In February, I wrote about wanting to spend more time outside in nature, two weeks later my family and I went on holiday to Wales, and 2 months after that we moved here! We’re now based in beautiful Llanelli, and feeling grateful, particularly for our daily walks along the coast.

I’m still seeing a small number of clients in London, on a fortnightly basis. I’m in the process of finding a therapy room in West Wales and excited about seeing clients here, too.

It’s all a big change. I frequently remind myself of the quote: “the only thing constant is change” and try to embrace all the newness. I’ve been reflecting on transitions and how long change takes to feel ‘normal.’

Our baby is now 10 months old and has been completely chilled throughout the whole move, he is a great conversation starter, making friends wherever we go. Obviously it’s been more challenging for our 3 year old.

I reminded myself how supportive visuals can be for little people (and big ones!) We showed him photos of the new house, the removals van, and the train he’d be taking to Wales. He loves the beach and all the new parks. And during the difficult times I’m trying to implement the advice from a book I’m still reading: How To Talk So Little Kids Will Listen: A Survival Guide to Life with Children Ages 2-7 I don’t want to use power over my son, the book has ideas for finding courses of action that work for everyone in the family.

People ask if we’re settling in. Yes, I think so. We’re happy to be here, although it still feels a bit like being on holiday. I wonder how long it will take to develop friendships, grow my first vegetable garden and feel comfortable saying: “ta ra.” Who knows?!

When parents ask about how long the therapy process might take, “who knows?” is not what they want to hear! I try to reassure them by showing them all the changes their child is making, support them to keep practising, and encourage them to believe in the process, their child and their own skills.

I’m hoping a benefit of life in Wales will be more time to write, watch this space. And if you’re a Speech Therapist anywhere nearby, and fancy getting together, please send me an email, I’d love to hear from you.

London feels different at 6.15am. There’s a sense of opportunity: a new day stretching out ahead. The streets and trains are less crowded, the city feels calmer. Now I’m self employed I bounce out of bed each morning with the sunrise… just kidding! I am doing two early starts a week though, so I can offer therapy sessions before school. Surprisingly, I’ve enjoyed being up earlier than normal. I’m using the change to try out new ways of organising my day.

Managing our time

Now that I work for myself I’ve suddenly got much more time to manage. Therapy Ideas has several components: community events, workshops, private therapy, with more to come—fitting them into the week is a puzzle.

I think some of the families I see for therapy might feel the same way about their lives. While speech and language therapy is a priority for them—they’re aware that simply coming to therapy sessions once a week isn’t going to cut it—it’s still tricky to fit daily practice into their lives.

I help families figure out what works for them

I start conversations with families about practising at home: parents (and children!) have wonderful, creative ideas about how to practise regularly, they need the opportunity to explore them and test out what works. I can pass on tips and tricks (if you need picture cards don’t try to practise in the bath) and hold them accountable, by checking each week how it’s going. I try to make sure parents feel comfortable enough to tell me if there’s a problem and I remind them that as routines change and their child matures they may need to find new ways of practising, at different times of the day.

Right, so in terms of organising my week, I think I need someone to hold me accountable, any volunteers?

I’m in a transition phase; I’ve left my NHS role and started work as an independent therapist. I find change tricky. I had an interesting conversation with Abi Roper and Tom Starr-Marshall that made me think — why is change in the NHS so difficult? And in a solution-focused kind of way, what makes particular projects successful?

Looking back, there was a pattern to my attempts at service development (try and follow along with the diagram!):

• I’d have an idea, then it felt like people were blocking me, I’d hear: “sounds great, but….” followed by a long list of why it wouldn’t work, or we couldn’t try it.
• I’d feel angry, frustrated and disappointed.
• I’d either: ignore the objectors and try the idea out, maverick style.
• Or start asking questions. This takes time and requires persistence.
• I’d try for quick wins to show the team that the idea was worth piloting.
• Then cycle through the process again, asking more questions and making more small changes, to try and show value.

Sometimes it worked and sometimes it didn’t! So what helped?

• The 5 Whys is a useful exercise for identifying barriers and understanding what was really getting in the way,
• using “yes, and….” (rather than “no, but…”) helped me stay open to other people’s ideas and viewpoints,
• working with allies, and
• focussing on both the end goal and the details, kept me on track.

Have you managed to push new ideas through and make changes? What helped? I’d love to hear your ideas.

We’ll be exploring this issue at the Therapy Ideas Workshop on 17 May. Join us! If you’d like to discuss whether the workshop would be a good fit for you, email me.

The change made me reflect on the positive aspects of the old job, so I’m jotting them down here.

Positives

It was a large, friendly team of therapists and I was well supported. I worked autonomously: free to manage my own time and workload.

I spent 18 months working with the same caseload, so I was able to get to know the families. When we met in the street, they would stop and chat; I felt a part of the community. I was also able to develop good working relationships with other professionals, such as staff in the Children’s Centres.

The team has a good universal service in place; they are working at the population level to raise awareness and prevent difficulties arising. In this respect they’re ahead of many other boroughs!

We were encouraged to carry out clinical projects, so I developed a drop-in group focussing on parent child interaction strategies, in my patch. With support from the Children’s Centre I was able to grow this group and access hard to reach families.

What I’m looking forward to

I think the new job will also be a positive experience; when I’ve moved through the initial ‘information overload’ phase and begin to find my feet, I hope I will enjoy the new challenge. I’m looking forward to developing the universal service and working with nursery settings.

I find starting in a new team difficult and admire locum therapists, who move from team to team regularly—I wouldn’t cope! If you’ve got any tips about how to make the transition as stress-free as possible, please add a comment!