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.

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!