3 Teletherapy mistakes to avoid

New service delivery models take time to learn but don’t get caught in the trap of making these 3 mistakes during your teletherapy practice. Read on to find tips on how to avoid these 3 mistakes and ways to get your OT teletherapy sessions running smoothly.

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I know many of you have learned so many tricks and tips along over the past few months in your teletherapy journey. I have learned so many too over the past 20 years of OT practice and still continue to learn new things each day.  

But...I needed to address some mistakes that I still see many therapists making in teletherapy practice. 

It pains me to see so many of you struggling to get through your sessions, spending so much time looking for resources and “burning out” using this service delivery model. 

Transitioning to a teletherapy service delivery model involves being open to learning a new way to use your expertise and knowledge to impact your clients. 

It’s less about using your hands and more about using your voice.  

It’s less about being the expert and more about being a coach.

Today, I wanted to talk about a few critical mistakes that I made earlier on in my career too so you can get your teletherapy sessions running smoothly. 

P.s. They will also help your face-to-face sessions run smoother too!

Teletherapy Mistake #1: Not setting the stage

Our number one job as pediatric Occupational therapists is to connect and establish rapport with the clients and caregivers that we serve.

Once you can establish connection and rapport your job gets a lot easier!

You can be the best therapist with many specialty certifications, but if you struggle to connect with your families it’s really hard to share your skills and knowledge.

It’s very important that we know how to explain our role as therapists so that others know how we can serve them best. 

So, how do you set the stage?

  • Give a clear explanation of your discipline in parent friendly language.

  • Make sure to emphasize that you will be working together to focus on skills that are important to the child/family and will be focusing on their everyday routines.

  • Be curious about the families concerns and priorities for their child, what they like to do and what things are important to them. 

Teletherapy mistake # 2: Not meeting the family where they're at

As Occupational Therapists we have extensive training in child development.

It’s very easy for us to see the delays that children may be demonstrating. 

It’s also very easy for us to assume the expert role and to want to “fix” those delays and give lots of strategies to improve the child’s skills. 

However, those delays need to also be identified by families in order for them to be a priority.

Have you ever left a family's home after giving them multiple strategies to try and when you return the next week they have followed through with none of them?

Typically, this means you have not met the family where they're at and you didn’t take into consideration their everyday routines and priorities when giving your strategies. 

How do you meet the family where they’re at? 

  • Plan together (aka Joint Planning) with the family about which strategies they want carry over. You will see much better follow through and outcomes when the family is a part of the process.

  • Offer ways to embed 1-2 activities into their everyday routines so they don’t feel like the strategy is just one more thing on their “to-do” list. Less is more!

  • Use materials that are in their home, don’t bring toys in unless you plan to leave them.

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Teletherapy mistake #3: Trying to entertain young children on the screen

Young children have short attention spans.

If your session is an hour-long, you can expect that there will be a lot of time that child will not be interacting with you on the screen.

Instead, our first goal should be to coach the caregiver and get them to interact with their child. (Get more tips on coaching here).

Here are tips to engage the caregiver:

  • Catch up with the caregiver at the beginning of the session to see how things have gone since you saw them last and also to make a plan for what they'd like to work on for the current session.

  • Empower the parent to use sensory strategies if their child is becoming dysregulated.

  • If the child is distracted by the screen, have the family prop the device somewhere out of reach. Turn off your video if needed and tell the parent that you are going to observe the activity that they have chosen to carry out with their child.


I hope these tips will get your teletherapy and face-to-face sessions running smoother.  I’d love to hear if you’ve had other “aha” moments over the past few months using this new service delivery model.  

If you’d like to gain more support with your teletherapy practice, coaching, or add new tools to your pediatric toolbox, check out The Therapy Village membership here!

If you found this post helpful check out these posts:

5 tips to simplify the transition from therapist to coach

50+ ways to rock your Early Intervention Teletherapy sessions

Melanie Batista, OTR/L

Melanie Batista is a licensed occupational therapist and founder of Growing Little Brains. She has over 24 years experience with expertise in helping children of all ages and their caregivers grow and learn. Melanie also has 2 boys of her own at home. 

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