As telehealth becomes more prominent across different settings, the therapist-facilitator relationship is more important and varied than ever.
Facilitators are incredibly important when it comes to the success of the client and they play a vital role in teletherapy. The facilitator can be anyone from the client’s parent, caregiver, teacher aid, student support specialist and so on.
How to Have Consistency Across Facilitators?
With many parents or caregivers now stepping into the unexpected role of facilitator without any training or experience, it is important to establish norms and expectations. Whether or not someone has any previous experience in such roles, it could be very helpful to ensure that they have a baseline understanding of what is expected of them.
Knowing expectations and boundaries will be very helpful for getting the most out of therapy sessions. In this article we’ll go through a few ways this is important.
IBCCES is the only provider that offers the best practices for facilitators in a 5 credit hour certification to ensure that no matter what the background is of your facilitator that they are prepared to help you get the best outcomes possible for your patients.
As an occupational therapist (OT), when using facilitators always make sure you are aware of applicable state policies and regulations. It is extremely important to make sure the facilitator is properly prepared and knows expectations beforehand so they can be as effective as possible during the therapy itself.
Why Having a Competent Facilitator is Vital
When practicing telehealth as an OT, having a facilitator can be the difference between a struggling or successful client. They play a critical role in promoting the attainability of teletherapy programs in schools and they allow conducting teletherapy sessions with certain populations to be much more fluid.
When the therapist is not physically present with the client, the facilitator plays a variety of important roles to make sure therapy stays on track. It is important they understand what those are just as well as the therapist does so the patient can achieve their full potential.
A Facilitator who Knows What You’re Looking For Can Save Explanation
For example, some OTs worry about holding telehealth sessions because they are afraid they won’t be able to address mobility issues the same way with telehealth. While there are certainly limitations to practicing telehealth, many of these limitations can be overcome with the help of a well-trained facilitator.
Facilitators Can be Crucial for Complex Cases and Comorbidities
It is also often believed that clients with complex comorbidities are not well-suited for teletherapy, however they are sometimes the ones who see the greatest benefits. Teletherapy is also a great solution for those with autism, can be good for individuals with Down syndrome who are learning to use an AAC device, and individuals with severe behaviors.
Telehealth Won’t be Appropriate for Every Patient
There are a number of areas that are not well suited for work via telehealth, even with a good facilitator. While in certain situations this can potentially be done with a good facilitator (such as when there is no other choice due to isolation imposed by COVID-19 lockdowns) these are not going to be a typical approach. Some of these include:
- Transfer training
- Balance activities
- Neuro re-education
- Hand therapy
- Other acute rehab situations
When considering if a patient is a good fit for occupational therapy online here are some questions to consider about the patient’s ability level:
- Are they able to sustain attention for a reasonable time?
- Do they have any visual impairments and how severe?
- Do they have any hearing impairment and how severe?
- Do they have any cognitive deficits and how severe?
- How comfortable do they feel with technology?
- Do have a good support system or potential facilitator (e.g. family, a caregiver) at home?
- Do they have any sensory issues and how severe?
- Do they have any behavioral issues and how severe?
- Do they have limited fine motor skills?
In these cases having a facilitator can be incredibly helpful because they allow the client to receive treatment with on-site assistance without having to go anywhere, which might otherwise be very challenging or not possible.
Forming a Powerful Alliance
To make the most of the facilitator-therapist relationship it is important to communicate effectively and set clear expectations upfront. The facilitator and OT have to be able to work together in unison as a team to ensure the client is successful.
To kick off the relationship make sure both parties understand two very important things:
- The common goal, which is to help the client be successful
- What the facilitator’s responsibilities are and what the OT’s responsibilities are
- How the OT will communicate various messages when needed throughout training
Responsibilities of the Facilitator
- Make sure the client is attending the session on time/assisting with the process of logging in and getting started
- Must be comfortable and competent with technology and help with any unforeseen technical difficulties – troubleshooting with video and audio equipment if needed
- Manage the client’s schedule and help them navigate obstacles that might impact their attendance
- Coordinate with the OT during sessions to make sure they understand what the client is working on and to ensure the client is completing their activities
- Form a strong relationship with the OT and be able to communicate openly with them
- Have knowledge of and sensitivity to the clients’ cultural and linguistic differences and be aware of how these differences might influence the client’s participation
- Must be organized and understand how to communicate progress, questions, and challenges between the client and the OT
Responsibilities of the OT
- Must be capable of giving clear direction to the facilitator so that they understand which activities the client must be completing
- Establish certain expectations before sessions begin, such as cueing and behaviors, reward systems, and forms of physical support
- Be able to build a working relationship with the facilitator
- Clearly communicate client goals and expectations so that the facilitator is on the same page
- Must make sure the facilitator is adequately trained and capable of assisting during sessions
Tips for a Better Therapist/Facilitator Relationship
While it’s important to keep the therapist/facilitator dynamic professional, it is equally important to treat the relationship as a relationship. Transparent communication, openness, and expressing appreciation will take you far.
It is also important to build rapport just as you would with a client. This brings the therapist/facilitator relationship to a human-level where you will be able to connect and begin to feel comfortable working together. Get to know each other and don’t be afraid to ask questions. The more comfortable you are working together, the more comfortable the client will feel during sessions.
Be empathetic when speaking with each other and use nonverbal behavior to express that you are listening and engaged. Small things like leaning in, nodding, making eye contact, and being conscious of facial expressions and gestures can go a long way.
Through clear communication, expressing your appreciation for each other and the work you’re doing, and being genuine with one another the alliance you form will be effective and transformative for your client.
Maintain the Relationship
Lastly, always address the relationship and set expectations when you feel as if you’re not on the same page. Discuss why it’s important to both have the same understanding of your roles and build a strong alliance. Ask how they are feeling and invite feedback throughout your time working together. Discuss goals and check-in with them frequently.
Conclusion: Make Your Facilitator Your Greatest Asset
Having a facilitator during teletherapy sessions can be an incredible asset for OTs if they know how to develop a strong relationship and make the most out of it. Sharing the common goal of helping the client be successful is a great foundation to build from.
Implement these tips and watch how your relationships become more meaningful and your teletherapy practice becomes more effective.
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