You go into work one morning in the speech therapy department. Others may call it the therapy department, or the speech-language pathology or rehab department - irregardless, that morning the secretary hands you a case file and says "We need an evaluation done and written by noon". There are thirteen other persons on your caseload already, each with their own paperwork and logistical needs. But, hey, let's get this evaluation done in the morning, when the patient is relatively fresh. What could go wrong, and how to prepare for the contingencies?
It starts with our stock in trade: Communication. Though we feel the pressure of time and someone watching us during the daily caseload grind, at the moment we meet that new customer - she or he is the center of our attention. The relationship we develop and maintain with the person largely determines what the outcomes may include. If you as an SLP have a good working relationship with the person, then what you might ask of that person, she/he may more likely follow whatever lead you provide. Some specifics on relationship-building, that begins with the first encounter at the evaluation:
BE HONEST. Tell the person referred you are sent (using the authority of the referring physician's order if necessary) to describe the person's skills for communicating, or thinking or swallowing. Explain in a manner the person can understand, the processes and mechanics of the evaluation and treatment planning process. Describe each step you are taking concisely, with its rationale. When you are done, explain the data analysis as possible while you are still online (in the evaluation setting). If data requires further offline analysis, offer to supply the interpretation as soon as possible.
BE EFFICIENT. Collect as much of the history information prior to entering the assessment setting. Have your interview questions polished and in a framework; insert additional questions to flesh out impressions as necessary. Practice your formal testing before the first visit, so that you have a routine that allows you to get the data and process it with the person present - when it is possible. Have your report writing procedure ready to start as soon as possible after the visit is over.
BE REASSURING. Given your data analysis and interpretation, your job is then to supply the recommendations and "close the sale". When you follow the guidelines of our Code of Ethics, by not guaranteeting results of treatment - but instead, by painting the picture of how treatment is systematic and designed to help the person function better - you have the best opportunity to show that therapy matters. If therapy is not an option, and you may see the person again, reassure them that you are available again if needed. If you are to treat the person, let them know that the standards for communication you set at the first visit, will continue throughout her/his association with you.
As the relationship continues and grows: Stay honest. Work efficiently. Always reassure your patient that she/he can count on YOU.
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