How much therapy is enough? The impossible question!

There is sufficient evidence in the literature related to speech-language pathology, physiotherapy, occupational therapy, and psychology to indicate that intensive therapy is required in order to influence the neurophysiological basis of various impairments. Conversely, the influence of therapy on reducing communication restriction, psychosocial impact, and well-being is less well documented in speech-language pathology, but research in related areas indicates that the amount of therapy required to have a positive influence on these areas is associated with a broad range of individual and social factors. Intensive therapy takes considerable commitment on the part of the therapist, patient, and family members, and is not always achievable or acceptable. Therapists can incorporate a broad range of approaches to increase the amount of therapy available to individuals which may include expanding self-management, computerized therapy, use of the family members and volunteers, and improving skill mix. Most importantly it is essential to consider the objectives of the therapy when determining the intensity.