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Reply To: Direct v Indirect Therapy

Sarah Barnett

Hi Saira

I agree with Rachel, this Ebbels et al article is really, really helpful.

I’d emphasise the bit about when/if the staff are trained/supported/monitored – because that’s a critical part, and without it the effectiveness wanes.
“… approaches led by education services can be effective – when staff are highly trained and well supported”
“… can make progress – when intervention is managed by an SLT, but delivered indirectly by others (Tier 3A), – provided they are well trained and supported, and closely monitored.”

So it might be helpful to clarify for the person supporting patents at tribunals that ‘direct’ v ‘indirect’ isn’t simply swap of delivery by therapist v by education staff. The ‘indirect therapy’ in SLT Tribunal reports should itemise the SLT time needed to (a) assess student, (b) co-planning with CT (b) design the programme, (c) model/explore therapy approaches with student, (d) provide resources for staff/home/student, (e) train, support and monitor staff in an ongoing capacity, probably front-loaded (f) liaise with home, (f) review and repeat, etc

The fourth standard of HCPC’s standards of conduct, performance and ethics is “Delegate appropriately”:
Delegation, oversight and support
4.1 You must only delegate work to someone who has the knowledge, skills and experience needed to carry it out safely and effectively.
4.2 You must continue to provide appropriate supervision and support to those you delegate work to.

I hope this helps.
Best wishes,