Becoming Independent: Ways of working and scheduling


To finish this series on Becoming Independent I’m going to write about two challenges I have: resisting doing things the way I always did them in the NHS and scheduling clients.

When I started working independently I kept asking myself: am I doing this because it meets my client’s needs or because this is the way I’ve always done it? One of the things I appreciate most about working independently is the freedom and flexibility I have to offer clients what they need.

Length of therapy blocks

Here’s an example. I started out booking clients in for 6 weeks blocks of therapy, like we used to in the NHS. Then I realised I didn’t need to be constrained by this timeframe if it wasn’t working for me. Although when I reflected on it, I realised it was working. 6 weeks is long enough to make measurable progress towards goals and allows me and the family to continuously review how we’re getting on. Parents can commit to blocks of 6 weeks; it doesn’t seem like speech therapy is something they’ll be doing forever.

In most cases, I have dropped the “consolidation period” between blocks of therapy, which we used in the NHS. Although I still use it for Parent Child Interaction Therapy because I see families benefitting from it. With direct therapy I see clients on a weekly basis for as long as they’re making progress towards their goals.

I’ve cut down on paperwork. I see parents each week and we discuss targets and progress, I don’t tend to write review reports or formal programmes, they’re not normally necessary.


I don’t have much advice to offer about how to arrange your therapy schedule, I wanted to flag this as one of my challenges. Parents enquiring about private therapy assume they can request an appointment time that works for them, which of course they can! However, as I only work two days a week it feels like more often than not our diaries don’t match up. Some parents are able to juggle things around; move the swimming lessons or switch the day of the week they work from home. Others aren’t, and ask me to recommend a different therapist.

I’ve learnt a few things that might be useful:

  • The 8.30am slot is popular, but doesn’t suit families who have other school aged children to drop off.
  • The 3.30pm and 4.30pm slots are also popular but don’t tend to be productive with nursery or reception aged children who’ve spent the day at school.
  • Many parents are surprised when I suggest they could drop their child to nursery/school later or pick them up earlier to accommodate therapy sessions. Nurseries/schools respond to this in different ways, some are happy to release the child for therapy and others are not. It seems to be worth a try.
  • When I had more free appointments, I tried to be strategic, e.g. offering mid morning (and sometimes hard to fill) appointments to children who did the afternoon session at nursery.

In some ways things are more straightforward now I’m close to capacity: either parents can make it work, or they can’t, and that’s okay with me. I bring up my availability early in the conversation, because if Tuesday at 2.30pm is impossible for a family, I don’t want them to feel they’ve wasted their time giving me a lot of background information.

That’s it for the Becoming Independent series! Did I miss something you’ve been wondering about? Let me know.


Photo by Cygnoir.