Telehealth Best Practices: Pirita Hämäläinen of VERSO Kuntoutus On How To Best Care For Your Patients When They Are Not Physically In Front Of You

An Interview With Dave Philistin

Target the treatment very carefully. The reason this is important is that targeting is directly linked with the efficacy of treatment. To be able to do this, the therapist must have good command of a wide variety of methods that they can implement in the customer’s or patient’s treatment at the correct time.

One of the consequences of the pandemic is the dramatic growth of Telehealth and Telemedicine. But how can doctors and providers best care for their patients when they are not physically in front of them? What do doctors wish patients knew in order to make sure they are getting the best results even though they are not actually in the office? How can Telehealth approximate and even improve upon the healthcare that traditional doctors’ visits can provide?

In this interview series, called “Telehealth Best Practices; How To Best Care For Your Patients When They Are Not Physically In Front Of You” we are talking to successful Doctors, Dentists, Psychotherapists, Counselors, and other medical and wellness professionals who share lessons and stories from their experience about the best practices in Telehealth. As a part of this series, I had the pleasure of interviewing Pirita Hämäläinen.

Pirita Hämäläinen, a Finnish psychologist, ABA and behavioral therapist, and CEO, runs her own rehabilitation service company VERSO Kuntoutus Ltd, located in Finland. Her company specializes in therapy and rehabilitation of children and young people with neuropsychiatric challenges and behavioral issues. With the right rehabilitation and treatment, the families’ well-being is improved through better life management, and they experience less stress. Photos by Tomi Lähdesmäki.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?

Already during my psychology studies — and even before them — I was interested in working with children. I worked in daycare centers that had children with special needs. I felt from a rather young age that I had care and attention to give to these kids. After I finished my studies and became a psychologist, I went to work in a neurological hospital for children. There, I had the chance to learn about the autism spectrum more closely, and I understood what a challenging matter it is.

After a few years, I looked into rehabilitation possibilities in the world of psychology and behavior, and I decided to study that further. It’s been 10 years now. I started from working with children in the autism spectrum, but have since expanded my work to include children with, for example, ADHD and Tourette’s. My passion for my work comes from seeing children with special needs learn new things and enjoy life. Rehabilitation truly works. When we do behavioral analysis, the main aim is to improve the quality of life for these children. And when it works, it reflects on the entire family!

Can you share the most interesting story that happened to you since you began your career?

There are many memorable moments, but about seven years ago, we started wide rehabilitation programs with children as young as 18–24 months old. One of the families had a child who was right in the middle of their sensitivity period for learning. The improvement was incredibly fast! Up until that point, I had read about and practised evidence-based techniques and treatments for a long time, but now I truly got to see it happening in front of me. It was amazing, and it made me feel like this approach works. We were able to achieve something highly valuable and meaningful for the family. The work with this family still continues on the long term.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

Find something beautiful around you every day — whether that beauty is in other people, nature or somewhere else. Everyone, including psychologists, go through hardship in their life and it can be difficult to maintain a positive outlook. But when you notice the beauty around you every day, your thoughts also become more positive. I sometimes see parents that I work with struggle with this as sometimes everyday life with challenging children can take its toll.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

I’ve received help from many rehabilitation professionals around the world — Finland, California and the Nordics. They’ve strengthened my belief that this methodology works and it’s worth the hard work to apply it in Finland, as well. More experienced therapists and psychologists have mentored me and given me plenty of concrete advice on how to do this work with my customers. I’ve grown enormously as a professional in the last 10 years thanks to this peer support.

Ok wonderful. Let’s now shift to the main focus of our interview. The pandemic has changed so many things about the way we behave. One of them of course, is how doctors treat their patients. Many doctors have started treating their patients remotely. Telehealth can of course be very different than working with a patient that is in front of you. This provides great opportunity because it allows more people access to medical professionals, but it can also create unique challenges. To begin, can you articulate for our readers a few of the main benefits of having a patient in front of you?

It’s beneficial to directly observe children and young people in face-to-face situations. You can really see for yourself how the child manages with different tasks and how the parents act in these situations. You gain more high-quality information in this way than when you hear accounts of situations from other people, for instance, from the parents in remote care. I tend to be able to grasp what the main issues of the child are faster when I see them for myself. It makes it easier to target the treatment correctly. I’d say in remote care, this process takes longer.

Additionally, when it comes to children with special needs, they already have a hard time focusing and being present in interactive situations. Face-to-face, it’s easier to manage these children, while remotely you only have your voice to guide them. Personally, I enjoy being physically present with children, it allows me to participate in their activities more closely.

On the flip side, can you articulate for our readers a few of the main challenges that arise when a patient is not in the same space as the doctor?

In addition to the lack of direct observation and struggles with focus, motivation can be a key challenge for children, young people and adults. Without it, remote care becomes very challenging. In addition, some issues are more difficult to care for remotely than others. It can also be difficult to target the treatment correctly for the child and the family. Face-to-face, it can be done quite efficiently, but, in the remote world, the importance of targeting is highlighted even further.

The way a therapist can combat these issues is to have a very solid set of professional skills. You need to be able to apply evidence-based methods to live and remote situations. You have to work with the family very intensively and also take the parents into consideration. They have considerable stress factors affecting them which can make them struggle with motivation.

Fantastic. Here is the main question of our interview. Based on your experience, what can one do to address or redress each of those challenges? What are your “5 Things You Need To Know To Best Care For Your Patients When They Are Not Physically In Front Of You ? (Please share a story or example for each.)

1. Have very good background information on your patient or customer. You don’t need their entire life story. For example, you should have a very clear idea of what the family is ready for. Are they prepared for everything that remote care actually entails? Are they motivated enough to commit to therapy? Do they understand that it’s not just showing up for a video call once a week, but there’s independent work in between sessions? Good background information helps to treat the customer or patient in a meaningful way. When your patient trusts that you know their unique situation, it also helps to maintain their motivation.
2. Assess the patient or customer from a functional standpoint. That means taking into account their entire life situation and it includes the family. Without this functional assessment, it’s easy to misinterpret the customer’s situation and you can miss very important things.
3. Target the treatment very carefully. The reason this is important is that targeting is directly linked with the efficacy of treatment. To be able to do this, the therapist must have good command of a wide variety of methods that they can implement in the customer’s or patient’s treatment at the correct time.
4. Work interactively and intensively. This means that the family and the child are not just at the receiving end of the therapy. There needs to be feedback both ways. This also makes the treatment or rehabilitation more fun — and having fun is the best way for children to learn new things.
5. If you work with children, you need to also remember to pay attention to the parents. They can be very stressed out because of work and their challenging child. For instance, if you’ve planned a session in advance, but the parents seem much too tired or stressed out to go through all the activities, lower the bar and make the session a little bit lighter.

Can you share a few ways that Telehealth can create opportunities or benefits that traditional in-office visits cannot provide? Can you please share a story or give an example?

What has really surprised me is that so many families and children are highly motivated to work remotely. We always do thorough evaluations and use motivating techniques, but remote care customers have committed to the treatment even more so than those who come in for face-to-face meetings. Remotely, you can’t really give up too much responsibility for successful sessions — that’s much easier to do in live situations.

From my customers’ point of view, remote care of course removes the challenge of long distances. Having to drive for an hour or more no longer stops people from getting treatment. I’m able to provide service to more people.

Let’s zoom in a bit. Many tools have been developed to help facilitate Telehealth. In your personal experiences which tools have been most effective in helping to replicate the benefits of being together in the same space?

I want to have a lot of interactivity. With our customers, we use video calls, chatting functions and surveys. We also monitor the treatment closely so that we stay up to date on how the child’s skills are developing. Interactivity in this case means that the families and the children can participate in planning the treatment and collecting data.

Whatever your form of treatment or whichever specialty you have, it’s important to have a tool that also helps your patients or customers see their own progress. Graphs are very useful for this! Families are more committed when they see visually that their hard work is paying off. At their best, good tools like this mean you don’t even have to spend time reasoning with your clients, they are much more willing to continue with the treatment and keep going. For us, the right tools have been provided by our partner Medixine.

If you could design the perfect Telehealth feature or system to help your patients, what would it be?

I’ve mentioned interactivity quite a lot! But I’d add more gamification — this would help children participate in their treatment even more actively and make it more exciting and fun for them. It would also be good if it was scalable for different devices from laptops to small mobile phones — not only for the patient but for the professional user as well.

I’d also like to integrate automation — but only up to a point. There should always be a real therapist managing the session. I don’t think robots can replace people. My system would also automatically create data on treatment and its success.

Are there things that you wish patients knew in order to make sure they are getting the best results even though they are not actually in the office?

I really want to emphasize that remote care and therapy still require time and commitment. Without those things, it doesn’t work. It’s of course the same for face-to-face care, but people should understand that remote care doesn’t mean just chatting once a week. It’s much more work.

The technology is rapidly evolving and new tools like VR, AR, and Mixed Reality are being developed to help bring people together in a shared virtual space. Is there any technology coming down the pipeline that excites you?

I’m very interested in these possibilities — they would certainly help children participate and get excited about their therapy! We have given some thought to how high technology could help in rehabilitating visual attentiveness. Another possible application would be working on social skills in VR with children in the autism spectrum. In addition, relaxation activities could work well in VR.

Is there a part of this future vision that concerns you? Can you explain?

I’m not concerned, but I do think some things should be considered and planned for. For instance, VR can provide a safe space to practise social skills and take steps towards real-life interactions. The aim should always be bringing the patient or customer closer and closer to natural situations. Becoming stuck in the virtual world can be avoided by planning the treatment carefully. Eventually, it’s also necessary to practise real-life interaction.

Ok wonderful. We are nearly done. Here is our last “meaty” question. You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

I’d like evidence-based methods to gain more ground in Finland and around the world. I want more people to know about them and to apply them — these methods change the lives of families and children. Their quality of life improves and life becomes more meaningful as difficult things become easier step by step.

How can our readers further follow your work online?

I have LinkedIn and my company VERSO Kuntoutus Ltd of course has Finnish social media channels.

Thank you so much for the time you spent doing this interview. This was very inspirational, and we wish you continued success.