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Teletherapy: your guide to getting started

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Amid COVID-19 responses, providers are looking for safer alternatives to face-to-face services and greater emphasis is placed on the role of service delivery via digital platforms, such as teletherapy or telehealth. It’s not as easy as switching on Facetime, but it’s also not as complex as you might think. Here we have some things to consider and resources to get you going.

NDIS services can be delivered via teletherapy. There is no separate line item, billing is the same as for a face-to-face session. If you believe teletherapy is the most appropriate mode for service delivery talk with participants about the benefits and how you can both get started.

Teletherapy provides real-time visual and audio connections between service providers, assistants and participants. It can be used to remotely plan and deliver therapy services as well as professional development, training and support.

It offers significant benefits to providers and participants, and a recent international review of telehealth services for allied health and nursing found it can be as effective as face-to-face services.

If you think teletherapy may be a good way for your organisation to build capacity and deliver services, there are a few things to consider to help make the transition a success.

9 essentials for teletherapy implementation

1-Align teletherapy services with organisational skills, strategy and services

Before setting up teletherapy service options it is important to ensure the services being offered align with the organisation’s strategic plan and services. Ask yourself: “what types of supports do we already deliver that can be transferable to teletherapy?” Teletherapy is not a new model of care or standalone service. Rather, it is a mode of service delivery which may help expand an organisation’s ability to service hard-to-reach participants and grow their geographical boundaries. Those involved still need to have the clinical competencies to perform the sessions. This should also involve checking your indemnity insurance coverage to deliver services via teletherapy. Provided the services are within your scope of practice, this should be covered – but check with your insurer if in doubt.

2-Engage appropriately trained and supported therapists delivering services

In addition to delivering services, therapists will need training/skills in coaching and engaging participants to use the digital platform effectively. Some clinical guides and tool kits can assist in understanding this (see Support resources section below).

3-Implement clear organisational policies and procedures

This should cover aspects such as how a session is conducted, the informed consent process and adherence to relevant national and state guidelines for data security and privacy. For more information on these requirements see Support resources section below.

4-Invest in reliable connectivity and suitable equipment

This includes technology such as webcams and software with IT support for set-up and troubleshooting. Investigate and choose an online platform that is within budget and appropriate for collaboration and sharing documents.

5-Provide guidance on a suitable environment for delivery

This includes factors such as privacy, sound quality and visual distractions.

6-Consider appropriate supports for participants

Ask yourself: who should be with the participant to help achieve the session goals? This may be a parent, teacher, assistant, local therapist, or it may be just the participant on his or her own. Do they have the necessary permissions and required skills to conduct the session effectively?

7-Provide technical and administrative support

Adding teletherapy to your service offering can bring additional technical skill and administration requirements. These should be factored in to the model, including the training needs of those who will be involved and support services for therapists.

8-Conduct a risk assessment

With any service delivery, good risk assessment is required to ensure the safe and effective outcomes. Teletherapy may not be suitable in all situations - where it is to be used, risk assessments should be performed, including:

  • appropriate participant presentation and suitably skilled person with the participant if required
  • cultural competency and appropriateness of the service
  • understanding the impact of national and state privacy laws and data security regulations (including when storing data)
  • awareness of the duty to disclose the risks associated with using any online platform
  • declaring responsibilities of each party—the disability service and the participant.

Resources for understanding and assessing risk can be found in the links below.

9-Get clinicians and participants on-board

Experiences shared by state health services reveal participants generally enjoy the services offered by teletherapy and see it as both effective and empowering. However, it can sometimes take longer for a clinician to accept and use this platform. Persisting can be worthwhile. Person-centred care and empowerment are at the heart of teletherapy—these align well with core values in many community service providers. It may be worthwhile to share training with clinicians to demystify teletherapy and share positive results from research.

Support resources

Specific responses to COVID -19

General teletherapy supports

  • Services for Australian Rural and Remote Allied Health. SARRAH has developed a position statement on telehealth and a collection of links to other commonly used resources.
  • New South Wales Agency for Clinical Innovation. NSW ACI has developed a range of support tools and guidelines, including a special interest group for clinicians interested in telehealth. This group is open to people nationally and can be a great way to share knowledge and build skills.
  • Victorian Telehealth Community of Practice. Supported by the Victorian Department of Health and Human Services, this site provides access to resources, networking and professional development on using telehealth.

References and further reading

If you would like more resources on telehealth, please get in touch with your BLCW Regional Coordinator for more information.

Wade V.A., Taylor A.D., Kidd M.R., Carati C. (2016) Transitioning a home telehealth project into sustainable, large-scale service: a qualitative study, BMC Health Services research, 16 May 2016 access via:

https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1436-0

Speyer R., Denman D., Wilkes-Gillan S., Chen Y., Bogaardt H., Kim J., Heckathorn D., Cordier R. (2018) Effects of telehealth by allied health professionals and nurses in rural and remote areas: A systematic review and mete-analysis, Journal of Rehab Med 50:3 access via: https://www.medicaljournals.se/jrm/content/abstract/10.2340/16501977-2297?ref=search