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Is anyone else besides me using Skype as a coaching tool? How about google + hangout? — 7 Comments

  1. Gunars, Your question really relates to more than Skype, it relates to telepractice in various forms. Yes, there are people who are using telepractice in different areas of communicative disorders, including stuttering. Deborah Cully was one of the pioneers in Canada. I predict that telepractice will continue to expand, and certainly reach people in remote areas or don’t have easy access to in-person services. Although it is getting better, there continue to be challenges in using technology to treat at a distance. I’ll mention one – in my field we must currently be licensed in the state where we deliver services. There are some clinicians who have applied for and purchased many state licenses, but that certainly is a financial burden. I do have to mention also, the there is discussion about Skype and whether it is HIPPA compliant. Protecting client’s privacy as well as delivering good service are important considerations in telepractice. I also think for people to deliver services via telepractice in my field, there should be training and clinical experience in university programs. I know of at least one university that is doing that.

  2. Gunars,
    I’ll try this again…. Safari just quit unexpectedly and took my comment to the “void”.
    I agree with Judy that licensing is one of the biggest challenges facing those of us who wish to treat people who stutter and their families with telepractice. I am legally able to work with someone outside of the United States (my country of residence) but am unable to see a client in Wisconsin which is 25 minutes from my home in Illinois. Another challenge is insurance reimbursement, which usually will only cover services if performed with the client present in an “office setting.
    That being said, I feel the future for telepractice is bright.
    Kevin Eldridge

  3. As I’ve said before in another forum, the term “telepractice” implies live online practicing. Practice, practice, practice — the thing that gets you to Carnegie Hall. But practising of what? What is implied is practicing of some fluency technique, again looking at only one element of a multi-faceted problem. That multifaceted problem calls for unlearning (and understanding) of old behaviors and then learning and relearning new ones, real-world desensitization, healing and strengthening. You don’t get that face-to-face with a sole practitioner sitting in a clinic room, let alone from somoone in a place far away. Meanwhile, in regard to the treatment of kids, it is absolutely crucial that the practitioner has the time and ability to bring parents and teachers onside with what he or she is trying to achieve with the client. I think the jury is out — or very much ought to be out — on whether this can be achieved through telepractice but that is where the face-to-face contact enters the picture. But the bean counters in school districts will like telepractice mainly as a way of outsourcing for the purpose of cutting SLP jobs to save money regardless of whether or not it is a better service-delivery model than the status quo. And school districts copy each other — “trending” is I think the term the hip folks in social media use these days. As with everything in the treatment of stuttering, what is needed is independent third-party assessment of outcomes over time. — Ed Feuer edfeuer@mts.net

  4. Ed,
    I use telepractice at times and I am not into Practice Practice Practice. If I can have a beer with my brother 1500 miles away, why can’t I talk to a client in the same way (minus the beer of course). You mention kids…. My kids FaceTime every day with friends. They see talking to a friend online as ubiquitous with talking in person. For this reason, I think telepractice with kids probably offers more promise right now than with adults. I find that parents while not as comfortable as their kids can engage in fruitful discussion via the internet as well.
    Kevin Eldridge

    • Kevin,
      Do you attempt to bring the teachers of your young telepractice clients onside with what you are trying to achieve in therapy? Has there ever been independent third-party assessment over time of your therapy including that done by telepractice and more traditional methods?

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  5. Dear neidersgunar

    I echo Judy’s remarks above. Telehealth is a growing segment of clinical work. In Western Canada geographical distance can be a barrier to healthcare and telehealth is one solution. I am the Executive Director at the Institute for Stuttering Treatment and Research (ISTAR) in the Faculty of Rehabilitation Medicine at the University of Alberta (www.istar.ualberta.ca). Our staff use telehealth to support and train speech-language pathologists in the delivery of stuttering intervention as well as to conduct initial treatment, follow-up and maintenance sessions with clients and their families. We evaluate the effectiveness of these programs on an ongoing basis and the preliminary data are encouraging. A major challenge is, as Judy described, maintaing licensure in the provinces, territories and states where our clients reside. One simple change that would facilitate telehealth delivery would be for regulatory bodies to accept that the location of treatment is where the clinician resides, not the client. Lastly, telehealth takes many forms at ISTAR including telephone follow-up sessions and formal videoconferencing sessions conducted over secured internet connections especially designed for health practice.