Tips and tools for using teletherapy in your practice

As the prevalence of teletherapy has grown, fueled by the need for physical-distancing during COVID-19, we as clinicians have been faced with the challenge of how to make teletherapy work for us and for our clients. The good news is that many therapists have already been doing teletherapy for years, and there is a growing body of evidence that suggests teletherapy can be just as effective as traditional, in-person therapy for many clients.  In fact, some studies have even shown that telehealth service delivery improves therapy attendance (check out this article by Covert and colleagues to learn more). Getting to the clinic in person is a struggle for many of our clients, even without COVID-19 as a concern.

But of course, there’s the bigger question – how do I actually DO teletherapy?  Read on to learn about a few of our favorite teletherapy tools across various platforms, and to learn how to adapt the amazing therapy and tools you’re already delivering.  I’ve taken some of my favorite features from several popular video meeting systems and outlined them below!

But first — HIPAA Compliance

Our first and foremost commitment as therapists is always to the wellbeing of our patients, and a big component of that is protecting our patients’ PHI (protected health information), especially online.  Before you begin teletherapy, you need to make sure you have a HIPAA compliant teletherapy option. Many Electronic Health Records (EHR) systems have a telehealth add-on that is HIPAA compliant, while other commercial meeting software programs may have ways to make their software HIPAA compliant. You usually will need to sign a Business Associates Agreement (BAA) to make sure that whatever software program you’re using is protecting your patients’ PHI appropriately. Reach out to your IT department if you’re at a larger institution, or if you’re a smaller practice (like me!), read up online about the HIPAA compliant options your video chat software of choice may offer.

Let’s talk video conferencing platforms

Zoom

A word that has become almost ubiquitous in 2020, Zoom is one of the most popular video conferencing platforms, and for good reason. One of my favorite features on Zoom is the ability to share your iPad screen. This is particularly seamless if you’re on a Mac, but is also an option on PC as well.

Here’s how to share your screen using Zoom:

1. To start, click the Share Screen button on the bottom of your Zoom toolbar (you might have to hover your mouse at the bottom of your video to get the toolbar to come up).
2. Once you’ve opened that screen, click “iPhone/iPad via AirPlay.” You can also do this by connecting your device to your laptop using a lightening/USB cable.
3. Then, you’ll be able to go to your iPad or even iPhone, swipe up from the bottom, and “screen mirror” – Zoom will pop up directions for you once you tap the “iPhone/iPad via AirPlay” button.

This will allow you to share your iPad screen as if you were sharing your screen on your computer. I love using this feature to show clients exercises on apps like Constant Therapy, or even to share a quick photo for us to talk about while practicing conversation skills. Although your client won’t be able to interact with your screen, being able to show your client your iPad screen is extremely helpful. Also, if you’ve got a tech savvy client, you could even have them share their own iPad screen with you, allowing you to see what they’re seeing in real time as they practice their Constant Therapy exercises. This is great for strategy teaching and cueing.

I find that making visual step-by-step instruction sheets for clients and their loved ones is essential for tools I need the client to activate on their end.

Google Meet

While Zoom might be the superstar, Google Meet is also a useful tool with a host of great features that shouldn’t be overlooked. Google Meet has made it so incredibly easy to use closed captioning, and I’m honestly dazzled by how accurate the transcriptions are.

How to turn on closed captioning in Google Meet

1. If you want to activate closed captioning on a Google Meet call, tap “Turn On Captions” in the bottom right-hand corner of your screen when you join a call.
2. Then, an area will pop up below the video that will immediately begin transcribing all spoken language in real time.

This is great for clients to use as a support if they are hard of hearing or if they benefit from written language support to help augment their auditory comprehension. It’s also easy for clients to turn this feature on themselves because it’s a single button click, which is a huge win.

WebEx

Another great video conferencing platform, WebEx has fantastic annotation tools. Here’s how you can take advantage of them.

How to turn on annotation tools in WebEx:

1. Once you’re in a call and you decide to share your screen, either you or your client can annotate (draw) on your screen.
2. Hover your mouse at the top of your screen and then the black toolbar will show up as you see in the picture below.
3. Follow the red arrow to click on the “Annotate” feature.
4. You can use the annotation feature to draw your clients’ attention to specific areas on your screen, or you can have your client do this to mark items on the screen. They can do this from their iPad with their finger or from their computer with a mouse.
5. You can even adjust the types of annotations you make by using the toolbar on the side of the screen.

Now, let’s get into some tools

Document Cameras

In the picture below you’ll see my document camera, which is fast becoming my favorite add-on tool to help make my paper-based materials more functional in teletherapy. A quick Google search will present you with a whole host of different document cameras, but do you know how to connect and use them? Here’s a step-by-step guide.

How to connect and use a document camera

1. Document cameras generally connect to your computer using USB.
2. Once you’re connected, you’ll be able to share your screen using your video system of choice (in Zoom, you go to “Share Screen”, then “Advanced” at the top of the share screen options, and then click “Content from 2^nd Camera”).

What do I use my document camera for? I love to make a quick schedule on my whiteboard, write out cues, and even display my existing materials just as I would have during in-person therapy.

Interactive PowerPoint/Google Slides Presentation

Did you know that on some meeting systems you can actually give your client remote control access to your computer?

• On Zoom it’s called “remote control”
• On WebEx it’s called “assign control”

If your client is using a computer, you can allow them to move the mouse around your screen and even move items on your screen. You can also create interactive PowerPoint or Google Slide presentations to mimic more manipulatives-based therapy tasks you used to do in clinic! There are also some more pediatric-focused tools like Boom Cards that can also be adapted for adult clients as well.

Assigning Homework

Having a program like Constant Therapy that allows your clients to do homework at home, and also lets you check in on their progress from anywhere in the world is incredibly impactful. Make sure you’ve downloaded Constant Therapy Clinician so that you can manage your patients’ homework from wherever you and your iPad are. And remember, if you have a patient who is struggling to make ends meet, especially in these tough times, we’re always happy to work with them on a subscription cost that fits within their limited budget. We offer scholarships for patients in need – just tell your patient to give our friendly Customer Support team a call or send them an email and we will take care of the rest! They are specifically trained in working with persons with communication disorders and have a wealth of patience and experience meeting the needs of our customers, your clients!

Check out Constant Therapy today for a homework and carryover solution that can be implemented anywhere, anytime! 

Jordyn is a practicing Speech-language Pathologist and Assistive Technology Specialist and is the Director of Pierce Speech, Language, and Learning Center.  She also is the Director of Clinical Operations for Constant Therapy Health, leading content development, advising on product features, and coordinating internal and external research projects.