Hello and welcome to Therapy Connect Conversations. My name is Megan Walker, your host. Today, our special guests are Simone Dudley and Kirstyn O’Rourke. Hi, Simone and Kirstyn.

We’re going to be talking today about delivering telehealth therapy in a child’s natural environment. And there are so many positives that can come from that. And this conversation is for parents and caregivers, therapists, people who work with children with disabilities and people who are just wanting to have more information on how telehealth actually works. 

So Simone, let’s start with you. Tell us in your opinion, what’s the best setting for providing therapy for children?

Thanks Megan. Well, the best setting to providing therapy is in the environment the child is at where the goal that you’re working on is most relevant or most important. For most of our clients, that natural setting is at home. Sometimes it might be at a grandparent’s place, sometimes it might be at childcare or playgroup or even an education facility. The natural setting is determined by the goal that the family has and the context that’s most relevant for that goal.

Okay, great. And so what are some further advantages for that child and their family who are receiving therapy via telehealth, particularly in their home?

If we are working with the family in a child’s natural setting, which is for example at home, one of the great advantages for the families is that they don’t have to pack up the children and hop in a car and travel to an appointment then sit in a waiting room. The therapy comes to them, so that’s a great advantage. Another great advantage accessing therapy at home via telehealth through Therapy Connect, in any case, is that we have a very short waitlist. Accessing our health services is almost an immediate proposition and the focus of our sessions, or where the greatest therapeutic impact happens is where the primary caregivers are working in a partnership with the therapists and the therapists are really building their capacity. Coaching and applying therapy strategies by just small little tweaks in routines, it might be a play routine or a home routine, that increase participation of the child’s routines that are really important for a family.

Okay, great. Thanks Simone. And Kirstyn, you’re a Lead Practitioner and Speech Pathologist at Therapy Connect. Hello, how are you going?

Good. Thank you, Megan.

That’s good. And so tell us from your perspective, there’s the wonderful advantages that Simone has talked us through, but what are some of the less obvious positive outcomes that happen through delivering telehealth in a child’s home environment?

Thanks Megan. I think the ideas that Simone has touched on are some of the really obvious benefits of therapy in a natural environment. Having worked in telehealth for a few years now, I think there’s some less obvious examples and benefits to telehealth that I personally tend to take for granted. One of the biggest ones is that natural progression for our parents and caregivers to take on the role of the coach in the therapy session and we sort of end up being sort of on the sidelines and helping that therapeutic process develop and evolve.

Our parents and caregivers working in telehealth, have this really unique opportunity, to take the wheel and drive that therapy session. This in turn increases their capacity and confidence in interacting and working with their children on their therapy targets and then, the effect of that is a much greater therapeutic impact and success rate we have with our clients here at Therapy Connect. That’s probably the main advantage I think, as practitioners start to work in the telehealth space, they realize, “Oh, wow. this is actually really, really good.”

Yeah, absolutely. And I’m just thinking of this through my lens as a parent and having gone through therapy with my child, that coach role that you touched on is so important because often parents feel that we don’t know what to do. So we’re learning just as much as the children are, aren’t we through this process?

And I think telehealth lends itself to be able to learn together as well in that setting to collaborate with the parent in that process. We have this physical barrier of a computer screen. Sometimes we as therapists, possibly tend to jump in a bit quickly, so when we have that barrier there, it can help support that process and collaboration.

Yeah. And when you’re delivering your therapy session, you are right there in the home of course. And so how important is it to use real-world scenarios and equipment and give us some examples of how you do that in your daily therapy sessions?

Simone touched on that and I guess it’s extremely important actually to be able to use real-world scenarios and equipment. I guess that then allows us to plan and implement therapy targets that are relevant to the child and relevant to that child’s world and familiar to them. For example, one of the examples I think of is one of my favorite icebreakers with an older child. I send them out on a treasure hunt around the house and bring back different colored toys and items from their kitchen, which then allows us to be drawn into that child’s world and they feel like we’re a part of their world and that helps establish rapport as well. 

When working with younger children as well, I think we have a unique opportunity. We are being drawn into that child’s world again, and we have the ability to follow the child’s lead, working or playing, interaction skills in an environment that’s familiar to the child and that they’re comfortable with. They are going to be much more willing to lead us around. One of the examples I think of is a colleague whose young client had four little baby chickens. The therapy session was transferred over to mum’s phone and the child was then able to take the therapist outside and see the chickens and the whole session was based on these chickens. This enabled us to deliver therapy using topics and examples that are relevant to that child and that child at that point in time as well.

Oh good. And Simone, I know that you’ve talked to me before about being right there in the home environment, you can see trigger scenarios, you can see challenge areas. And Simone what’s a favorite activity that you have to get children engaged when you’re doing a therapy session on the OT side?

Well, it’s funny. I actually also used to use Kirstyn’s activity, sending kids on missions, and that was lots of fun and they would come back with lots of show and tell objects. Probably from a therapeutic point of view, one of the most common challenges that I think can work really well is solving meal time challenges and supporting a child’s regulation around mealtimes.  The idea that a therapist can conduct clinical observation during a meal time and really observe a child’s regulation or the difficulties they might have sitting still and attending, making decisions around food, and then working with the primary caregiver on strategies to help prepare that child beforehand, that might have a sensory component or an environmental component or an emotional component during meal time. I think that would be an example where in a real context, it’s all possible to achieve that via telehealth and it’s a bit exciting when you have that level of therapeutic impact.

Absolutely. Because in the clinic, you’re not seeing as much are you? But if you’re right there in the home, as parents sometimes we exacerbate the situation and you’re there as the coach to sort of steer us in the right direction in terms of our children. Simone, just tell us then how does it look when you’re working with older children and adults. Is the telehealth experience in the home different in that situation?

Well, yes. I think that when you are working with an older teen or a young adult or an adult, they’re much more in control of determining their space and their goals. In that way, they’re working, in most cases directly with the therapist. The same principles apply. You are really wanting to be in the context, that’s the most important for that young adult or older teen. So that context might be somewhere in the home or it might not be. Sometimes we’ve done sessions in community venues for example. So problem solving around where is the best environment is really part of, I think what we would all want to achieve as therapists. 

Okay. Yeah, great. And Kirstyn our last question over to you, and then I’ll get Simone to let us know how people can get more information. Kirstyn, tell us on the flip side, we’ve talked about all the amazing positives of telehealth, of which there are so many and the list keeps going. And as telehealth is so much the norm now, so all these benefits are just expanding. What about the other side? What are some of the challenges working in telehealth?

I’m really glad that you asked this question because telehealth doesn’t come without its fair share of challenges. I think that certainly is reflected in the practitioners that I work with. I mean, I’m forever in awe of their ability and our ability to work flexibly and think outside the box and adapt and change. And that’s just not change from one session to the next that’s within a session, like challenges might include things like, I’ve had a cat often walk across the screen. I don’t know why that happened, but that cat seemed to like walking across keyboards, a dog might into the hassle or a sibling might want to join in on the session.

I think we need to sort of view these challenges as an opportunity. An opportunity to then reflect on what life is like for our clients and for their caregivers and for their families. Life, especially with children is chaotic. So when we’re being brought into the home by telehealth, we can experience that sort of chaos. And I like to perceive that not as a challenge, but as a benefit, we can experience life as that caregiver does.

I guess in my previous experience as a speech pathologist working in the clinic setting, we can set it up and it’s nice and neat and we have out only the toys that we want out and other things might be hidden under a rag. So it’s very, very controlled. So I guess it’s when we lose control in some of those challenges that we have that ability and then that license almost to sort of think outside the box and think flexibly, which is, I think when we get the best therapeutic outcome for our clients. This also gives us the opportunity to establish rapport with our clients, because we’re experiencing the chaos together and we can bring parents in on that as a consultation as well, “Oh, what do you think we could do to make this better?” 

Simone, tell us for people who are listening, who are new to learning about Therapy Connect, you’ve been going for six years, you’ve got over 50 staff. Tell us about the services that you offer, your current availability and how do people get more information?

So we are an online allied health practice, we have speech pathologists, occupational therapists, psychologists, physio dietetics, social work, an early educator. Our client services team will be really keen to answer any inquiries you might have on 1-300-757-806, and our website www.therapyconnect.com.au has registration forms for those that want to access our service or inquiry forms for those that want to find out more information. There is a lot of resources on our website and other videos to look at if you’re after more information.

Fantastic, and Simone people can get support from you from wherever they’re located, can’t they? And you don’t have the long waiting lists that people might be finding in some regional areas?

Absolutely, Megan. Our clients are dispersed all over Australia and even overseas. So we’re able to see anybody from anywhere. Our wait list’s almost nil for every service stream. We have been really fortunate with our ability to recruit experienced practitioners when we need them. We are in a great position to be able to provide clients with access fairly quickly to allied health supports.

Fantastic. Thank you both so much for your time today and you run such a beautiful heartfelt organisation. Thank you for the great work that you do.