Hi friends! Pinky's up because today we are having our inaugural Tea Time interview with Marissa Rocheleau, a speech pathologist who blazing trails in tele-therapy!
Q: What practice setting are you sharing about today?
A: Telepractice speech pathology
Q: What is your educational background? What degree(s) and/or specialties did you earn?
A: I have a Masters degree in speech pathology and hold my ASHA CCCs. Given that I work in telepractice, I am licensed in seven states.
Q: How long have you worked in this practice setting?
A: I started part-time in 2014 and went full-time in 2017.
Q: What does a typical work-day of telehealth look like for you? How many hours a day/week do you typically work directly and indirectly with clients? How do you occupy your time between clients? Do you have opportunities for personal breaks throughout your day at all?
A: A typical day for me is between 5-15 clients, depending on if I’m working with school-based students in groups or private clients individually. Sometimes I am back-to-back with my sessions for a couple hours, and other times I build in a break of 30-60 minutes, during which I write SOAP notes, get my sessions prepared for the next round of clients, eat some lunch, or throw a load of laundry in the dryer. I work full-time in telepractice right now, with 50-75% of that being direct time depending on the week. When I’m not doing that, I work on my business coaching and membership site business.
Q: Do you formally clock in and clock out, if so, how is on the computer or via sheet, etc.?
A: When I’m doing a school contract, it’s a little more stringent on the paperwork than private clients, so I document the time I spend with my students exactly in a shared calendar. My private clients I manage a little more loosely and just share a quick SOAP note and date of service in their invoice.
Q: Who provides you with your schedule? Do you typically stay on this schedule or does it fluctuate depending on patients’ availability?
A: I create my own schedule based on my caseload. I typically stay within this schedule, but I have some flexibility built in for reschedules and meetings.
Q: How long do you work with your clients per session and how long are they typically on caseload?
A: Sessions are typically 30 minutes each. School clients last the full 9 months of the school year, while private clients average 9-12 months of work with me. Some are shorter at 3-6 months, while others can last several years, but I think that’s about average.
Q: What type of diagnoses do your patients typically have? Can you please provide 1-2 activities you would do in a standard treatment session with one of these patients?
A: This depends again if I’m working with students in schools or private practice, as I see both children and adults privately. School clients are typically the more “mild to moderate” caseload of articulation, language, social thinking, fluency, etc. just because the schools I work with send the more severe cases to an onsite therapist, but I’ve definitely worked with those students before. Private clients I get a lot of early childhood articulation and language, aphasia, and accent modification.
Q: Do you have meetings to attend throughout the day? If so, how long and who attends these meetings with you?
A: Yes, I have meetings several days a week with school staff, companies I contract with, my own contractors I staff, and then IEP meetings. Meetings typically last 30 minutes but IEPs are obviously longer at around an hour.
Q: What type of documentation do you complete? (i.e. how long does it take, how frequent are your notes due, etc.)
A: I complete evaluation reports and SOAP notes for all clients, and then progress reports for school clients quarterly. SOAP notes I do daily even if it’s just a quick rundown and evaluation/re-evaluation reports just as needed.
Q: What does a typical evaluation look like? How long does it take? What assessment tools do you use?
A: If it’s a private client, I typically meet with them for 15-30 minutes to begin with just to plan out what we’ll do together and set expectations for my delivery of services. In schools, I simply pull students from classes as needed to do an evaluation, just like you would in-person. Evaluations can take anywhere from 30 minutes actually working with the client to several hours, depending on what I’m evaluating. Of course I supplement standardized assessments with conversational samples, interviews, record reviews, parent reports, etc. Some favorite tools I use (yes, digitally!) are the GFTA-3, CELF-5, SCCAN (neurological rehab test), and the SSI-4.
Q: What is a ball-park range of what a SLP can expect to earn in your practice area?
Working in telepractice as an SLP is really variable. Some companies take into account where you live geographically when assigning you a rate, while others simply base it off your experience and fit for the position. Like the South where I live (Florida) is notoriously low paying despite some areas having a high cost of living. You want to find a company that pays enough for you to afford paying your own taxes (if you’re a 1099, which you probably will be), cover fees like insurance, health insurance, and license renewals, and still be able to live off the wage. I would recommend trying for $45-50/hour as an SLP in telepractice on a 1099 contract. W2 positions will be about 30% less than that because they’re paying your taxes.
Q: How (if anything) did you get your “foot in the door” to work in this setting?
A: I took a part-time contract with a telepractice company when I started out. More companies are getting specific in wanting people who have either worked in schools for 1-2 years (given so many of their contracts are school-based) or have done telepractice before. It’ll be interesting to see how this changes with so many people having done telepractice during COVID closures.
Q: What is your favorite part of this practice setting? Can you provide a favorite memory of a patient/client that you know OT positively impacted their life?
A: Good question! My favorite part is honestly getting to work from home. It works really well for my personality, which is introverted and hard working when left to my own devices. A favorite memory I have is just being able to still connect with clients through the computer. When a student asks if they can stay late to chat with me, I’m thrilled because I know I’m making a difference in their life, not just their speech.
Q: What is the biggest mistake you’ve made in this setting? How did you correct this mistake (if possible) or what did you learn from it?
A: The biggest mistake I’ve made is not being proactive enough in my communication. And this can go from keeping teachers and parents in the loop to scheduling IEP meetings. It’s so important in telepractice to really be on the front of communication because you’re not there in-person. I find great success in having an open-door policy where people know they can reach out to me in addition to attending meetings with the team as much as possible.
Q: How do you personally prioritize your self-care and prevent/manage burnout?
A: This is a tough one in any setting. As I said, telepractice really works well for me because I can simply turn off the session and go stretch outside with my dogs rather than feeling “on” all the time as I do when I work in-person. I’m not great at this, but I would highly recommend scheduling a lunch break that you actually stop working through and then leave work at “work” at a certain time. It can be easy to just keep working on things when it’s just in another room at home!
Q: If you could go back in time, what advice would you give yourself (or to a new grad) who wants to enter this practice setting as an OT?
A: Two-fold advice. Don’t be afraid to get your feet wet even part-time or by observing people in telepractice, but know that it may be a difficult setting at first if you’re a CF given all the supervision requirements. Sometimes it’s easier to make the transition even after just the 9 months of your CF when you have some basic treatment and evaluation skills under your belt that you can then adapt to the online setting.
Q: What are you up to next/where can people follow you?
A: On October 1st, I’m launching a new membership site that’s the first of its kind. Called Telepractice Connect, it’s designed to bring you all things telepractice all the time, from discussion boards, to continuing education, to no-print downloads. I’m super excited to be offering this much-needed resource, especially as so many therapists are looking at virtual or hybrid approaches for the fall. It’s open to any discipline working in telepractice, so SLPs, OTs, and PTs are all welcome! You can learn more at www.telepracticeconnect.com.
Marissa Rocheleau, M.A., CCC-SLP is a licensed speech language pathologist specializing in telepractice. She owns Linguabilities, a private telepractice company, and Telepractice Connect, a membership site for online educators and healthcare professionals. Marissa enjoys working with clients of all ages online in addition to teaching others all about how much potential telepractice has. You can reach her on Instagram @telepracticeconnect or Facebook under the same name.