In March of 2020, the COVID pandemic forced people to search for online services. I was one of the few SLP's in Canada who was offering asynchronous therapy. My private practice was swamped with referrals because my website featured the keywords, online speech language therapy and online literacy apps. My domain and my blog posts were ranking high in search engines.
Guess what I did next? I closed my clinical practice and founded Therapy Biztech to become a strategy consultant.
What is Asynchronous Therapy?
Asynchronous means not at the same time. In asynchronous therapy, the client and therapist rely on store-and-forward technology rather than 1:1 sessions.
Here's how it works:
Therapists design and direct therapy using written communication, images and videos, software, apps, etc, making these available in a secure portal.
Clients log in and complete structured lessons. The sequential curriculum motivates clients to generate progress data. Progress may be demonstrated through submitted videos, completed levels in a software program, or usage data generated by apps. It's flexible and rewarding for clients.
Because the curriculum is available 24/7 behind a login, clients work on their goals consistently. Their time and effort lead to meaningful clinical outcomes without the high cost of traditional therapy.
Asynchronous therapy is a huge time-saver for therapists. There is no need for the therapist to present the curriculum to the client in live sessions - not in person or via telepractice. Instead, the therapist designs therapy programs using a mix of commercial therapy resources and internal ones. A small set of resources can be used in creative ways with a large number of clients. The therapist thoughtfully puts together a sequential curriculum without the client present, and then makes this available in the portal.
This preserves the mental health of therapists. Traditional therapy can be massively embarrassing for therapists if sessions are observed by family members or school staff. Often therapy looks like play to an untrained eye so other adults might question the value of it. People forced to participate might be resentful and uncooperative. Group therapy can be unpredictable. Children can be inattentive. Telepractice sessions can have technical glitches.
Problems in live sessions, criticisms from observers, plus negative self-talk can all contribute to imposter syndrome for therapists. How sad! Huge numbers of therapists feel ineffective as therapists.
In public jobs, therapists complain about high caseloads, inadequate pay and administrative burdens. It is common for therapists in public jobs to leave the profession or change positions annually due to high burnout.
Private practice attracts therapists who have experienced burnout. They want control over their career. Unfortunately, the problem of imposter syndrome can really plague private practice therapists. They need to charge a high hourly rate in order to thrive in business, yet feelings of inadequacy can sabotage business-minded thinking.
Asynchronous therapy prevents the discouragement of imposter syndrome. It is easy for clinical professions to edit writing mistakes before they are published. Videos can be deleted and re-recorded. If the client is not engaging with the therapy curriculum, the therapist can change it.
Asynchronous therapy is not passive. It is not an online course without any accountability. It is the opposite. The therapist monitors progress and uses clinical judgement to direct the client in taking steps to successfully complete therapeutic goals.
Consultations are for expert guidance, problem-solving and encouragement. This doesn't need to happen in real-time. For example, feedback can be recorded and made available in the portal. Written treatment plans can be based on a template that is used over and over. It’s therapy that scales without trading more hours for more income.
For therapists, asynchronous therapy offers something important - freedom from hourly billing. Asynchronous therapy packages can be based on a monthly fee or a program fee instead.
It's a model that protects therapists, keeping them in the profession and allowing them to gain confidence. Over time, therapists using this model with a niche caseload have the opportunity to become experts in their field.
Asynchronous Therapy Gave Me the Life I Wanted
Asynchronous therapy gave me the freedom and flexibility that I had always wanted. My income was no longer based on selling my time by the hour. I offered live consultation sessions by webcam, but never delivered curriculum in these sessions. My clients worked on their goals consistently on their own time. I could log into the platform and see if they were completing their assignments and indeed, they were! Their time and effort produced life-changing transformations.
Asynchronous therapy gave me a high level of fulfillment as a therapist because I could serve a large caseload that had similar needs. This gradually built my confidence and gave me expertise. I was finally able to generate a professional income in my private practice, not just because asynchronous therapy is more lucrative than traditional therapy, but also because I was comfortable charging appropriate fees in my business.