Attachment to our clients makes diagnosis more difficult

There’s nothing like getting a huge hug from a 3-year-old speech therapy client: what a way to tell me he enjoys therapy!

The affection goes both ways: we grow attached to our clients. We notice progress, point it out to families, and celebrate with them. When we work with families for long enough, we meet new siblings, hear about first days at school, and get invited home to birthday parties and for tea!

Clouding my judgement

But is it possible for therapists to get too attached? I’m trying to make a tricky differential diagnosis and reflecting on whether my affection for this little chap is muddling me up. Am I observing his skills through rose tinted glasses? Placing more of an emphasis on things he can do while skimming over things he can’t?

I’m trying to clarify my thinking by making objective observations: noting down what I see without interpretation. I’m comparing these observations to what I expect from a child his age, as well as his clinical presentation from a year ago. I’m reviewing how he responded to different types of therapy and attempting Dynamic Assessment. I’m also planning to observe him at nursery, to see how he responds to other adults. I’ll figure it out!

Do you form close bonds with particular clients? Do you think it supports therapy outcomes? Or do you have to focus on being impartial?