What is Online Therapy?
When we think of online therapy, we often picture video-conferencing, but there are many ways a therapist can communicate with you online.
Online therapy differs from the ‘telehealth’ model of prescriptive therapy, adopting a person-centred approach that allows for the flexible use of technology that works best for the client or family.
Where telehealth or teletherapy may favour video-conferencing, online therapy is much more than that. It’s coaching parents and teachers to achieve therapy goals. It’s file sharing to observe behaviours in real-time and in-context. In fact, it’s whatever the client wants it to be.
The aim of online therapy is to build a team around the client to give them a 24/7 support network that will work towards therapy goals.
Online Therapy Goals
With the typical medical or prescriptive model of therapy, a clinician will tell you what’s wrong with you and what you need to do to improve. But who sets up these goals?
In online therapy, the goals are set by the client. A therapist may have studied extensively in their chosen field of therapy, but you are the expert in your own life. If ordering your weekly groceries at the shop is more important to you than hitting a certain score on a speech and language assessment, then the therapist will help you to order your shopping, using the strategies that they have expertise in.
To truly understand the goals and motivations of the client, we talk to them and the people closest to them, working together to come up with goals that satisfy them. From here, the therapist starts to build a team around the individual, who will work together to achieve the goals they have set.
By setting person-centred goals, this approach to online therapy can be applied to many of the mainstream therapy services. At Umbo, we apply this to speech pathology and occupational therapy.
Building the Team
Online therapy works best under what is known as a key worker model. This involves the therapist identifying someone who is close to the client, who acts as somewhat of a ‘guide’ to the client or family.
A key worker can be a teacher, support worker, playworker or anybody the therapist and family deem suitable to fill in this position in the team.
From here, the therapist leads the team - typically made up of family members, the client and the key worker - and coaches them on therapy strategies that will achieve the goals that the client or family have set. By doing this, the team has set up a program that takes place anytime, anywhere.
Through file sharing and phone calls, the therapist can coach team members through particular situations in real-time, making their lives more manageable and putting therapy goals in context.
Real-Life Goals in a Real-Life Context
When you see a therapist in-person, consultations almost always happen at the clinic. By taking the client outside of their home environment to a place where they know therapy is going to happen, we are potentially encouraging unwanted behaviours, where the individual will act how they act in a therapy setting, but not necessarily how they would act in a real-life situation.
By delivering therapy sessions via video-conferencing or on-screen observations in the home, we’re getting to see the client’s behaviour in a real-life context. Let’s look at an example.
If a client has some mealtime struggles, we’d have to take those situations and explain them to the therapist at the clinic, where this kind of behaviour is never exhibited in front of the therapist. Even when using video recordings of behaviour, the therapist will only get to see the behaviour either during or after it has happened. As a result, the clinician can lack the context needed to make truly informed decisions.
Alternatively, if we are able to allow the therapist on the other side of a screen to observe the family dinner table, and see exactly what happens before, during and after mealtimes, the clinician can use the context around the situation to make a more appropriate observation of the behaviour.
Even in video-conferencing consultations, the client will be in their home environment and therefore a lot more comfortable in exhibiting their usual behaviours in the presence of the therapist. The clinician’s presence is far less invasive and can allow the therapy session to take place without disturbing the client’s routine at home.
Nowadays, the typical 9-5 is becoming less and less common. We know families have different schedules and online therapy allows you to be flexible.