Who has the best approach?

With a previous post ("Are You A Technician? A Psychometrician?"), I began to describe two perspectives the SLP might bring to the job, regardless of the customer base or service setting where the SLP might work. With the roles of the technician vs. the psychometrician,  I wanted to call attention to not only how each role is endowed with unique responsibilities, but also how each role can limit the autonomy of the SLP.

To keep it real, the majority of my days and those of most of my peers have significant portions devoted to repetitive,  focused tasks. We all spend time at specialized and circumscribed activities available for our use by our education, training and experience. But if this were the entirety of the workday, I would run, run like the wind from such a job. Growing in this profession means, to me at least, that you should be able to use all your skill set; to challenge yourself to think while you work; to use your good work to indirectly market your profession: I can hear it now....

(Sung to the tune of 'Dark End of the Street') -

"Do you know - what an SLP can do?
She may help you talk, but you hear better too;
He helps you swallow; helps you think on your feet -
She lives in the real world so your life's more a treat.

YOU AND ME - tangled tongue, straightened out by an SLP....

He sees the big picture,
Not just the skill constricture;
She works well with mothers, bosses
And your MDddddddddddddddd

YOU AND ME - tangled tongue, straightened out by an SLP" -

I am calling this perspective on the clinician, the "diagnostician". How do all three perspectives compare in a nutshell??

WHO DOES IT?		HOW DO THEY THINK?		WHAT DO THEY THINK?
SLP as technician		Let’s do this one thing.		I’ll do all the ‘x’ you want to give me.
SLP as psychometrician		Let’s do this exactly right.		I am your lab bench jockey.
SLP as diagnostician		Let’s do it so this person cans communicate/swallow/think better.		I do it all for person ‘Y’.

I see the diagnostician as the apogee of evolution in our field: the diagnostician draws her/his decision making skills from a broad general skill set, in addition to the specialized knowledge required for the CCC. Technician and psychometrician skill sets are folded into what the diagnostician does, but there remains much more. Perspectives #1 and #2 are domain specific, but #3 is more and more a generalist - though knowing how to be specific, for the needs of each of the persons she serves. Where the technician and diagnostician fill a role, the diagnostician embodies an identity.

I hope that these ideas can help fuel more thought and discussion about how the SLP approaches her work.

Would you like a garden?

Regular readers of this blog, or of my other writings and presentations, know how enthusiastic I am about gardening in clinical speech-language therapy. It is fun. It's rewarding for clinicians who do the work, and for the persons enjoying the 'fruits' of the work. Though not expensive to carry out, the creation of gardening structures and the sweat equity you put into their use, can offer incredible returns on investment in a clinical laboratory to serve the persons you are entrusted.

Entertaining, innovative; providing multisensory stimulation; a haven from the clamor and buzz of modern life; and you can eat the toys! Like hippotherapy,  aquatherapy and corporate SLP, gardening can energize the SLP'S career - but I believe the gardening laboratory should be an experience that SLP's have from the beginnings of their career.

I would like to see a laboratory garden (or teaching, training, therapy or whatever kind of garden you call it) in every SLP training program: very simply put. You learn during your training to assess phonology; you learn to train phonatory function to help someone speak clearly in real life; you learn how to use FEES for swallowing - and you can also find 10 words that go with 'tomato', while growing Napa grape tomatoes.

The options for stimulating communication and thinking are too numerous to count now. Would this garden require an SLP student to develop a horticultural skill set, in addition to their professional training?  Not necessarily. But at least 4 options exist for starting and sustaining the 'therapeutic garden' for a university speech and language clinic, with various levels of start-up and maintenance costs. Are there other advantages to the new professional? To the training program? To other programs and departments at the school?

Yes, yes and yes. The new professional gains working experience in a real-life environment that is conducive to clinical magic. The training program has a recruiting tool, as well as a student training site that can be shared and coordinated with the help of other departments (e.g. life sciences, consumer science, nutrition) to achieve unique or unified missions.

In the state of Illinois, there are 15 college/ university programs that prepare future speech-language clinicians for the bachelor's degree or above. I look forward to reaching out to each program as an unpaid consultant during the program's summer term. The goals of consultancy are to identify programs committing to development of a therapy garden by fall 2016. SO - Illinois SLP training program directors: Do you want a garden?

Are you a technician? A psychometrician?

(Blogger ' s note: I was unabashedly a fan of MAD magazine parodies when much younger, and still admire them for what they taught me about truth-telling.  Here's the truthiness I see in how an SLP structures her/his job.)

To the tune of "Take Me Out to the Ballgame"

Are you just a technician?
Do you do one job o'er and o'er??
Even if your one job is in demand
The pent-up boredom splits you where you stand:
Where a half of you works your butt off,
And the other half ' s going numb -
I'd much rather get techie, when all in one piece
So find your butt,  and insert thumb!

(To the technicians everywhere who really love their job: when you are mindful about your work, even a repetitive SLP activity is rewarding. Sometimes, though, it's hard to be mindful. Doing all day 'bedside swallows', hearing testing, oral peripherals, MBS's, and back in my training days, "IT- PAHS" (Illinois Test of Psycholinguistic Abilities"; - it was a pivotal life lesson to learn how to appreciate the discipline involved in doing repetitive tasks. Pinning your ears back, staying attuned to the needs for high quality in repetition, and keeping the ideals of quality customer service up front - equally important. But maybe, when you hear yourself referred to by physicians as "the swallow technician" - that actually happened - you want to use more of your skills acquired in graduate training. Why, otherwise, would a physician use your services for much more than the finite job )

To the tune of "La Bamba"

You are a psychometrician!
Your day is filled up with
Testing people from dawn to dusk
If there's a protocol to be had
You'll pull it off the shelf,
You'll glean it from its husk
And when it's time to know the score, they ask -
What is the score?
That is the score!?
YOU know the score....

(I do admire the skill of a professional tester: such an armamentaria for truth - telling in those test kits! Training and experience allow the psychometrician to capture systematically a portrait of a person's function. The pressures of the modern human service workplace, be it education or health care, - be it for adults or children - seem to benefit the services of this "psycho - ", as standardized data collection appears the favored documentation of outcomes, by third party payers. Inevitably, though, management of the person's case teaches you that understanding a person's needs cannot simply be -  placing a frame about a photograph.)

What else can be done? Is there another approach to patient care that allows an SLP to consider multiple dimensions; that allows you to apply the art of communication,  as well as the science?