.(ASHA, Speech-Language Pathologists Providing Clinical Services via Telepractice: Position Statement [Position Statement], 2005).

As an effective and ethical mode of treatment, telepractice benefits clients by providing them with easy accessibility, flexibility, safety, efficiency, and privacy in their sessions. Therapists can enjoy these benefits as well with the bonus of lower overhead and the ability to expand their practices beyond their local markets.

Who provides telepractice or online speech therapy services?

Several types of therapists or professionals with different specialties can use telepractice in their businesses. Examples include:

Speech and language pathologists:

To provide speech and language services to rural schools,
To provide voice, aphasia, or cognitive therapy to satellite clinics from hospitals or private practices or to individuals in underserved or remote areas,
To provide speech, language, or cognitive services to remote home health agencies, and
To consult and train individuals or families, for instance, communication coaching, augmentative and alternative communication (AAC), early childhood parent training, etc.

Audiologists:

To provide hearing screening,
To provide infant hearing screening,
To provide hearing aid training, etc.

Equipment and technology

Security and functionality are key considerations when transitioning to and using telepractice for your business.

Hardware

Computer
Web camera with 15 FPS (frames per second) capture rate (built-in or separate)
Headset with attached microphone (analog or USB)
High-speed internet connection (150 kbps minimum)

Telepractice Platform

In addition to basic hardware, teletherapists need a video conferencing tool. Some teletherapists use Skype or other general-use video conferencing tools to provide online speech therapy (telepractice). However, they typically do not comply with HIPAA and may put your clients at risk for privacy and confidentiality breaches. Additionally, this type of video conferencing software provides only basic chat and screen-sharing functionality, limiting the ability for the client and therapist to change and exchange materials simultaneously.

Candidacy

As revolutionary as telepractice is, some clients may present physical or cognitive challenges that prevent them from benefiting from telepractice (online speech therapy). Sustaining attention, following simple commands, and manipulating a computer mouse are some of the physical and cognitive requirements for participating in teletherapy. Teletherapists should develop their protocols to determine candidacy for telepractice.

The environment of Telepractice Session

To provide high-quality telepractice (online speech therapy), the therapist should consider the environment and the location, of the client and the clinician. Light, distractions, noise level, comfort, and safety should be evaluated and modified as needed before beginning a session.

Use of Facilitators

Younger children working from home may need the supervision of their parents, especially at the beginning of the program. The parent may need to teach the child basic computer skills for speech telepractice and prepare the child for his or her sessions. Children who receive speech telepractice services from their school will need supervision as well. Facilitators may include a teacher’s aide or another type of support personnel on-site.

The aide may:

Escort children to and from therapy sessions
Set up equipment for sessions
Troubleshoot as needed
Control child’s behavior as needed and
Communicate with on-staff teachers and staff about scheduling and changes.

Telepractice speech therapy activities or therapeutic materials

The good news about teletherapy is that it provides numerous opportunities to engage clients once the basics of telepractice have been established. Some EHRs, like provide games and apps as part of their plans. Numerous speech therapy game resources make it easy to incorporate activities into your speech sessions as well. PBSkids.org, Boomlearning, and Funbrain.com are a few examples. For more ideas, check out our video below.

While it’s fun to experiment as you become more experienced with telepractice activities, there are some tried and true activities you can use as you ramp up.

Icebreakers are generally a great way for group therapy clients to open up in a safe environment and develop trust with other members of the group as well as the therapist. And it’s generally accepted that better relationships with therapists lead to better outcomes. Examples of icebreakers or games include Hangman, Tic-tac-toe, or Pictionary.
Telepractice speech activities aren’t reserved for the beginning of each session. Taking brain breaks can be another way to incorporate activities during sessions for the benefit of the client. Short brain breaks simple exercises, are believed to improve client brain function, retention, attention span, engagement, and motivation while reducing disruptive behavior. They can include actions like humming, dancing, or 5-minute-long scavenger hunts. Looking for more brain-break ideas? Watch our video to see our favorites.
Language and social skills clients could also benefit from therapy games. Through activities, clients can develop emotional skills and empathy through games like Emotions Bingo and Taking a Break to Calm Down. Conversation skills can be developed through telepractice activities like Making Connecting Comments or Think It or Say It. The methods through which these sessions are conducted are numerous as well and can be accomplished through handouts or by watching YouTube videos. Short animated films are, indeed, a total hidden gem in the pediatric teletherapy world.
Early intervention clients can also benefit from telepractice. While some therapists worry telepractice may not be a good fit for their 0- to 3-year-old clients, engaging with parents during your sessions is a great way to improve outcomes. Building relationships with parents helps you:
Understand what’s important to the parents
Generate treatment ideas
Build accountability
Reduce the amount of time you spend on planning sessions

To maximize the outcomes of these sessions, consider sharing resources with the parents around the aspects of telepractice speech therapy including technology, the home environment, parent involvement, and the child’s behavior. Teletherapy changes the dynamics of a therapy session and as a therapist, you have the power to make it a positive change. Managing expectations upfront can help the family feel comfortable and encourage open communication.
Looking for tips on how to maximize your time with parents, see our interview with Dr. Todd Houston below.

Documentation

As you consider and use telepractice, ASHA advises that teletherapists provide clients with an informed consent form before conducting speech therapy online. Clients should also be informed regarding:
Differences between telepractice and traditional therapy,
Potential confidentiality issues, and
Descriptions of the equipment involved.
LicensureCurrently, speech and language pathologists providing telepractice or online speech therapy must be licensed in the state of their client’s residency.

Marketing

Because of the growing popularity of telepractice, you may consider marketing this aspect of your practice. Creating a digital presence is a great place to start and includes creating a website with regularly produced content that people would trade for an email address and promoting your business on social media.
Traditional or offline marketing strategies are also a good way to generate business. Printed and promotional products, networking, and referrals along with partnering with a trustworthy telepractice platform that builds client trust are excellent ways to help advertise your business.

Telemental Health – What’s All the Buzz About?

You’ve probably been hearing a lot lately about telehealth or telemental health. You might be a little put off by the idea of virtual service delivery. You might even be a little curious. So, what is all the buzz about?

Telehealth, in all its forms, is a hot topic in the provision of health and mental health care. It is quickly becoming an accepted mode of service delivery, especially for clients who may be geographically isolated. The service has been around for many years. Backed by substantial research showing its efficacy, telehealth is now gaining ground in the mental health world as an alternative to face-to-face therapy. Telemental health is also becoming more accepted by insurance companies and third-party payers.

Driven by technology and accessibility needs, telehealth, in all its many forms, is opening doors for people to access healthcare like never before. And for healthcare providers, it is providing an innovative and cost-effective way to reach clients previously inaccessible.

You might be thinking, “Sign me up!” Before you dive in head first, it’s important to understand exactly what it is. And what it’s not.

What Is Telehealth?

Telehealth is one of over 40 terms used to describe the online delivery of health services. Depending on the discipline and the organization, telehealth may be referred to as telemental health, teletherapy, online therapy, video therapy, asynchronous or synchronous therapy, telemedicine, or something else. In some ways, these terms differ. Sometimes they are used interchangeably.

The fact is, there are no one, clear, universally recognized term used by all disciplines, licensing boards, or organizations.

In general, telehealth is broadly defined as the use of electronic communications to provide long-distance clinical health care and health-related education. It can also be used for non-clinical purposes such as public health and health administration activities.¹ Telemedicine most often refers to the specific delivery of remote clinical services.² In the case of providing mental health services, it is most often referred to as telemental health.

Essentially, when you provide telemental health services, you are conducting a therapy session with a client who is not in your office but rather engaged with you in some form of electronic interface. The specific type of interaction will vary but possible forms include live video, audio (phone), secure messaging, secure email, or live chat. Interactions may be live synchronous (life) or asynchronous. A lot will depend on the client’s needs, access to technology, and client preferences.

Tech Matters

You might be thinking live video means Skype or FaceTime. While these are awesome tools, they are not appropriate for the provision of telemental health. Just as in in-person therapy, you are required to maintain a client’s privacy and confidentiality. You must guard their Protected Health Information (PHI) as required by HIPAA. Skype and FaceTime do not meet the requirements for HIPAA security. The same is true for regular email and text messaging.

As a telemental health provider, you must choose technology that is HIPAA-secure and reasonably protects your client’s PHI.

TheraPlatform is a robust, full-featured, HIPAA-secure video conferencing platform designed for therapists. Choosing a HIPAA-secure platform gives you the confidence that you are doing all you can do as a therapist to provide the best level of security you can for your clients.

Know The Rules

Just as in the brick-and-mortar setting, you as a therapist have rules to follow. The provision of virtual services is no exception. Many of the same rules apply such as maintaining privacy and confidentiality, safety, and duty to warn, or informed consent. What may be different are how you address these issues. Online therapy presents different challenges than might be present in in-person counseling. For example, how will you get your informed consent signed by an online client? How will you handle an in-session crisis?

In some states, the rules for the provision of telemental health may differ somewhat from in-person therapy. As a licensed practitioner, it is imperative that before you embark on your telemental health practice, you ensure that you understand your licensing board’s requirements and that you can demonstrate compliance.

All of this talk of secure technology and compliance might have you second-guessing the idea of telemental health. Don’t let it intimidate you! Remember the old saying, “Knowledge is power.”

When you were first starting, even the idea of actually doing a session with a client was scary. The more you learned about your craft, the more competent you became. The same is true for telemental health. It is simply a new modality for providing the awesome services that you already offer clients. The more you learn about it and prepare yourself for that step, the more confident you will become and the more you will be able to reach clients who may have previously been unable to access care.

If you have questions or need more information, reach out to colleagues who are practicing telemental health. Take continuing education courses on the topic. Telemental health is here and you can be a part of the future of therapy.

Adapting Client-Centered Therapy to the Teletherapy Approach

In the mid-1900’s Carl Rogers proposed a revolutionary new approach to therapy. Up to that point, the clinician was typically seen as the expert and even authority in the therapy space. However, Rogers proposed it is the client themselves who are the true experts over their own lives and their own needs in therapy. In line with this, he taught counselors and therapists to practice client-centered therapy.

In today’s mental health treatment, another revolution is occurring as many providers are now offering client sessions through telehealth (teletherapy) approaches over secure and HIPAA-compliant video conferencing. Learn all about how you can adapt the classic principles of client-centered therapy to the modality of teletherapy:

Genuineness

Rogers said that good client-centered therapists need to demonstrate three key qualities. Chief among these is genuineness. This simply means that the therapist brings their true self to the therapy relationship. This does not mean that the therapist spends excessive amounts of time discussing themselves or their problems. Rather, it just means that the counselor is open to sharing his or her genuine reactions. Offering this leads to more open communication in the therapy relationship.

This quality can be brought into the online therapy space. Clinicians can show their real selves by demonstrating open communication and genuine reactions. Even though a video chat, clients will be able to perceive the clinician’s willingness to be themselves. It will add to their ability to be comfortable in the process of therapy, to communicate openly, and to be appropriately vulnerable.

Empathetic Understanding

Rogers also said that the clinician must convey empathy to the client. This helps to build a therapeutic relationship. It can help to validate and normalize the client’s experiences. It also helps to mirror the client’s thoughts and feelings back to them, which can allow them to reflect more deeply during the therapy process. Ultimately, this may help clients to make greater gains in therapy. It is quite easy to convey empathy to a client even over a teletherapy modality. Typically, conveying empathy can be done in many of the same ways as you would within traditional face-to-face therapy approaches.

Unconditional Positive Regard

A third major tenet of Rogers’ approach is unconditional positive regard. This is the practice of accepting the client for who they are. Along with this, the therapist gives the client support and care no matter what they are going through. Essentially, it makes therapy a place that is free from the fear of judgment. It can be very therapeutic for clients who perhaps do not receive that from other people in their life.

Just as with being genuine and conveying empathy, it is quite easy to adapt unconditional positive regard to the teletherapy approach. Simply make the therapy sessions a place where no topic is off limits and there is no judgment for any topic that is discussed. By combining this with empathy, the client will know they are accepted and cared about. Even when miles apart, these techniques will help the client to feel safe in therapy. It may even provide a beneficial corrective experience for them.

Aside from using client-centered techniques to make a safe space for your client, be sure that you are also using a teletherapy platform that will keep their information safe. The best teletherapy platforms are designed to be confidential and HIPPA compliant. This security will serve both you and your clients.

Teaching Aids for Teletherapy

In a traditional setting, a therapist has access to a variety of teaching aids, or tools, to use when working with clients. But what about when working with clients in a virtual environment? When thinking about conducting therapy online, you may find that current capabilities go far beyond video conferencing alone. You can have access to many of the same tools that you have access to in the office, just in a different format. But what types of tools are we talking about?

Types of Tools

Just as computers changed the way you do ordinary things like typing documents via a typewriter or conducting video conferences via a camcorder, they have also provided us with electronic counterparts to many of the things we may find in our office and make use of during our therapy sessions. For example, you may find using a whiteboard during your in-office sessions with clients to be rather helpful. If so, and you are considering taking some or all of your sessions online, you will be pleased to find that you can utilize an interactive whiteboard in a virtual setting as well.

If you have not used a whiteboard in your practice before, it might be worth considering. Utilizing an interactive whiteboard can be useful in mental health therapy, for example, in that it allows therapists and clients to work together in mapping out thought processes, connecting feelings to the thoughts that precede them, and identifying patterns. A whiteboard can also be used for things like brainstorming and making lists of pros and cons when working on solving complex problems with clients.

In addition to a whiteboard, another option that is available online just as it is in the office is the use of flashcards. Flashcards can be particularly useful for speech therapy. They can help work with clients on target sounds, building vocabulary, and more. In addition, other tools that are available online include scenes, games, and interactive apps, though they are not necessarily available on all platforms.

Availability

Whether you are a mental health therapist, social worker, behavioral therapist, or speech therapist, there is a variety of tools that you can utilize to enhance your therapy sessions, but not all of them will be available on every platform. And, since these teaching aids can be such useful tools when conducting therapy sessions online, it is important to include them in your decision process when considering which platform will work best for you and your clients.

Teletherapy does not need to be limited to video conferencing alone. Depending on the platform that you choose to use for online therapy, you may or may not have built-in tools at your disposal. However, if you choose a platform like TheraPlatform, you will have access to a variety of useful tools, including an interactive whiteboard, flashcards, scenes, games, and interactive apps. These tools can enhance your ability to serve your clients, so it is worth keeping them in mind when considering what platform will work best for you.

Online Marketing Strategies for Your Teletherapy Services

When you are entering the avenue of teletherapy services, you will likely be doing much of your marketing online. This will be an important part of your business as you build your client caseload. Try these online marketing strategies for your teletherapy services:

Well-designed Website

If your therapy work is going to be online, many of your customers will be looking to find you and learn about you through your website. Today, most people look at a website before they engage with any service or company. The content of your website is important to provide people with the information they need. The design of your website is equally important. People tend to quickly become disinterested in looking at an unprofessional or difficult-to-navigate website.

Make sure your website looks professional, is easy to navigate, and is visually appealing. You may want to include a description of your services, a photo of yourself, and links to other resources.

Begin a Blog

One way to market to potential clients is with a blog on your website. That blog will serve many functions. First, if you use SEO strategies, it will rank highly in searches and help potential clients more easily find your website. It also gives potential clients a better understanding of who you are and what they can expect if they work with you. A blog also gives value to your clients because you can put helpful information there that they can refer to and use. A particularly helpful blog may also become shareable on social media, which can continue to draw clients to your services.

Social Media Presence

Another helpful marketing approach is a strong social media presence across multiple platforms. Facebook tends to be the most popular platform. With this, you can post daily to reach thousands of people—both current and potential clients. You can highlight mental health symptoms, techniques for self-help, and of course, describe how your services can also help.

Twitter is another popular platform. You can use it to share information and get your services on people’s minds. With hashtags, you can get topics related to your business and even your business name trending. Use Hootsuite to easily post to both Facebook and Twitter simultaneously. You can even schedule posts, so they can go live throughout the day without your actively being on the platforms.

Offer an Incentive

One way to get people connected to your online marketing is by offering an incentive in exchange for their contact information. Once you have their contact information, you can easily reach out to remind people of your services. Popular incentives include eBooks. Alternatively, you can create and offer free resources to address any kind of mental health concern or wellness goals.

Final Recommendations

When you are marketing your online therapy work, it is important to start with a platform you can trust for your online services. Many platforms will also assist your marketing by advertising you to potential clients when they visit the platform’s main page. Of course, through all your online marketing and online therapy work you also want to use confidential approaches and HIPAA compliant.

Telepractice and the shortage of speech pathologists

According to the School Board News, schools all over the United States are experiencing severe shortages of speech pathologists. Public schools struggle not only with new hires but also with the retention of current speech pathologists. There are more and more speech pathologists leaving school settings due to high caseloads and excessive non-therapy work.

According to the U.S. Department of Labor’s Bureau of Labor Statistics (BLS), which monitors the supply and demand for more than 800 occupations, in occupational projection estimates for 2004–2014, speech-language pathology ranked 17th out of the 20 large-growth occupations that usually require a master’s, doctoral or first-professional degree. The profession is expected to demonstrate average growth (reflecting an increase of 7% to 13%) through the year 2016. By 2012, there are expected to be 59,000 unfilled positions.

In addition, there are not enough younger speech pathologists to replace those who are ready to retire. It is estimated that approximately 50% of speech pathologists, age 45 and older, will retire over the next 15 years.

The shortage of speech pathologists will continue to grow not only because there are not enough graduates, but also because the number of children diagnosed with communicative disorders will continue to increase.

The National Association of State Directors of Special Education (2003) reported that the number of disabled students is growing at a rate almost three times greater than the overall student population.

The American Speech-Language-Hearing Association (ASHA) has estimated that by 2025, there will be approximately 9.7 million Hispanic-American children with some type of communication disorder.

Moreover, children and schools that suffer the most shortages of speech pathologists are located in rural or remote geographic locations. According to a 2008 ASHA survey, the largest needs are found in the Pacific and mountain regions. Some rural schools note that they are lucky if they have one applicant a year.

Given the severe shortage of speech pathologists, telepractice is rapidly becoming not only an alternative method of delivery but the ultimate solution for schools, which for years could not supply their students with speech services (ASHA 2010).

Kentucky, Maine, Minnesota, Ohio, and West Virginia are among the states that have already turned to telepractice.

Effectiveness of Telepractice

Telepractice has been proven to be effective by more than 40 academic studies. Listed below are some of the published research studies on telepractice.

Mayo Clinic Proceedings, 72(12):1116-1122, J.R. Duffy, G.W. Werven and A.E. Aronson, December 1997: Results of the Mayo Clinic’s project indicate that “Telemedicine evaluations can be reliable, beneficial, and acceptable to patients with a variety of acquired speech and language disorders, both in rural settings and within large multidisciplinary medical settings.”

The Department of Speech Pathology and Audiology at Kent State University (Ohio) and the Department of Communication Sciences and Disorders at the University of Cincinnati (Ohio) are great research contributors to the field of telepractice. One of their research projects demonstrates that telepractice is as effective as traditional speech therapy: “Student progress reports indicated that the children made similar progress.”

Journal of Telemedicine and Telecare, Susan E. Palsbo, Center for Health and Disability Research, 2007: This study was conducted to determine if telepractice was equivalent to in-person service delivery. Results show that “post-discharge therapy and evaluation using videoconferencing are equivalent to face-to-face therapy and evaluation for post-stroke patients.”

American Journal of Speech-Language Pathology, “An Internet-Based Telerehabilitation System for the Assessment of Motor Speech Disorders: A Pilot Study,” Anne J. Hill, Deborah G. Theodoros, Trevor G. Russell, Louise M. Cahill, Elizabeth C. Ward and Kathy M. Clark, February 2006: This study explored the effectiveness of telepractice application for the assessment of acquired motor speech disorders.

The researchers of this study concluded that “the online assessment of motor speech disorders using an Internet-based telerehabilitation system is feasible. This study suggests that with additional refinement of the technology and assessment protocols, reliable assessment of motor speech disorders over the Internet is possible.”

Teaching Aids for Teletherapy

Types of Tools

Availability

Offline Marketing Strategies for Your Teletherapy Services

When you advertise offline for your teletherapy services, you will want to use a balance of traditional marketing methods and some approaches that specifically highlight your teletherapy niche. Consider using these offline marketing strategies to advertise your teletherapy services:

Printed Advertisements

A traditional marketing method is printed advertisements. These can come in various forms such as business cards, brochures, and postcards to mail out. When you design the content be sure to include information on your teletherapy services. You might want to have a description of the services, who they are best suited for, and how to connect with you on your teletherapy platform. Include a photo of yourself, so that potential clients can get an impression of who they would get to work with.

Promotional Products

Another great way to advertise your business has always been through the use of promotional products. These are items you can hand out to potential clients and referral sources. Typically, you would include your business name and contact information. Common items might include pens, pencils, and stress balls. For teletherapy services, consider something that fits the niche such as a mousepad, stylus pen, cell phone stand, screen cleaning cloth, earbuds, and adhesive phone wallets.

Building Referral Sources

Receiving clients through referral is another tried and true method. You will need to let key people in your community know about your services so that they can connect potential clients to you. The most common way to do this is by visiting doctors’ offices and hospitals. There, you can drop off information, including brochures and business cards. You can also meet with them individually or give a presentation to the staff regarding your services and the types of clients you are prepared to see.

When you are providing teletherapy services, you will want to connect with many other providers to let them know of your services, because you will be trying to reach a particular set of potential clients. Good referral sources may be social workers, hospice workers, pastors, and other members of the community that frequently interact with home-bound people. Those who are restricted to their homes or who struggle to visit traditional psychologist’s offices are prime candidates for teletherapy services.

Networking with Colleagues

There are many benefits to networking with your colleagues both in your community and at national conferences. It can be a source of support and it can be a way to market your teletherapy services. There are many providers, who are not currently offering teletherapy and when they are approached by a potential client seeking such services, they will want to refer that client to someone who does. When they are familiar with you and your services, they will refer the client to you.

Partner with a Platform

When you engage with teletherapy, you will need to use a platform you can trust, that is reliable and confidential for your clients. You can also consult with your teletherapy platform provider regarding their recommendations for the use of online and offline marketing approaches.

Online Marketing Strategies for Your Teletherapy Services

Well-designed Website

Make sure your website looks professional, is easy to navigate, and is visually appealing. You may want to include a description of your services, a photo of yourself, and links to other resources.

Begin a Blog

Social Media Presence

Offer an Incentive

Final Recommendations

How to Set Up Your Office for Teletherapy Sessions

As you look to expand your services through teletherapy (online therapy), you will be able to reach many more potential clients. Those clients will be connecting to you through the convenience of their homes. Meanwhile, you will be utilizing your office or therapy space in a whole new way. The traditional therapy setup may not immediately adapt to the format of teletherapy. To set up your office for teletherapy sessions, consider giving attention to these components:

Background

In a typical therapy session, your client would be within your office setting and able to see a variety of décor. However, with teletherapy, your clients are only seeing a limited part of your therapy space, which will be the background behind you during the telehealth counseling sessions.

It is important to set up a background that is coherent and not too distracting, but which also represents yourself in some way. Be thoughtful about your décor selection and arrangement, then consider how that background looks on-screen, before the first teletherapy session.

Lighting

For many people, the ambiance of lighting is an important component of their therapy space set-up. Many people like to keep lights low for calm or capitalize on natural lighting. When it comes to teletherapy sessions, lighting is both important and possibly challenging.

You will need to be thoughtful about having enough light behind yourself so that the background is not too dim. You will also need light in front of you to brighten your face. If you will be in a space with natural lighting, also pay attention to how different times of the day may look on-the screen to your clients. As much as possible, you want your clients to be able to see you clearly throughout the session.

Noise/Sound

While a quiet space is important for most therapy sessions, it becomes even more important during teletherapy. Without the total visual context, ambient sounds or noise can be quite distracting and potentially even distressing for clients. Make sure the space you will be using is quiet. Utilize a white noise sound machine outside your office door to help block outside sounds.

Comfort

During your teletherapy sessions, you will likely be sitting at a desk, which may feel a little different from your typical style during traditional therapy. Maximize your comfort for prolonged sitting with a desk that is the right height and a comfortable, perhaps even ergonomic desk chair. Make sure to also keep nearby any items you need to remain comfortable, such as a beverage and tissues. This will allow you to remain mostly stationary throughout the teletherapy session.

Technology

A crucial element for your teletherapy sessions will be the technology you need for communication. You will need to set up your space with a computer or laptop, webcam, and microphone, along with stable internet. When you set up these components, be sure to test them to ensure they are all working properly. You may even want to practice connecting with a friend or family member to check that your webcam and microphone settings are just right for your video and audio.

Adapting Client-Centered Therapy to the Teletherapy Approach

Genuineness

Empathetic Understanding

Unconditional Positive Regard

Telemental Health – What’s All the Buzz About?

You might be thinking, “Sign me up!” Before you dive in head first, it’s important to understand exactly what it is. And what it’s not.

What Is Telehealth?

The fact is, there are no one, clear, universally recognized term used by all disciplines, licensing boards, or organizations.

Tech Matters

As a telemental health provider, you must choose technology that is HIPAA-secure and reasonably protects your client’s PHI.

Know The Rules

All of this talk of secure technology and compliance might have you second-guessing the idea of telemental health. Don’t let it intimidate you! Remember the old saying, “Knowledge is power.”

Fitting Telemental Health into Your Practice

So, now you know what telehealth, and more specifically, telemental health, is. The question now is, how can you use it in your practice?

The awesome thing about telemental health is that it can be utilized in any number of ways in your practice. Research supports the use of telemental health with many client populations, issues, and modalities.

One caveat before we talk about ways you can use this service:

Not every client will be appropriate for telemental health services. You want to be sure that you have clear criteria and complete a thorough screening/assessment before offering the service. This step is in keeping with your clinical and ethical responsibilities as well as determining the best fit for the client and you.

Services

Here comes the exciting part! Let’s talk about the ways you can add telemental health to your practice. Some of these services may surprise you.

Telemental health is a highly effective method of service delivery for many types of clients:

Individual Therapy
Couples Therapy
Family Therapy
EAP Services
Clinical Supervision (will vary by your licensing board’s requirements)

While not considered therapy, coaching services are another increasingly common online service that may complement a therapy practice:

Personal Coaching
Executive Coaching

Integrating Telemental Health Services

There are several ways to offer these services in your practice:

You may consider offering this service to established clients with whom you already have a good therapeutic alliance.
You may choose to offer an online option for new clients.
You may choose to offer some combination of online and in-office services.

More and more, telemental health is becoming an accepted and popular alternative to in-office services. You may find clients requesting it more frequently, especially those who are highly mobile, tech-savvy, or find it difficult to get to your office consistently.

Even some insurance and EAP companies are starting to recognize the efficacy of telemental health and may cover certain types of telemental health services. When verifying benefits, be sure to ask whether telemental health services are covered so that you know whether this service is an option for your client.

As you look at the list of services, you might be wondering about determining the types of clients who you might consider for telemental health. There has been some debate as to whether telemental health is appropriate for use with higher-risk clients such as those with a history of self-harm or trauma such as PTSD. Research from the U.S. Veterans Administration has found that telemental health services can be an effective intervention for clients with issues such as PTSD and mood disorders.

What seems to be of most importance when choosing clients to work with in telemental health is the level of skill, experience, and comfort of the therapist. If you’re confident in your clinical skills and have the training and expertise, you may be more comfortable with taking on more complex cases via telehealth. Other therapists may choose to limit their telehealth practice to certain types of cases or circumstances. How you offer and utilize telemental health services is up to you and the specific needs of your practice and clientele.

The 5 Big Benefits of Telemental Health

There’s no question, telemental health is changing the way mental health services are delivered. Research has consistently proven its effectiveness in treating a vast array of mental health disorders in a variety of populations. But so have face-to-face mental health services.

Telemental health offers several advantages that traditional, in-person therapy delivery may not. And, these advantages can benefit both the client and the clinician.

Improved Access

One of the most often cited reasons for not seeking mental health care is poor accessibility.¹ This lack of accessibility may be due to a client’s geographical distance, a lack of appropriate providers in a particular region, or even a client’s inability to leave the home for some reason.

Being able to provide telemental health services can help alleviate the shortage of clinicians in a particular area. Clients can have access to more options.

With telemental health, geographical distance or location becomes far less of an issue. With relative ease, a client and clinician can connect electronically. Suddenly, the miles between them become a non-issue.

Flexibility

We live in a busy world and not everyone who wants therapy can fit appointments into a snug 9-5 schedule. Job responsibilities, families, drive time to and from appointments and other time constraints can sometimes limit how and when someone is available.

Clinicians struggle with this issue as well. Offering appointment times that work for you and your prospective clients can sometimes feel impossible. It can be frustrating and overwhelming. You want to help but you too have personal responsibilities to balance.

Clients and clinicians want the flexibility to schedule appointments on a schedule that fits their respective needs. Telemental health allows clinicians to set a realistic, flexible schedule that increases their availability.¹ Client can choose a clinician who offers availability at times that meet their needs.

Convenience

Telemental health is convenient and let’s be honest, we all like convenience. Clients can access help when they want to, how they want to, and choose a clinician who can meet those requirements. And, they can access help from wherever they are. Traveling or being home with a sick child used to mean a canceled appointment for sure. Now, clients can arrange to see their therapist no matter what life tosses in the mix. With the internet being available almost anywhere now, being able to access help when and where you want has never been easier. And, the growing population of tech-savvy clients demands it.

Comfort

For some clients, the fear of seeking mental health help and the associated stigma is very real. They may fear others finding out they’re seeking help.² Other clients may have issues with leaving their homes or feeling safe in an office setting. Being able to engage in therapy in the comfort of their home or other secure space can eliminate these barriers.

Engaging online is comfortable for many people. People are increasingly turning to the internet for their emotional and psychological needs so the idea of seeking help online is becoming more mainstream. Surveys have found that almost 80% of Americans use the internet to see mental health information.³Telemental health fits rightin with the practices people already engage in.

Cost Reduction

Telemental health can reduce costs for you and your client.

Missed appointments, repeated cancellations, and unfilled appointment slots can be frustrating for clinicians. The missed appointment and the follow-up time you spend on it costs money. If you charge a fee for missed sessions, it costs the client money. Missing work to attend an appointment or driving an extended distance costs the client money.

Offering appointments that accommodate the needs of their clients at times that work with their schedules and location means fewer last-minute no-shows and cancellations. Instead of a client last-minute canceling because they’re stuck across town, you might offer a telemental health session later in the evening. That’s a win for both you and your client.

Offering telemental health as an option gives clinicians an additional way to fill some of those chronically unfilled appointment times. Think about it, a client may not have time to drive to your office on their lunch hour, have an appointment, and get back on time. But, they might be able to have a television with you on their lunch break. You get a client who might otherwise have passed on you due to scheduling issues. Your client gets the help they are seeking.

As the telemental health field continues to grow, clinicians and clients will find seeking help is becoming easier than ever. Clients will be able to see clinicians in ways that feel safe and fit their lifestyles. Clinicians will be able to help clients previously out of reach and have a rich, thriving practice. And that benefits everyone.