In this presentation, Kelly Alhooie identifies three common mistakes clinicians make in pelvic health teletherapy—over‑relying on teaching stretches and manual techniques, ending treatment too early, and lacking confidence in remote care. She then outlines three practical recommendations to overcome these pitfalls: (1) probe the patient’s deeper “why” to address underlying motivations such as relationship connection; (2) use the patient’s home environment as a therapeutic asset rather than a limitation; and (3) develop methods to achieve therapeutic results without hands‑on interventions. To illustrate the approach, Kelly shares a case study of a new graduate who, despite initial fear of treating erectile dysfunction via video, applied the method—focusing on the patient’s deeper why, pain‑science education, and home‑based coaching—to help the patient regain erectile function and intimacy, thereby boosting the clinician’s confidence in teletherapy. The overall message is that clinicians can transition from hands‑on care to effective remote coaching by shifting mindset, deepening patient understanding, and leveraging the home setting.
Chapters
So this is the 3 things that I believe that most providers are not doing correctly. So number 1, we're just straight up teaching at them. We're showing them stretches, we're showing them manual therapy, we're showing them exercises and thinking, hmm, I guess this is all I can do for you. We're also just stopping at a couple of sessions because we just get to, well, I've showed them all the stretches, I've showed them all the exercises, 'Now I don't know what to do with them.' And so we're truly not getting them to the finish line, which means they're not getting the result, which means they also think that we can't help them. And the reality is we really can. And the third thing I see is most of us don't have enough confidence or believe that we can actually help the patient with the provider, or with the patient over the actual computer screen. They— we believe that they have to be in front of us, and that's just not true. So 3 things that we should be doing during the teletherapy session. Number 1, you must dig to the deeper why. You must ask the question. So I'm going to give you guys this example here. If someone is coming in for pain with intercourse, why are they truly coming to see you? I want you guys to put it in the chat. Why are they truly coming to see you? Guys, I want to make this interactive. Got to make sure you're paying attention here. Why is someone with pain with intercourse coming to see you? Can you put it in the chat for me? They think something is wrong with them. Yes, that's true. They're worried about relationships. It affects the relationships. They want to enjoy it. Okay, these are close. These are really close. Jenny, I like it. They want to connect with their partner. Guys, they're missing a connection with their partner. That's truly why they're coming. So if we're not digging enough, if we're not getting to the root of really why they are there— they're not there to solve their pain with intercourse, I just want to let you know that. They really are not. They're there because they want a deeper connection with their partner and they're craving that. So we've got to be able to get to that deeper why for them to understand that we see them and that we hear them. Number 2, you really want to use their environment. At the clinic, it's a staged environment, but in their, but in their house, it's something that they're going to be doing day in, day out that's potentially causing the problem. Number 3, understand how to get the results without using your hands. We truly believe that these guys are our magic, and it really isn't. This is our head. So here's a testimonial from a new grad, a staff member of mine that came into my clinic, and she has never done teletherapy before. And she was terrified because we see males with erectile dysfunction on teletherapy. We see tailbone pain patients. We see chronic pelvic pain patients. We see anyone and everyone and any diagnoses through teletherapy. And she was like, Kelly, I don't know how to see someone with erectile dysfunction through teletherapy. Like, is he gonna pull down his pants? Like, what's gonna happen? And I'm like, no, no, no, that's not how this works. Through the teletherapy method that I showed her, I was like, no, we're gonna help guide him so that he understands what he, what truly is his deeper why and get him to understand that it's not just the physical aspect. There's a psych aspect, there's a pain science aspect. And we have to create all the pieces of the puzzle and put it together for him so that he can get the best outcome. And through the method, she was able to guide this, uh, one of these males with erectile dysfunction to where he was able to have an erection, be able to be intimate again with his wife, and understand what was causing his erectile dysfunction all through teletherapy. So, and it just made her feel so much more confident, and she was able to do it. And so now she loves teletherapy. She's like, I want to do it all the time. And so, um, through the method here, she was able to feel more confident in her skills of coaching people through the computer screen.
