In the conclusion to their book, Jane Stokes and Marian McCormick wrote that they hope it makes you think “Hmmm…” – it certainly does.

As Jane and Marion designed the curriculum for a new postgraduate course in speech and language therapy they collected stories, and then wrote this book to add to the conversation about issues that underlie the SLT profession. The book has 10 chapters, 5 written by Jane and Marian, and 5 contributed by other people. It raises challenging questions and explicitly invites the reader to examine their professional beliefs.

There are a number of chapters I’m looking forward to re-reading and think I’ll review regularly. Marian’s chapter about reflective practice inspired me, and reminded me that one outcome of reflection needs to be a goal for the future. Aoife Gallagher’s chapter “To intervene or not to intervene” had me nodding with agreement. I’ve been considering the role of parental expectations, fear and anxieties in my own clinical work so was interested to read Aoife’s ideas about how to make services transparent and responsive.

In her chapter about supervision Jane introduces models from related fields, that we in speech and language therapy can learn from. Keena Cummins’ chapter on using video clarified issues I’d been struggling with in my therapy sessions. Her analysis of the value of face watching and mirroring between adults made me reflect on some recent interactions with parents. I hadn’t considered the link between spirituality and speech and language therapy. I enjoyed Sophie MacKenzie’s chapter on this topic, which discussed the narratives clients use at different points in the therapeutic journey and person-centred care.

I was scribbling down thoughts and questions as I read this book and enjoyed how it encouraged me to consider why I do what I do. If you’re a therapist who enjoys asking why and getting stuck in to some interesting discussions, I think you’ll enjoy this book. 

The book includes quote from students of Jane and Marian’s course, I was stunned by how insightful they were. If you’re looking to hire a new grad keep your eye out for therapists from the University of Greenwich!

A couple of weeks back, at the ASLTIP conference,  I led a session about how to start a speech and language therapy blog. I knew I didn’t want to stand and talk for an hour, so I included activities as we went along, which I hoped would leave attendees ready to write their first blog post when they got home.

We started by discussing why we were interested in blogging and who we wanted to read our posts. People were keen to explain what speech and language therapy is and how therapists work, share their expertise and resources, and use their blog as a place to reflect, so as professional development.

Next I showed the group how easy it is to start a blog with WordPress. I played them a video of me setting up a new blog and writing my first post in 5 minutes. I hope I reassured them that you don’t need lots of technical skills to start a blog.

We talked about titles and the importance of being clear, so that people know what you’re writing about and can find your posts. I talked about how using photographs can makes posts stand out, encourage people to read them and break up the text. I explained the purpose of linking to other websites (it helps your reader and respects your “sources”) and showed them how to do it. And I encouraged them to share their posts on social media.

We discussed finding our voice, and sounding like ourselves. Blogs aren’t reports or research papers, so don’t need to be written in a very formal style. I shared with the group a tip from Kate Kiefer Lee: try reading what you’ve written out loud (or to your dog!) Does it sound like something you’d say? If it doesn’t, go back and take out some of the words you wouldn’t use in conversation.

We discussed the responsibilities of being an SLT blogger. Then I finished up by sharing resources. I use Trello for keeping track of ideas I’d like to blog about, then when the mood to write strikes, I can just pick a topic from my list. I read other blogs (you can find SLT related ones by searching on google or using the #slpeeps hashtag on Twitter) and find the resources about blogging from Braid Creative useful.

The group got stuck in with the activities and asked some questions that made me think, thank you! If you were at the workshop and you’re now blogging, send me the link, I’d love to have a read.

Any questions about blogging as a Speech and Language Therapist? Let me know.

Last week I had what I thought was a winning therapy idea, when it didn’t pan out I had to improvise.

Two of my kiddies are working on verbs and we’d been practising “cutting.” I’m targeting /sn/ clusters (“snip!”) with another child. I was inspired by some recycled packing materials to try a hair cutting activity.

I drew faces on paper and taped wavy, strings of cardboard packing stuff on for hair, it looked great. I handed a pair of children’s scissors to the girl working on “snip” and she gave it a good go. But the scissors were too small and not sharp enough to cut the “hair” – oh dear. We started snipping other bits of paper, and then rapidly moved on to sticking things on to a picture of a “snail.” For the two boys working on “cutting” it was Toca Hair Salon to the rescue – phew.

Therapy is all about improvising: therapy sessions rarely go exactly to plan. We can’t follow a recipe, instead we spontaneously make communication opportunities from whatever is available, and teach parents to do the same.

When I caught up with my former NHS colleagues recently, they asked me how my independent practice was going. I commented that I’d never seen children make as much progress. We started unpicking possible reasons for this rapid progress, was it that:

• I see the children once a week on an ongoing basis? Or
• The parents are particularly engaged because they’re paying for the service? Or
• I’m able to tailor therapy to a child’s particular needs? Or
• A combination of all three factors? Something else entirely?

I had a think.

The role of parents

The parents I work with take an active role in the therapy process, however, when I worked in the NHS this was also the case – so it can’t be that simple. I think timing may be a factor: parents contact me when they’re ready for therapy. In the NHS they might have to wait 6 months for a block of therapy, which comes at a time that doesn’t suit them (moving house, one parent away on an extended business trip, death in the family etc.) Parents then look like they’re struggling to engage with the therapy process, when the sessions have just come at an inconvenient time.

A friend suggested that parents who access NHS therapy are often engaged at the beginning of the process but become increasingly frustrated with the lack of flexibility they’re offered. I’ve seen the opposite happen in independent practice: parents engage with the service, they then see progress, and this reinforces their work and commitment. They feel ownership of the therapy process and continue to work hard at home, which means more progress and more reinforcement, and they continue to stay engaged with the process.

The flexibility to be client centred

Seeing the children on a weekly basis must have an impact on progress, however, I think my flexibility to provide them with exactly the type of therapy they need is more important. I’m not restricted to offering blocks of 6 sessions and then a long “consolidation” period, I can get to know the children and their families and they can get to know me. I’m not limited to seeing the children in groups containing a wide range of abilities and I’m not restricted in the type of therapy I can offer depending on the child’s diagnosis or the care pathway they end up on. I’ve spent a whole therapy session negotiating with a child and his mother how and when they’ll practise at home. I’d have struggled to justify this type of session in the NHS, but without it we weren’t going to get anywhere.

What motivates a therapist?

My motivation has changed since I began working independently; I still want to support children to develop their communication skills for the best start in life, I now also need to maintain my business to make a living. As most of my clients find me by personal recommendation from existing clients, I need to provide a quality service that meets their needs. In contrast, in the NHS I was judged on my ability to meet targets, such as waiting times for initial assessments. This can lead to situations that don’t make sense to families or support progress, such as being invited to an appointment two days before Christmas, so a therapist meets her target.

How stressed is your therapist?

Finally, I wonder about the contribution of therapists’ stress levels on progress. Being my own boss has significantly reduced my stress levels, I’m excited about therapy again. I’m now able to bring my whole brain to work, I feel confident to try new therapy approaches and I notice subtle details that perhaps I missed when my workload was out of control. Could these little details account for some of the progress I’ve been seeing?

Have I missed out a key factor? Therapists, what have you found supports progress? Parents, what did you notice about a time your child made speedy progress?

At a recent study day (Child Talk What Works consensus event) I heard Dawn Smith, Healthcare Professionals Advisor, talk about commissioning SLT services. She suggested we tell stories about the impact our services have, with compelling headlines and concise evidence. She talked about the importance of making “effective relationships … across increasingly complex systems” and said that the services thriving under the new commissioning arrangements have “transformational leaders.” It was an interesting talk.

We need to write headlines, and stories with evidence, but we’re not writers. We need to make “effective relationships” with finance people, and non-clinicians but we don’t know what makes them tick. And there wasn’t much on how to be a transformational leader on my SLT degree course.

Dawn’s talk made me reflect on something I’ve been mulling over for a while – to be successful SLTs, in today’s tricky climate, we need to be open to learning from other disciplines, and I don’t mean other allied health professionals. We have excellent clinical skills, we have trouble with the other part of our roles, such as getting sign off to try new models of service delivery, working collaboratively with professionals from other disciplines, and balancing conflicting priorities. I think we can learn from professions like software developers, project managers, writers, religious leaders, entrepreneurs and performers.

Let me give you an example. In September I attended an improvisation workshop. One of the activities involved pretending to pack a picnic with your partner, we did this 3 times. In the first round, whenever you partner suggested an item to add to the picnic basket you had to reject it outright and explain why it was a terrible idea. In the second round when your partner suggested an item you reluctantly agreed to pack it, but explained why it wasn’t such a great idea. And in the third round when you partner suggested an item, you responded “yes, and,” accepting the idea and adding to it with your next contribution. This was an “aha” moment for me. I’ve been in so many meetings that get derailed by the passive aggressive behaviour we experienced in the second round, the “yes, but….” response to a suggestion. The third round felt energising and collaborative, exactly what I want to channel into meetings. Here was a simple, practical tool, I could use immediately in my work. Bingo!

On 20 January 2014 I’m involved in an event called #dareconf mini, the tag line is: Learn to collaborate, communicate and reflect. It’s designed for digital professionals but I think the themes are also relevant for therapists. SLTs are pretty good at reflecting but we can definitely do with some help collaborating and communicating with all these new people in our ecosystems.

The presentations will cover:

• How to communicate with compassion
• Undermining the power of our organisations
• How parts of our jobs make us feel like a fish out of water
• How to balance vulnerability and courage, to make bold choices
• Using facilitation to help people work together in times of change
• How to be a coach and a mentor

As well as leadership and how to leave your comfort zone.

Have you found it difficult to explain what your team does to people who have no shared frame of reference? Have you struggled to negotiate shared objectives with an angry stakeholder? Have you wrestled with how to phrase a project proposal, or request for training in a way that gets you your desired outcome? This day on people skills can help. Each presentation combines a personal story with a practical “how-to” you can apply to your work and you’ll take home a personalised workbook with next steps from each talk.

This full day of practical learning, includes lunch and costs just £165 +VAT if you book before 18th November. Join us. And help spread the word: email this information to friends and colleagues, post about #dareconf Mini on Facebook and Twitter, and tell your boss!

I’m considering how to explore this theme of what SLTs can learn from other professionals. Do you know someone I should talk to? Let me know.

She talked about what speech therapy was like when she started out:

• Makaton was just being developed. She got involved with the charity and ensured the signing system was widely used in our area. Recently she taught the team to sign, “I’m dreaming of a white Christmas!”
• The Derbyshire Language Scheme didn’t exist.
• Some children were considered “ineducable.” This changed with the 1970 Education Act, after which all school age children were entitled to an education.

I might have 30+ years ahead of me as a Speech and Language Therapist. When it’s time for me to retire, what will I tell colleagues about starting out? They may be astonished to hear that we write clinical case notes on paper by hand. We consider assessments standardised if data has been collected from 1000 children. And in this era of “inclusion” hundreds of special schools still exist.

Maybe I’ll tell them I was one of the first UK therapists to start a blog! Times are changing; what will the therapy world look like in 30 years time? (I see iPads, lots and lots of iPads!)