Telehealth Occupational Therapy: What to Expect
How can such a “hands-on” therapy be done virtually?
What if my child is used to sensory equipment in the clinic? Can their sensory needs really be met?
Is therapy going to be “watered-down” if I do it virtually?
These might be some of the questions you’ve asked yourself when considering telehealth for occupational therapy. I know I certainly had my reservations at first. If you asked me a year ago, never would I ever have been able to articulate what I feel now about telehealth therapy. Thanks to COVID-19, many clinics, therapists, and clients worldwide have looked to a virtual platform to continue therapy services while remaining safe at home. Early in quarantine, I wondered how connected I would feel to my clients over the computer, and I’ll admit, it took some time to find my virtual groove. However, it didn’t take long for me to see that not only can telehealth be a successful platform for OT, but, in some instances, it can be an even more effective mode of therapy.
Telehealth has not only offered a safe option for me and my clients to work together during the pandemic. It has also allowed me greater access to understanding clients’ real lives—without the possibility of my physical presence throwing off the authenticity of what happens on a daily basis. I’ve been able to see their homes, see what their routines are, and understand the intricacies of everyday activities, interactions, and demands. Whether a home has six children and one parent or two parents and one child, everyone has their own version of “difficult,” especially during these unprecedented times in 2020. On the other hand, every person and family system also has their unique strengths that create resilience, not only around COVID, but in the face of general life challenges. It is through this authentic work that my clients and I have been able to use telehealth to pinpoint the barriers that need to be addressed and the strengths on which we can capitalize.
Telehealth using your phone, tablet, or computer.
“I had the pleasure to work with Cassie Wilcox through an exclusively teletherapy platform. My son needed help with handwriting and related fine motor skills. Cassie was able to connect with him via an online meeting and build rapport with him. My son appreciated the way she spoke to him directly and engaged him in his therapy plan. Cassie was able to view my son’s positioning, and to help him correct his form as needed. I was so impressed by her ability to see what he was doing on screen, demonstrate (on her screen) how something should look, and then coach us both on successful positioning.”
Therapy anywhere that works best in your life and suits your needs.
What do your telehealth sessions look like?
Similarly to in-person therapy with children, I ask parents to be present for virtual sessions. After all, I only get to spend a teeny, tiny portion of time with my pediatric clients, and I want to empower parents in the therapeutic process with their kids. With the child, parent, and myself present, we are able to play, learn, problem-solve, and even innovate together. In teletherapy:
Parents get the opportunity to take an active role in their child’s therapy,
And kids get to feel empowered by guiding therapy sessions, deciding what equipment or toys we use, and determining where they want to be in the home.
Despite my work in sensory integration, there is no need for expensive therapy equipment, and I always emphasize to parents that we will use what is already available in their home. It’s amazing what you can do with a couch cushion, laundry basket, and step stool. In teletherapy, we still move in unique and therapeutic ways, come up with sensory strategies as “brain fuel”, and most importantly, have fun. I have even successfully implemented auditory programs (e.g., Therapeutic Listening®), Interactive Metronome®, and bodywork techniques virtually. I also use many visuals directly on the screen to help facilitate children’s engagement and learning. Even more, parents often feel it’s easier to focus on therapeutic discussions in the virtual platform. With a child engaged with a familiar toy or in their cozy space at home, parents are finding the time to slow down in session to carefully think through their questions, reflect on their thoughts, and experience the full support of parent coaching.
With any client—whether child or adult—I am right there doing the activities alongside the person. I find that this not only helps people learn the strategies through demonstration more easily, but it also enhances the feeling of connection even when we are separated by pixels and binary codes. This is critical because we know that connection and attunement are essential components to positive brain changes (3, 4).
How long are your telehealth sessions?
Like in-person therapy, my telehealth sessions last approximately 50 minutes. Children are often not fully participating the entire 50 minutes. Rather, they are usually a direct part of the session or 30-45 minutes, which allows for ample parent-therapist connection for the remainder of the time. Again, this has allowed us the opportunity to really slow down to reflect on parent concerns, problem-solve around implementing home program strategies, and ensure that the parent is feeling truly supported.
Is your telehealth platform secure?
The platform that I use for teletherapy sessions is completely HIPAA compliant, and no installation of any programs is required. My clients can feel assured knowing their private information is safe and secure.
Not sure what to think? Schedule a free intake with me through telehealth and see how you feel.
While I have found more value in telehealth than I ever thought possible, virtual therapy still isn’t for everyone. Scheduling your free intake will help both of us determine if we’re a good therapeutic match, and you will get a feel for the virtual platform. We can always talk about in-home therapy options.
References
1. Cason, J. (2014). Telehealth: A Rapidly Developing Service Delivery Model For Occupational Therapy. International Journal of Telerehabilitation, 6(1), 29-35. DOI: 10.5195/ijt.2014.6148.
2. Ferguson, J., Craig, E.A., & Dounavi, K. (2019). Telehealth as a Model for Providing Behaviour Analytic Interventions to Individuals with Autism Spectrum Disorder: A Systematic Review. Journal of Autism and Developmental Disorders, 49, 582–616.
3. Siegel, D.J. & Hartzell ,M. (2003). Parenting from the Inside Out: How a Deeper Self-Understanding Can Help You Raise Children Who Thrive. Jeremy P. Tarcher/Penguin, a member of Penguin Group (USA): New York, NY.
4. Rosanbalm, K.D. & Murray, D.W. (2017). Caregiver Co-regulation Across Development: A Practice Brief. OPRE Brief #2017-80. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, US. Department of Health and Human Services.
5. Walker, B.J., Washington, L., Early, D., & Poskey, G.A. (2020). Parents' Experiences With Implementing Therapy Home Programs for Children With Down Syndrome: A Scoping Review. Occupational Therapy in Health Care, 34(1), 85-98. DOI: 10.1080/07380577.2020.1723820.