Telepractice Considerations

March 21, 2020

During these difficult times, ISHA has heard from numerous members about options other than face-to-face services due to closures in order to address the needs of students and clients safely and effectively.  A service delivery model that many are considering is telepractice.  ISHA’s Telepractice Committee member, Andee Szwabowski, has compiled the top five teletherapy essentials you must consider if you are new to this service delivery model.

Technology matters. In order to provide quality service delivery, it’s imperative that both you and your client have a strong internet connection.  Consider having your laptop or desktop hard wired to maximize bandwidth for screen sharing, or placing the computer as close to the modem as possible.  Desktops and laptops are preferred over tablets, cellular phones, and Chromebooks, as these devices lose interactivity when materials are screenshared.

Facilitation is essential.  If your client is school-aged or an older adult, it is absolutely imperative that a tech-savvy adult is present to help monitor and assist with the therapy session.  It’s important to spend time, prior to beginning services, training this person on how best to support your services. Set clear expectations about availability, positioning, and how to successfully coach your client when needed.

Privacy is non-negotiable.  Therapists should be aware of federal and state regulations relating to privacy and security, including those pertaining to storage and transmission of client information.  See the rules for both HIPAA and FERPA for guidelines, especially when choosing a video platform, and grouping clients together for services.  Remember it is your responsibility to obtain documentation of informed consent.

Organization is key.  Take time to organize your therapy materials ahead of time into folders on your computer.  This includes bookmarking your favorite online resources for quick retrieval.  Know what exact resources you are going to use before you begin a session, and how to modify them so your client can be successful.  If you aren’t sure where to look for resources, professional online communities can be very helpful if you need assistance.

Practice is beneficial.  Before going on camera, it’s very helpful to practice giving a session to a familiar person, such as another adult, friend, or a child of your own.  Take time to learn the features of your platform, as well as how to troubleshoot the technology, prior to giving a live therapy session.  The more you practice, the more seamless your session will be.

As you continue to evaluate if telepractice is the appropriate service delivery model during this time, it is also important to understand the rules surrounding telepractice and telesupervision.  ASHA recently sent an email outlining the allowance for telesupervision for undergraduate and graduate students.  While ASHA is now allowing for telesupervision due to the circumstances, Illinois law does NOT allow for telesupervision.  Based upon these rules, Illinois law requires “on-site” supervision, which is defined as the student and supervisor being in the same location.  ASHA guidelines do not supersede this law. 

As you navigate these uncharted waters, it is also important to consider and investigate reimbursement.  Currently, telepractice cannot be used or reimbursed for early intervention.  If you are planning to seek reimbursement through insurance, it is necessary to confirm that reimbursement will be provided through the individual insurance companies. 

Finally, it is vital to visit ASHA’s Telepractice Portal for more information, guidelines, and considerations for this service delivery model.