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Zoom in. Team up. The new era of therapy

- Tamsin Oxford

Can online platforms help therapists and tutors transform teaching and care beyond the pandemic?

Online work, internet © Curiosity

The Covid-19 pandemic transformed the world. It shoved organisations into a digital space, it thrust students and tutors into online learning, and it shifted global goalposts on everything from therapy to care to business. 

Tools such as Zoom and Microsoft Teams became the de facto meeting standard as the world leveraged connectivity and technology to stay in business, online and engaged. Over the past year, these tools and their usage have evolved and mushroomed. They have become more than just the sum of the connectivity parts, providing people with access to services and solutions that they never had in the past. From speech-language therapists to individuals discovering their potential working from home, these new platforms are opening doors and creating opportunities, but they have come with their fair share of complexities. 

Change leads to opportunity

“This is a novel and exciting period for speech language therapists,” says Dr Joanne Neille, Senior Lecturer in the Department of Speech Pathology and Audiology. “Online wasn’t something we really engaged with prior to Covid-19 and we needed to embrace these platforms quite suddenly and make significant adjustments. We’ve made some significant achievements, but there are challenges that [we] continue to encounter, and some ethical dilemmas.”

For Neille, online teaching and supervision have opened many doors, specifically with regards to training, teaching, and providing students with fresh skills sets that equip them to work in different contexts. It has improved students’ and lecturers’ abilities to approach teaching and learning from a global perspective, and given them more access to conferences and continuous professional development (CPD) events that previously may have been too expensive or out of reach.

Jennifer Watermeyer, Associate Professor and Director of the Health Communication Research Unit, agrees: “The American Speech Language Hearing Association (ASHA) had an online conference together with our local South African Speech Language Hearing Association (SASLHA) in November 2020, with local and international speakers and input that normally wouldn’t happen without huge funding and costs. This has opened up other opportunities for learning and CPD that were not necessarily that easily accessible or affordable in the past.”

Currently, students in the Speech Pathology department are learning about cleft palate care on an international online course that is immediately accessible and that does not require the department to hunt for local lecturers at cost.

Virtual therapy

Online teaching and training have handed local students a global perspective on a virtual and accessible plate. It has also allowed for therapists to potentially engage with, and treat, people who previously couldn’t access therapy due to distance, time and logistical limitations. 

“Being able to offer therapy face-to-face online has broadened the scope for enlarging [the] practice as we can target anybody, anywhere in Africa,” says Watermeyer. “We have a well-established speech therapy and audiology profession in South Africa, but in other countries skilled professionals are few and far between. Now we can easily connect with patients and colleagues across the continent.”

Neille agrees: “We can access greater numbers of clients for remote interventions, potentially moving beyond the borders of South Africa to countries that have limited access to speech language therapy services. Two of our biggest challenges are accessing people in remote areas due to logistical challenges and the shortage of skilled therapists – with only 3 266 registered speech therapists to a population of 60 million, you can see that there aren’t enough therapists to service the needs of the people.”

People in urban settings have greater access to services while those in remote areas have to travel long distances, sometimes up to a day, for a 45-minute session. This is where the real value of online therapy emerges. Patients can log in, connect and undertake therapy without travel or extensive costs. But there are limitations. 

People with neurological impairments, those who aren’t confident using technology, or who have limited data or poor connectivity are at an immediate disadvantage when it comes to online therapy. Their experiences can be challenging, and these limitations impact on the one factor that makes this therapy so valuable – the connection with people.

“Relationships are key to our profession and with online it isn’t always possible to read people, or target issues remotely,” says Neille. “We have to engage with patients to help them become more confident with the technology before we can even begin to think about offering a language intervention service.”

In addition to engaging with the technology, there is the need to consider the therapy environment as a whole. When patients attend sessions, the tools and equipment needed to support the therapy are on site, while in the online environment these often have to be sourced by patients and carers. In addition, there is the risk that the therapist will engage more with the carer than with the patient if the latter has cognitive impairment. 

“Assisting with materials and technology is one side of the coin, but we have found that there is a risk of the carer becoming too involved in the therapy, or clients not setting up their sessions in the right setting, like on the bed or sofa, for example,” says Watermeyer. “If the line is bad or there is poor connectivity, or if there is excessive background noise – all these factors negatively impact on a session.” 

There is a lot that still has to be overcome to turn online into as engaging and capable a tool as face-to-face. Captioning, carer engagement, assisted therapy, connectivity – these are evolving in the online environment. Yet patients in complex situations and with challenging disabilities still struggle to receive the right levels of care. Certainly, online has opened the door, but to truly realise the full capabilities of online therapy and training a lot more needs to be done to ensure that online shines as brightly as it should.

  • Tamsin Oxford is a freelance writer.
  • This article first appeared in Curiositya research magazine produced byWits Communications and the Research Office.
  • Read more in the 12th issue, themed: #Solutions. We explore #WitsForGood solutions to the structural, political and socioeconomic challenges that persist in South Africa, and we are encouraged by astounding ‘moonshot moments’ where Witsies are advancing science, health, engineering, technology and innovation.