children-inrural schools need therapy too

Solving the Rural Area Therapy Shortage

Not Enough Therapists

Although it is heartbreaking, it is true. Without online therapy, there simply aren’t enough therapists to meet the needs of Rural America. The shortages exist in Speech, Occupational and Mental Health Therapy alike. Take mental health for example. Although shortages exist everywhere, 85% of them are found in rural communities.

Even worse, most counties in Rural America function without any mental health professional residing there–be it a psychologist, psychiatrist or social worker!  Consequently, those in need must travel quite a ways to get the required help.  Not only does this postpone badly needed intervention, but at times it also eliminates it with potentially fatal consequences.


Over 75% of SLPs said higher caseloads were the biggest problem. It is easy to understand how clients suffer from their therapists being overburdened. Most of the time there is an inverse relationship between the therapist’s caseload and the quality of the therapy. However, you might think that heavy workloads only impact the clients.

Unfortunately, the client’s loss is only half of the problem. Attempting to satisfy a substantial caseload causes the therapist to feel overburdened, pressured, and just plain exhausted. This results in more frequent therapist burnout and isn’t a recipe for stability. While therapists want to work hard, they want a normal life like everyone else.


And if the frustration wasn’t enough, there is another serious problem. The loneliness engendered by having so few colleagues around them takes its toll as well. Therapists in rural communities feel isolated, missing other clinicians with whom to share their experiences. If this true in the professional sphere, it is even more so felt socially.

Professionals in Rural America face another problem too. Since rural areas are often far from urban cultural centers and universities, therapists are restricted from participating in training and development programs that would enhance them professionally. They feel "left behind" and unable to learn new teaching strategies.

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Where’s the Money?

And what about money? A Rural Special Ed Director recently lamented that rural schools couldn't afford to have their own Speech Language Pathologists. The situation isn’t better for Occupational or Mental Health Therapists. It’s not only the budget cuts due to low tax revenues.  Small districts spend more per student than their urban counterparts. In other words, it’s a structural flaw, seemingly impossible to correct.

The financial strain is even more complicated. Rural districts must pay a higher premium to staff agencies to find a therapist that is willing to spend time traveling and the district must pay the additional transportation expenses in addition to that. After all of these extra expenses, what is left for the therapist?  There is no way that rural salaries could be competitive. The result? Therapist in rural schools lack much needed financial incentives.


It is certainly no wonder why many therapists don’t just "stick it out." One study found the turnover of teachers in rural districts was over 20% (over twice the national average). Over 70% of those who didn’t return said that they took jobs in larger school districts. It is no surprise many said they resigned due to social and cultural isolation.

Online Therapy to the Rescue!

The future would certainly look bleak but for the advent of Online Therapy. With Online Therapy, geographical constraints with all of their attendant problems; heavy caseloads, isolation, and non-existent financial incentives cease to exist!  The result? Happier therapists and more fortunate children are receiving the quality therapy they deserve!

teletherapy rural schools

Can Teletherapy for Rural Schools Help Prevent Suicide?

Is Teletherapy for Rural Schools and Suicide Connected?

While most of us automatically associate stress and tension with living in a big city, the surprising truth is that the youth suicide rate is significantly higher in Rural America according to a troubling new report published in Jama Pediatrics. And it’s climbing!

The research shows that the adolescent and young-adult suicide rate in the U.S. 1996-2010 was double in rural areas as compared to urban areas. Investigators, analyzing 67,000 deaths, found the rate of suicide for both males and females alike living in rural areas was about double the rate in cities.


Perhaps blame can be assigned to the preponderance of gun ownership in rural areas. That over 50% of the deaths were with guns, coupled with the higher percentage of gun ownership in rural areas, may suggest that guns are the culprit. Maybe educating parents how to “keep the guns safe” could stem and possibly reverse the tide.

But it’s not so simple!

Lack of Awareness

Since the understanding of mental health issues in rural areas is subpar, many potential dangerous conditions such as depression tend to be under-diagnosed.  Consequently, parents and teachers often miss the warning signs that could prevent tragedy. Creating greater awareness and understanding is an imperative.


Interestingly, the “Rural Personality,” which is based upon strength and self-reliance, a source of pride, may be preventing those in need from seeking help for their mental health problems.  The stigma of “weakness” may serve as a hurdle too difficult to surmount, even when qualified therapists are available.


And then there is the lack of anonymity which is part and parcel of living in a small town.The close-knit community, with all that it has to offer, actually may be undermining its constituency from finding the help they so desperately need due to the shame it would entail.

Get your free copy of our groundbreaking ebook: Teletherapy Diminishes Client Engagement: Debunking The Myths


But let’s get to the core of the problem: how are the youth in Rural America are unique?  Since those in rural areas tend to live much further apart, their wholesome face-to-face interaction with others and participation in social networks is more limited. Social isolation can often foster loneliness and depression, sometimes with fatal consequences.

What’s more, although it was nearly a century ago, the Great Recession took its most significant toll on Rural America. As a result, even today, those living in rural communities are more likely to have lower incomes in general, and adequate health insurance that provides mental health services in particular.

Unfortunately, a weaker economy providing fewer jobs means that a greater percentage of the youth who were raised in Rural America leave their communities for higher ground, seeking employment in metropolitan areas where there are greater opportunities.  This, of course, only serves to heighten the loneliness of their peers whom they leave behind.


Perhaps the most tragic problem (and most solvable with teletherapy for rural schools) is the lack of mental health professionals. In fact, more than 85% of the mental health professional shortage is in rural areas. Over half of rural counties don’t have any mental health professional at all.

Consequently, those in rural communities seeking professional mental health care must drive far distances to find it when teletherapy for rural schools is unavailable. This can be a serious deterrent, delaying necessary care, or worse, postponing professional intervention until the problem has become exacerbated, and perhaps out of control.

Teletherapy for Rural Schools to the Rescue

Teletherapy for rural schools: the innovative model of connecting a client to a therapist through video conferencing through GoToMeeting or Skype holds great promise to help relieve this deplorable situation.  Hopefully, as teletherapy continues to grow, relief for the suffering youth will be more available, and we’ll see those suicide rates plummet quickly!

online therapy for rural schools and confidentiality

Online Therapy for Rural Schools, but is it Confidential?

Advantages of Online Therapy for Rural Schools

The benefits of online therapy for rural schools are many and on the rise.  Take for example the convenience and flexibility that the Internet affords. Without compromising quality, online therapy is often less expensive. And expanded access to language preferences and specialties increases the likelihood of that perfect fit!

But is it confidential?

Risk of Compromising Confidentiality Online

Many assert that privacy, or protecting client information, puts into question the value of online therapy in general, and online therapy for rural schools in particular. Their claim is that the reliance on technology and electronic communications threatens patient confidentiality unless great care is exercised.

It is reasonable to be concerned about hacks and privacy leaks due to the online transmission of information. Cyber security isn’t a booming business and adding layers of sophistication for nothing.   These breaches could be either intentional or accidental. Think about email for example. We all know that there is no way to ensure 100% security.

Problem of Confidentiality in Any Therapy

But let’s face it. Being that we are all human, there is rarely, if ever, guaranteed privacy. So why should we impose a standard on the “online world” that is unattainable in the “offline world.”  Perhaps you were unaware as to how easy confidentiality is at risk of being compromised in traditional face to face therapy.

Did you ever consider who is to prevent office personnel and others who handle patients charts from peeking at them? This “inadvertent” compromise of privacy happens more often than you think.  As a matter of fact, gaining access to a client’s chart may be as simple as going into an unlocked filing cabinet or accessing a record in the database file.

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Or what about when therapists converse with other staff members or a supervisor in an organization about a client, cavalier about protecting the client's anonymity.  Since ethical standards regarding confidentiality vary by profession, such accidental information may then further disseminated amongst the less professional staff.

It could be as simple as observing someone entering a mental health clinic or therapist’s office.  Surely there is a compromise of privacy and confidentiality any time the public can witness those individuals who come and go in search of improving their mental health.

Precautions to Reduce Risk Online

This all being true, there are things that you can do to protect yourself when receiving therapy online.  Select an online clinician whose website is secure and can keep all communications private and confidential. Assure all communications are addressed to your therapist. Do not share your computer or email passwords. If you don’t have a separate computer for therapy, be sure to close the browser when you complete the session.

Online isn’t as Risky as You May Think

The bottom line is, receiving therapy online is really no less safe than face to face. Both are very confidential; neither is 100% perfect.  It is well known that therapists regard protecting your confidentiality as sacred. You need not suspect a credentialed therapist would ever reveal to violate your trust and confidence intentionally.

But as most of us find out, confidences are sometimes at risk even in the best circumstances.  So, if you consider the many benefits of online therapy for rural schools and weigh them against your confidentiality concerns, rest assured that you are probably safer than you think.

teletherapy for rural schools

Teletherapy for Rural Schools: 3 Reasons to Become a Generalist

Advantage of Being a Specialist

Excluding those at the very top or bottom on the employment spectrum, society, in general, seems to place a premium on specialists over generalists. So it’s understandable that when fresh graduates enter the workforce, they're naturally inclined to seek a specialty in their field of choice.

In fact, one marketing study after the next reveals that we're indeed a “boutique” society. Consumers of services and products greatly value and are willing to pay for something unique. So it certainly seems to be a “no-brainer” for a therapist to specialize.

Beyond choosing what appears to be “financially intelligent,” another key benefit to specializing is that specializing allows therapists to develop an expertise through study and clinical experience, thus reducing risks of making mistakes in their work.

Rural Schools Require Generalists

However, this discounts an important market for therapists to consider. Whereas in the past Rural America was beyond the pale of consideration for many,  teletherapy for rural schools has changed all that. The accelerating need for qualified therapists in Rural America coupled with online therapy has completely transformed the equation.

These same clinicians who wouldn’t think of moving to a small town can now provide those residents therapeutic services from the comfort of their home at their convenience. What’s more, since rural areas require the therapist to serve the needs of a diversified clientele, it is the generalist, not the specialist who is more valuable.

Advantages of Generalist

But don’t think that the benefit of becoming a generalist is limited to providing teletherapy for rural schools. It is important to become a generalist for other reasons as well.

1. Expertise

Becoming a generalist provides exposure to multiple dimensions. Generalizing helps the therapist gain significant insight into different types of prognoses and develop an array of modalities to serve various types of clients. Generalizing is invaluable to developing one’s career–irrespective of what direction it will end up going in.

Get your free copy of our groundbreaking ebook: Teletherapy Diminishes Client Engagement: Debunking The Myths

Additionally, what isn’t appreciated is that being a generalist is a specialty itself. Generalists are forced to be more creative, flexible, and comfortable with change. These are valuable skills. Lastly, being a generalist cultivates the need and ability to be open-minded and attack new problems with a fresh perspective.

2. Refreshment

A fringe benefit is that being a generalist protects the therapist from getting bored and even more importantly significantly reduces the risk of burn-out. There is always somewhere new to turn to try previously unexplored options when you're a generalist.

3. Survival

Perhaps most importantly, being a generalist is one of the greatest insurances against being sidelined by changing markets, which is particularly relevant in our uncertain times. Whereas there is security in knowing a specialty, should the situation dictate a lateral move, while the specialist may be ill-prepared, the generalist is poised and ready.

Even in the animal kingdom, certain species can only survive in a specific environment, where the conditions must be perfect. If those conditions are sufficiently altered, they risk extinction. However, more adaptable species, which aren’t bound by the same limitations to survive and thrive can “go with the flow.”  Employment is no different.

Teletherapy for Rural Schools

To make it simple, Rural America’s diverse needs are advantageous for generalists. Now, with the wonders of technology, these therapists can provide teletherapy for rural schools from the comfort of their homes.  It’s a win-win-win: for the therapists, clients, and school administrators. Are you ready to become a generalist?