This past January, my first semester of in-house clinical practicum as a graduate student started. It was nerve-wracking! After all these years of studying speech-language pathology, it was finally time to put my knowledge to the ultimate test. Feeling nervous and overwhelmed, I began to question myself. How would I ever be able to conduct therapy—face-to-face—with a real, living, breathing person?!

I recall my first session—nerves boiled up inside of me, but I managed to successfully provide speech therapy to my client. I was sweating bullets the entire time, trying to hide my nervous tension behind my data clipboard. I felt relieved after the session, and proud to have taken the next step toward my future career. Then I had another session … and another. With each passing session, I grew more confident.

Just as I started becoming comfortable with my clients, implementing goals and activities, it was time for Spring Break. The week passed and I was excited to return to my clinical work. But my excitement quickly turned to disappointment when I learned it would be impossible. The COVID-19 pandemic hit and forced us (and everyone) into quarantine.

Continuing Clinical Practicum Through Teletherapy

The next three weeks continued with online distance learning, but no clinical practicum. I was heartbroken over the fact that my clients weren’t receiving therapy. It’s one thing to be required to stay home. It’s a whole other ballgame when you have a communication disorder. We all take communication for granted by easily texting and video chatting with friends and family. But for those with a communication disorder, the ease of communication may not be such a luxury. This pandemic could be a time of severe isolation, which is something I saw with my clients.

Fortunately, our clinic directors and staff worked diligently to roll out a teletherapy platform in approximately three weeks after we initiated distance learning. When it was time to jump into my first teletherapy session, it felt like the first day of clinic all over again . . . nerve-wracking! I was overjoyed that my clients would be able to continue therapy, but I’d only had half a semester of in-person experience. It’s one thing for a seasoned SLP to bring skills and experience to teletherapy. I was just beginning to learn and discover my own skill set. I was anxious about delivering the best possible therapy to my clients in this strange new setting.

The first week was extremely rocky, partly due to technical difficulties and navigating the presentation of therapy goals online. But after seeing my clients again and working through the new platform, my confidence sparked again.

There are various aspects that come into play when determining if a client is appropriate for this platform: internet & technology access, ability to pay attention to tasks, and setting appropriate goals. I was extremely fortunate that all of my clients would be eligible to come back for teletherapy. A few of them really surprised me with their commitment to teletherapy! It’s provided them an outlet to escape their day-to-day hardships while rehabilitating their communication skills. That said, there’s a major disconnect that occurs online because of a lack of social cues through videoconferencing. And I already feel the stress of being “on” … it feels like you’re being watched. But overall, the experience has been positive and gratifying.

Unfortunately, others in my cohort haven’t been as fortunate as me, having only received one or two of their clients back. They’ve felt anxious and stressed because of the possible lack of clinical experience and hours they’ll receive by the end of the semester. Fortunately, therapy groups, like our school aphasia center, have moved to teletherapy as well to help those students gain valuable clinical hours.

Pros and Cons of Clinical Practicum Through Teletherapy

I’ve only been doing this for seven weeks, but I’ve already found that there are both pros and cons of providing teletherapy during COVID-19 as a grad school clinician:

Pros

• During a typical, in-person clinical session, two grad student clinicians would treat the client. Meaning, they’d have to split the amount of session time to count toward their clinical practicum hours. During teletherapy, both student clinicians participate during the full session time, which means they’re each able to count the full amount of session hours toward their clinical practicum. This has been a tremendous advantage!
• We use Zoom for teletherapy sessions and being able to use the screen sharing feature to show clients my materials virtually has been amazing. There may be a glitch or two, but everything has worked out pretty seamlessly in the end.
• Teachers Pay Teachers and Boom Learning Card creators have produced free content and materials, which has been truly amazing. I know not everything can be free and making materials is not easy. As a student, having free materials available has been a life- and money-saver.

Cons

• It’s been an adjustment treating pediatric clients online. They’re definitely the most challenging! I’m sure all SLPs can attest to the struggle of maintaining children’s attention when you’re not face-to-face. You have to work 10 times harder to make sessions engaging for a child who feels like they’re a world away on the internet.
• Unfortunately, all of my materials are at our on-campus clinic. And as an unemployed grad student, making my own materials is the most cost-effective way to develop more. It can be overwhelming to adapt and create therapy materials to be appropriate for virtual sessions for each clients specific goals (especially for pediatric clients).

We’ve Been Given an Opportunity

As SLPs, we’ll have to continuously adapt to various clients with differing abilities. But now we’re seeing how we’ll also have to be nimble in our service delivery . . . adding teletherapy into the mix. I’ve actually viewed the past several months as an opportunity. Teletherapy has been utilized as an effective alternative to face-to-face speech therapy for many years, but it’s the first time graduate students (as a whole) are experiencing it as a clinical setting. It’s an experience current SLPs probably didn’t have as a grad student clinician, or even early in their career.

Although times may feel hard, I encourage you to view this experience in a positive light, especially knowing you’re continuing to provide effective therapy to those who need it during especially tough times. We’re going to have a tremendous advantage with this teletherapy skill set. It will be an excellent resume booster that future employers may start to require in light of the recent pandemic.

I have another full semester of treating clients online and I am feeling optimistic about how this will impact my professional career. I choose to turn this situation into one of my greatest opportunities!