Benefits of Therapy vs Telehealth
Written by: Nimra Khan / Treatment / February 2, 2022 / 8 minutes read
The onset of the COVID-19 pandemic has brought with it many changes to healthcare systems and has perhaps increased the need for accessible services, even while we are adhering to restrictions and public health guidelines. In the speech therapy field, where much of our work can involve being in close proximity with others, the need for increased distance and less contact has changed the norms of our field in the past couple of years, too.
I can still recall, at the onset of the pandemic, barely touching on teletherapy – in-person services were the norm, and although virtual services were available, this was a minority of appointments and in-person was preferred. I also worked in a clinic setting with children, where parents feared that teletherapy was not as effective as in-person therapy services. It was definitely a learning curve for therapists and clients, but one that was not too difficult to adapt to, no matter the age of the client.
Before we consider the benefits of each type of service, let’s consider what research into telehealth has shown us.
How do therapists feel about tele practice?
A study in Australia (Hines et al., 2015) interviewed a selection of SLPs to determine their view on the benefits and disadvantages of teletherapy. This study found that, although SLPs were initially hesitant about its use (even describing it as ‘foreign’), once it started to be used and progress was observed, everyone felt much more positively about it. There are no doubt challenges, especially as it concerns collaboration and access to technology. However, being adaptable as therapists, and the acceptance of the people they worked with, were factors in teletherapy success.
Is teletherapy effective?
Many studies have been conducted over the years which have shown support for teletherapy. This includes studies that have shown the communication of patients through video conferencing to be equal to their face-to-face interactions (Palsbo, 2007). Another study has shown that there is not difference in the positive outcomes in a group of people receiving in-person vs virtual services (Mashima et al., 2003).
A recent study conducted in 2017 (Jahromi et al., 2020) which assessed the effectiveness of teletherapy for stuttering treatment also found positive results. 30 patients at a rehabilitation centre for their main concern of stuttering (all above the age of 14 years old) received services over Skype. These sessions were conducted weekly, with an average of 15 treatment sessions across all participants. At the end of this study, it was found that the severity of stuttering had reduced significantly and concurred with previous studies that teletherapy can help resolve stuttering with effectiveness. Interestingly, one of the limitations mentioned in this study was to overcome concerns of the patients and their families for using Skype. Researchers provided more information about Skype use to help people be more comfortable. Many of us now have to use video conferencing in our work lives more regularly now.
Benefits of in-person therapy
>>Control of screen distractors
For many individuals, the screen is a major distractor. A benefit of being face-to-face for therapy sessions is that it removes this as a concern. For some individuals, this can be due to an underlying condition which makes distraction more easy or visual input more stimulating -which a screen can often provide. I have seen this benefit with adults and children.
>>Nonverbal language
It is much simpler to work on certain goals surrounding non-verbal language when in-person, as the medium of Zoom can often remove the need for better use of body language and scenarios in which moving around can be easier to continue while speaking in the same room.
>>Certain speech sound difficulties
I have found that people can be just as successful with virtual therapy in learning speech sound production. However, some individuals would benefit from tactile/physical cues to help their production. Motor speech difficulties can make speech sound changes even more difficult. However, many speech sounds can be targeted in similar ways without a physical cue. For example, we often work on the ‘L’ sound with clients, and the use of explanations and visuals can be effective.
Many people consider a presentation to involve a large audience and a PowerPoint, but this does not always have to be the case. Even a meeting to 5 people about a recent project’s progress can cause similar levels of nervousness.
Benefits of teletherapy
>>Convenience of location and time
A nice part of teletherapy is that it can more easily fit around your work schedule, without the addition of thinking about travel time. For individuals who complete their work later into the evening, it can be especially helpful to just switch to a Zoom meeting room. This can also be helpful for managing the family schedule, for those individuals who have children. If you live in a remote area, teletherapy can reduce those long drives usually involved in accessing in-person services. If distance has limited the number of options for you before, accessing teletherapy services could make this much easier for you.
>>Limited resources required
Linking to the above mention of no travel time, resources such as having access to car or other public transport service are diminished when using online services. All that is required is a phone or laptop and reliable internet service.
>>Decrease stigma and increased privacy
As you could be accessing these services from home, it does not require as much explanation to others if you would like to keep this more private. As well, the ease of access can help reduce the stigma around seeing a ‘therapist’ – it isn’t quite so dramatic, and with the addition of privacy from your own home, it is even easier. If you do not want others to be able to know you are accessing speech therapy, then it is easier to keep this private.
>>More accessibility
For many individuals with temporary or chronic illnesses that limit their mobility, teletherapy can be a much easier option to still receive support. For example, although wheelchair accessibility has improved in many locations, it can still require extra considerations for people who will need to travel in a wheelchair, or require extra in-person support in order to move around.
>>Reduced COVID concerns
When I see clients in-person, especially since the start of the COVID pandemic, I need to add in at least an extra 15minutes to allow for sanitization before the next client enters. However, this is a non-issue with tele-practice. I can provide services to client back-to-back without any fears of COVID transmission. This also provides more safety for clients – reduced travel and limited number of contacts. This also means that, should the therapist or client have mild symptoms, they can cancel easily or decide to continue the appointment if they are feeling well enough, without fear of spread. This has been especially important with asymptomatic COVID.
>>Reduced wait time
Many aspects of paperwork and travel time are reduced with virtual therapy for the speech therapist involved. This also links to the above point about no cleaning time needed, which can add up to more time available to see clients. With many school and hospital services having longer waitlists, it can be relatively simple to access a therapist virtually.
Despite many concerns about teletherapy, especially at the onset of COVID, research before this pandemic and during it has shown that is can be very effective, as long as people are willing to adapt. If you would also like to consider your own social communication skills, professionally or otherwise, read about our communication wellness course.
Hines, M., Lincoln, M., Ramsden, R., Martinovich, J., & Fairweather, C. (2015). Speech pathologists’ perspectives on transitioning to telepractice: What factors promote acceptance? Journal of Telemedicine and Telecare, 21(8), 469–473. https://doi.org/10.1177/1357633X15604555
Maryam Eslami Jahromi, Leila Ahmadian & Kambiz Bahaadinbeigy (2020) The effect of tele-speech therapy on treatment of stuttering, Disability and Rehabilitation: Assistive Technology, DOI: 10.1080/17483107.2020.1754475
Mashima, P. A., Birkmire-Peters, D. P., Syms, M. J., Holtel, M. R., Burgess, L. P., & Peters, L. J. (2003). Telehealth.
Palsbo, S. E. (2007). Equivalence of functional communication assessment in speech pathology using videoconferencing. Journal of Telemedicine and Telecare, 13(1), 40-43.
To speak with one of the speech-language pathologists at Well Said: Toronto Speech Therapy, schedule an initial consultation by clicking the link below or calling (647) 795-5277.
