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Teletherapy: The Good and Not-So-Good

Updated: Sep 12, 2020


Teletherapy, or telehealth, or telemedicine has been a service delivery method for over eight decades or so. Much like the rest of the healthcare world, teletherapy has gradually evolved and doctors, practitioners, pharmacists, and other healthcare professionals have accepted this new way of practice in various ways- some with caution and some with curiosity and enthusiasm. It was originally discovered as a way for doctors and specialists in hospitals across the world to communicate and share treatment methods during the acute care of seriously ill patients. It then immersed into a network to provide services to those in rural areas, too far away from optimal medical care, to access the care that they needed. Now telehealth has morphed into a very dynamic network that allows anyone to access the services that they need, regardless of their location, socioeconomic status, or condition. And it must be stated that we are now living during a time when telehealth/teletherapy is much required as face to face interaction can be compromising and unsafe.


With the ongoing changes in the world, required safety measures, and proof that teletherapy is just as effective as face to face therapy in most cases, Bright Skies Therapy and Consulting believes in the power of teletherapy. With skilled, knowledgeable practitioners, evidence-based strategies, collaboration, and supportive parents and caregivers, we know wholeheartedly that we can help children, teenagers, and young adults reach their potential.


Although Bright Skies Therapy and Consulting is in the enthusiastic group, truly trusting the teletherapy process, it's only fair that both sides be considered. Here are the pros and the cons to modern-day teletherapy:




Pros:

* Teletherapy is a money saver.

This pro works out for both the client/child/family and the therapist. In participating in teletherapy services, clients/families can save money on travel to and from a clinic or office, any mileage fees a home/visiting therapist may charge, potential childcare costs for siblings, and on food or snacks from the local shop your child may beg for when traveling to and from therapy! Therapists/practitioners can also save money as they may not need to spend loads of money on renting a space, the money required for postage (as most communication is electronic), or money required for certain supplies and equipment. These factors in turn allow for teletherapists to charge less for their services!


* Teletherapy is a time/energy saver.

Not only can commuting to a therapy office or clinic cost clients/families money, but it can also cost them time and energy. Living in the 21st century can be exhausting as each family member in one household can have multiple individual engagements and activities. There's nothing like that dreadful after-work rush to get every child to their respective after school engagements, 3-4 days of the week. Whereas with teletherapy, a therapy session can be conveniently scheduled to fit the family's busy schedule. Again, with teletherapy, you can minimize travel time thus allowing more time at home where learning in a natural environment is optimal.


*Teletherapy is accessible.

When accessing teletherapy services, there are various ways to connect: computer, tablet, phone, video, audio, etc. Living in these modern times, it's safe to say that many people own some type of communication/multimedia device. As a matter of fact, according to Statista.com, "The number of smartphone users worldwide today surpasses three billion and is forecast to further grow by several hundred million in the next few years." This information supports why teletherapy can be accessible to so many people, particularly those who lack access to other resources, as the world continues to rely more and more on technology. Although computers and/or tablet devices are ideal for teletherapy services, fancy equipment is not necessary and should not be a reason why one can't have access to good support and healthcare.


Other accessibility factors to consider are sensory challenges (e.g. managing crowds/public places, external temperatures, times of day, etc.), access to transportation, reliability on transportation, physical distance, and/or inaccessible buildings. All of these factors can hinder access to therapy when services are provided in a clinic or office. However, teletherapy eliminates these barriers as one can benefit from the necessary therapy support from the comforts of their own home.


* Teletherapy facilitates parent/caregiver involvement.

In the traditional pediatric therapy service model, a child and their parent/caregiver would visit a clinic or office for their prescribed therapy. The child would participate in their 50-minute session, leaving the therapist and parent/caregiver to chat for the last 10 minutes before moving on to their next engagement. With this method, the parent often leaves the office/clinic to run errands, waits in the lobby as they manage work obligations, or simply takes the time to sneak in a nap! There are also some offices/clinics that can't allow parents/caregivers to actively participate in their child's therapy session due to privacy laws. These multitasking and confidentiality efforts are commendable, however, they compromise the true effectiveness of the therapeutic process. Parent/caregiver involvement is KEY in optimizing the true effectiveness of therapy and their child's/loved one's potential. With teletherapy, parent/caregiver involvement is more likely as both the child and parent are more relaxed within their home environment. It also avoids the risk of compromising one's privacy/confidentiality all while encouraging openness and true parental/caregiver participation.


* Teletherapy makes way for more choices.

Have you ever done a Google search to find the best service provider, but when you find the best, you discover that the service provider/therapist/practitioner is 10 cities over? With teletherapy, this barrier wouldn't be a factor. Teletherapy eliminates the variable of distance and allows clients/families with variety/options when choosing a preferred practice, therapist, or practitioner.


*Teletherapy is safe.

Now more than ever, the health and well-being of our loved ones is crucial. We have never had to be more careful about germs, transmission, and/or public health and with teletherapy, families can be more at ease. Again, teletherapy eliminates the need to attend sessions at a shared, public place which in turn avoids the risk of catching potentially harmful diseases.


*Teletherapy supports privacy.

There are times, children, teenagers, young adults (e.g. college students), and even parents/caregivers protest therapy in fear of being judged or seen by peers. With teletherapy, children/clients/families can feel comfortable in knowing their privacy and confidentiality is respected and unknown to others as they participate from their preferred person environment. This in turn makes room for improved therapy outcomes and overall participation.


*Teletherapy can support daily routines/activities.

Therapists hear it all the time, "he doesn't act like this at home!" Children/clients often present differently depending on their environment and/or time of day. It is not uncommon for a child to struggle with regulating their behavior at school or in the community but be sufficiently organized when at home. This same concept can occur in the reverse. Regardless of a client/child's response to their environment, teletherapy typically occurs in one's natural environment which evidence shows is the optimal therapy setting. Teletherapy in natural environments also allows therapists to observe true behavioral responses and/or promotes opportunities to provide support in challenging situations or routines (e.g. homework time, dinner time, etc.).


In considering the above pros when discussing teletherapy, it's fair to acknowledge the potential cons of this evolving service delivery method. Some of these cons are as follows:




Cons:

* Not all families have access to computers/tablets.

Although much of the world owns a smartphone/cellular device, there are still some households that don't have access to secure, private computers/tablets. Reasons for this vary (e.g. cultural belief, financial, personal preference, etc.) but it shouldn't limit access to quality services. Teletherapy via computer and/or tablet is ideal (especially for speech, occupational, and physical therapy), yet support can still be provided by other means (e.g. group sessions with a friend, phone consultations, mobile-friendly apps, and email communication).


* Teletherapy compromises human interaction and engagement.

The world of therapy was based on human interaction and engagement. Since the beginning of time, various therapies have been provided in clinics, offices, hospitals, schools, and community settings- consisting of a practitioner and one or a few clients/children in an interactive setting. This way of therapy has allowed for face to face interaction and engagement in a way that teletherapy can't fully allow. This isn't to say that teletherapy fully lacks the ability to facilitate interaction and engagement, however, the process of building rapport can prove to be more challenging.


* Teletherapy requires a time commitment from parents/caregivers.

When completing therapy via a device, over the internet, it is ideal (better yet, mandatory) that a parent/caregiver be actively present during the session (age depending of course). This in turn requires a time commitment from the parent/caregiver that may not be required when services are provided in an office/clinic.

* Teletherapy relies on technology.

Let's face it, the world is becoming more and more mobile. We have loads of access at our fingertips and the networks and coverage get better and better with time. However, the Internet isn't always reliable. Communication devices aren't always reliable. And technology as a whole isn't always reliable. It can be quite frustrating when technology is faulty and it can be even more frustrating for some in learning how to navigate modern-day electronic devices. All of these factors have the potential to compromise a teletherapy session, thus making it frustrating for some, and absolutely unacceptable for others.


* Teletherapy isn't suitable for every client/child/case.

There are times when teletherapy just isn't the ideal service delivery method. Certain diagnoses/children/clients/families require specific specialized treatment methods or therapy programs, that teletherapy just can't support. For example, a child with cerebral palsy may require manual therapy, and this requires face to face, live therapy sessions. Another example may include a young adult with Autism Spectrum Disorder who exhibits unsafe/aggressive behaviors. Cases such as these undoubtedly require hands-on therapy, facilitated by a trained, specialized therapist for safe, optimal results.


Overall, teletherapy is a new way of providing therapeutic care. For some practitioners, the transition to teletherapy has been seamless and mandatory (e.g. mental health therapists), meanwhile, other therapists/practitioners (e.g. occupational therapists) have to work a little harder as they creatively adapt to the changing world. There are still some who prefer the more traditional way of face to face therapy as seeing the benefits of teletherapy isn't quite in clear sight. Nonetheless, with the ongoing uncertainty of COVID-19, the inevitable evolution of technology, and the increased desire for convenience, the healthcare world's shift to teletherapy is in order, and Bright Skies Therapy and Consulting wholeheartedly believes in the power of this shift.

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