I will be transparent that I want to write this blog objectively, but it's going to be difficult given all my unique perspective of this problem. 

I’ve been that SLP with a high caseload who felt like I was simply getting by -- not making progress and not giving my students the individualized attention I wanted to.

Additionally,  I’ve interviewed the therapists who come to me feeling overworked, feeling like they don’t have the tools necessary to treat their caseload, feeling under appreciated due to a lack of support.

Now, I'm on the other side of that picture, as well.  I’ve spoken to schools that can’t afford another therapist to travel on-site to assist, that can’t find another therapist with the specialty needed to help their on-site staff with specific needs, schools that don’t have an efficient way to address their therapist’s pain points.

So, now that you understand my subjective role in this topic, I'll get to the point.

So often, I hear people with the opinion that it is either on-site services or teletherapy. However, this is not the case.

Many times on-site services can be enhanced with the addition of teletherapy: on-site providers can be supported and caseload caps can be adhered to. So many pain points can be addressed (and eliminated) when you open your mind to utilizing this innovative service delivery model in addition to your on-site staff.


Medical leave can be highly stressful for the individual going through it and for the employer. However, by simply partnering with a teletherapist in your district, services can be covered while your valuable therapist takes the necessary time.  As long as your district has a computer/tablet with a built in mic and headset -- the teletherapy support team can handle the rest.

What I personally love about DotCom Therapy is we don’t have contract minimums -- we often step in to support an on-site therapist on maternity leave or with an illness and are happy to transition tasks back to them when they return. It’s not an if or then -- it’s a unified approach to confirming there isn't a delay in services when life happens.

Specialized + Bilingual Services

The overall scope of school-based therapy is extremely broad. The ability to access a therapist who is bilingual in Spanish, for example, or a therapist who has a background in the alternative communication device you’re working on is extremely powerful when trying to make educational gains. The beauty of teletherapy is that regardless of where that specialist resides, they simply need to meet the licensure and certification requirements in your school’s state and they’re able to step in to work with the multidisciplinary team to get those specialized goals addressed.

Caseload Caps

When referring to school-based speech-language pathology, many states have caseload caps utilized to dictate the appropriate number of students an SLP should have on their caseload before services are risk being compromised. Though not every state utilizes this and how each district approaches it is up to the regulatory agency in that state, teletherapy can be utilized to assist with those caseload numbers exceeding that amount. This helps confirm all therapists have the capacity to provide their caseload with the time and attention needed for high skilled and educationally driven services.

Evaluation Support

There are times during the school year when a therapist’s workload will become unbearable resulting in late nights, exhausted sessions, and a massive amount of coffee consumption (that last one may just be my personal “go to”).  Therapist caseloads will stay consistent because those evaluations haven’t been added to their numbers yet, but their workload is significantly high. Once again, teletherapy is the solution. Accessing a skilled provider [without providing compensation for travel] is the perfect way to get that evaluation completed. A teletherapist can even add that student to a small caseload if you're in danger of reaching a caseload cap.

Why is this important? You keep your on-site therapist taken care and help them avoid burnout by monitoring their workload on top of their caseload.

Clearly, I'm a pretty huge supporter of teletherapy and I see the full power of this service delivery model.  However, above all, I am a supporter of school-based therapy services which includes both the therapists and the schools.  

In order for therapy to be successful we have to open our eyes to the possibility of quick, but effective, solutions needed when the aforementioned areas arise.

Once we open our eyes to those solutions, we realize that therapists can truly unite--both teletherapists and on-site therapists -- to decrease workloads and increase educational gains!


Elise Mitchell



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