Hallo Carol, my name is Loreto and I work at Languagecourse.net. The best way to learn a language is to be in contact with it as much as you can. Obviously, an immersion programme is the best way to achive that and improve all your language skills.
If you are unable to do that, you should try to read English newspapers and books, watch English tv, etc. It will help. We actually offer a free Vocabulary Trainer that will help you learn/revise vocabulary for your TOEFL exam. It is free and I am sure it will help you. You can find it here at the top of the page:
Speaking is definately something you should practice, as you will need a minimum level to pass your exam. Do not be ashamed of making mistakes. We all do, but it will improve and the number of mistakes will be reduced as you practice. Internet is a very good asset, and I am sure you will find people that will be happy to practice with you.
If you decide to finally travel abroad, we will be happy to assist you.