Please join us every Wednesday for the next seven weeks as we examine the unique aspects of treating stuttering with online therapy.
This week’s focus – ethical considerations of providing therapy online
Telepractice must comply with the standards of in person therapy. Initial comparison of videoconferencing and conventional face-to-face speech language therapy has indicated that children made similar progress with both methods, and students and parents overwhelmingly supported the telemedicine service delivery model (Grogan et. al., 2010). I have not formally studied differences in treatment results, but my experience supports these findings.
Online assessment requires special consideration, because some assessment instruments are copyrighted and cannot be transferred to clients online without permission. For subjective assessment, I rely on information from the initial interview and the Speech Satisfaction Scales that are part of the Dynamic Stuttering Therapy protocol (Dahm, 2007). Assessing fluency, speech rate and length of blocks, can be easily done online by recording speech samples. That allows for quick assessment using the SSI-3 (Riley, 1994).
Care needs to be taken to ensure the client’s comfort, privacy and confidentiality. My clients electronically sign a statement agreeing to the terms of treatment and giving permission to record speech samples for training purposes. I am careful not share identifying information or recordings without explicit permission. Speech samples are saved in files on an external hard drive. Skype sessions are held in a private place and no one is allowed to observe sessions without the client’s permission.
When treating people in countries foreign to the provider, it is important to be sensitive to cultural, linguistic, religious and geopolitical issues so as not to cause discomfort to clients. I feel honored to be able to treat people who stutter who I would otherwise not have the opportunity to know. Sensitivity and respect for differences is imperative. This extends to topics for practicing conversational speech, modesty in dress, and other cultural differences. Having lived both in the Middle East and the United States, I have learned a lot about differing cultures. This understanding, and the bond we share of wanting the experience to be successful has a positive impact on service delivery.
Last week: Series Introduction
Coming next week: Technical Requirements for online therapy