Teach the secrets

There is one function of the clinical life of SLP's; one component that is trained best, without a doubt, in the daily trenches where we find ourselves. It is a fundamental tenet that learning is most successful in the environment where the learning will be used. What we want to train in new and inexperienced SLP's, is their ability to teach the persons served, and their support systems, what is happening with the individual therapeutic encounter.

Teaching the person served, the skills that may help sustain the level of performance on skills you have seen in therapy. EXAMPLE: a schoolkid who has learned in the quiet room to use his "s's" clearly for reciting in therapy....gets to read to his family each weeknight the dinner menu, loaded with "s" sounds his mother has written out for him. "Tonight's meal: the spices include stevia, sarsparilla and sage..." Since the child gets to be the center of attention while practicing his speech skills back in real life, there is an increased chance for buy-in. The mindful SLP, one who realizes early in the clinical encounter that, - one day, sooner than later that this special relationship will have to end, begins to teach the persons and those around him some of the secrets of therapy.

After all, when the encounter is over and there is no longer means or rationale to continue treatment, someone else need be in control of using the skills treatment focused upon. In the majority of cases, the person becomes her/his own therapist. For those who benefit from continued guidance, the SLP brings in the circle of support.

Here's another example: when an adult with a swallowing disorder is progressing through her training, the earlier she or her surrogate can help perfect the skills that are desired through massed real life practice. Swallowing behavior having implications of high risk to health, the more frequently the training should occur. As the person served and his support gain confidence in generalizing a skill, from the clinic to everyday life, the final form of a long term skill use can be seen.

Some general tips for continuing a skill set introduced in SLP treatment, might include:
* Explain all procedures in simple terms. Instead of "paraphasia", say "word finding problems" or an equivalent; instead of "mand", say something like " "when you command someone to get a behavior you want". You are giving up management of this learning to others.
* Empower the persons who are assuming the management.  "When I am not here, I won't know what you do....but if you have liked what has occurred, try to do it this way. I hope it has made sense to you. You can DO this!"
*Establish the final form of the training material and carefully document the process and outcomes you get. There is a great satisfaction for the SLP who has seen a good outcome for the person served, equipped the person and the circle of supports, then communicated the program events clearly and efficiently.

Teaching the secrets of therapy to the person and the support circle? It increases buy in, improves the stature of the profession among its potential consumers; it brings closure to the therapeutic alliance for this specific instance, and expands the perspective of the person served for future encounters that could occur.
Comments, as always, are welcome!