Module 8: FAQs and common misconceptions

1. Does online therapy work?

Yes! There is an emerging body of work that proves the effectiveness of online therapy across a variety of disciplines. There is literature that supports the use of online therapy including but not limited to occupational therapy, physiotherapy, speech therapy, and nursing.

 2. How do I engage my client online?

It depends who your client is. If a client doesn’t like engaging with you in-person, you let them lead the interaction, let them to lead their own activity, or get someone else to engage with them while you talk to a support person or observe from afar. The same goes for online therapy – if the person doesn’t want to engage directly, there’s no need to push it.

Online Therapy Example:

Tim and Tom are twin brothers. Tim is outgoing and boisterous – he loves attention. Tom is more reserved, and doesn’t like it if the focus of attention is on him. Tim and Tom are both working on cause and effect with their OT. Tim and the OT interact frequently in a 1:1 video-conference – whenever Tim beats the drum in front of him, the OT claps and gives him verbal praise, which Tim really enjoys. Because Tom is shy, his mum places the laptop inconspicuously but in a position that allows the OT to view the interaction. Tom is encouraged to beat the drum in front of him, and when he does, his mother claps and gives him verbal praise. Afterwards, the OT gives Tim and Tom’s mum feedback about what she observed.

 3. How do I perform an assessment online?

It depends what you are assessing... In any case, it’s crucial to remember why you are assessing. We assess in order to gain knowledge about the direction of our goal. First we ascertain the client’s goals and preferences, then we explore the strengths and weaknesses of the support circle and client in relation to that goal. If you need to take a history, talk to your client and support person about their history. If you need to observe behaviour, interaction, language, processing time, observe through a live video or video recording. Be creative about the way that your team can collect information locally and share it with you online. If you are using a standardised assessment, then there are many well-known tests that have digital versions, such as the WISC, CELF-5, and BASC-3.

4. How do I choose appropriate intervention approaches or resources for online therapy?

Let the client and support circle guide your choices, just as you would in-person. If you feel you are “limited” by online therapy with a particular client, then the client either isn’t suited to online therapy, or you need to rethink your approach.

5. Speech is easier to do online because it’s about talking. Can OT and physio work online?

Online therapy is about creativity. A therapist so often shares skills with someone in-person, then relies on them to practice in-between consultations. The better you are at coaching, the more skills you will be able to share through coaching the people who support the client. 

6. What happens if we lose our connection?

The reality of internet service in Australia is that is not always reliable, and in many areas, it’s non-existent. If you lose your connection during a session, it is often necessary to reschedule. However, in order to prevent this from happening, we should prepare by making sure that where we are doing therapy (both clinician and client) is in an area where there is a sufficient connection. Use telephone as a back up if possible, and remember that you can use an asynchronous approach if the signal is consistency unreliable.