The Technical Challenges Of Telepractice

Recently, speech-language therapy has undergone a quiet revolution. You guessed it, like everything else, it’s gone online, and it is called telepractice (or teletherapy).  As technology accelerates, the revolution continues to gather steam. So perhaps it’s time to take a closer look at some of the criticisms of telepractice to see if they are accurate and justify the hesitation of a full embrace.

Perhaps the most readily apparent problems that seem to plague telepractice are in the technical realm which are virtually nonexistent when the therapy session is face to face. For example, It would seem to be difficult for the client to communicate with a therapist who is not in the same room. Simply put, where is the eye contact if client and therapist do not face to face?

1. The Visual Challenge And Its Solution

But this doesn’t need to be a problem. The fact is that there is much that the SLP can do through the online venue to promote eye contact and thereby enhance clinical effectiveness. Besides the therapist making eye contact, the client needs to look directly into the camera also to ensure eye contact which will result in a more natural interaction between therapist and client.

And if for some reason the built-in camera on the therapist’s laptop just isn’t doing the job, why not attach an external camera of higher quality?  Keep in mind that most quality cameras have a remote control zoom which facilitates framing the picture without reaching for the camera or leaving the image. Sometimes the solution is simple. Assure there is enough light in the room!

2. While Distractions are Problems, They can be Reduced

Unfortunately, telepractice increases the risk of distractions because the clinician being in another location is oblivious to what the client is viewing on his/her screen. This distraction could be as simple as someone walking behind the therapist, or the client seeing a cluttered desk.
Therefore it is imperative that the therapist endeavor to maintain a clean, distraction-free background. Removing distractions begins by being aware of other people moving around in the therapist’s environment.  This solution may be as simple as the therapist positioning her desk in such a way that no one could walk behind it. And if the SLP is doing telepractice from home, be careful not to allow children to run around in the background.

3. Audio Problems? They Also Have an Answer

It could be that the most difficult challenge of telepractice is in the audio realm.  After all, speech-language pathology is about oral communication!  That is why the slightest deviation from sounds such as a buzz or wind sound, or even time delay between responses has the potential to throw the entire session into disarray.
At times the answer is relatively simple.  Perhaps the therapist needs to speak with more clarity. Or maybe she needs to remove her jewelry that is clanging or discard whatever is covering over the microphone.  Bottom line, the therapist should do that which is necessary to eliminate the noise pollution and keep any extraneous sounds to a bare minimum.
On a more technical level, the therapist needs to invest in the highest quality headset and video conferencing system possible.  After all, the quality of the sound system is at the very core of telepractice and its success.  For all practical purposes, the microphone is the client’s ear. If the therapist is close enough to the microphone, she need do nothing fancy.  The client will hear the therapist no matter what, so the therapist needs only to talk.

But Is Solving The Technical Challenges Of Telepractice Enough?

But even if those technical problems can be solved thereby bringing telepractice up to par with face to face therapy, what about engaging the client?  How can online therapy ensure that the client will become and remain engaged? Stay tuned for Part II next week to find out why telepractice doesn’t compromise client engagement either.