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From: Ellen-Marie Silverman
Date: 12 Oct 2010
Time: 11:28:21 -0500
Remote Name: 205.188.116.143
[[. . . it is so important to address the feelings and needs of the individual when it comes to making therapeutic decisions that will work for each individual. In your opinion, do you ever feel that long-standing feelings should be addressed prior to beginning therapy with a Speech-Language Pathologist? The reason I ask is because I know there are so many questions dealing with when and where to draw the line from speech therapy to the recommendation to seek counseling.]] /// Hello, Allison, this may be a quick question, but it is a basic and deep one requiring a slow, thoughtful answer. Unfortunately, I do not have the time nor space to respond now and here in the detail I would like. I can only hope that what I have to share will offer you some useful direction to further consider these matters to find a course that satisfies you. /// First, it is vital that a speech-language pathologist working as a speech-language pathologist function as a speech-language pathologist by only providing services requested by the client that fall within the profession's scope of practice and by doing so in an ethical manner. Managing feelings of grief, loss, anger, hurt, resentment, and so on --- the client's, the family's, and your own --- always play a dynamic and vital role in treatment. /// If the adult client, despite professing to want to work to change, is not attending regularly, following through on practice assignments, or changing to be more and more consistently as he or she wishes, then a decision needs to be made as to whether or not to continue speech therapy, at least at present and with the current speech-language pathologist. That may involve considering adding or substituting counseling or psychotherapy of some sort and should be of the utmost urgency if a client seems in danger of hurting himself or herself or another in any way, after the proper authorities have been so notified. /// As speech- language pathologists, we help clients alter their mind-body connection through instruction and guided practices. Not only may we expect to observe behaviors change but emotions emerge associated with this directed behavior change. We do not wish to encourage repression of such a natural occurence in our clients and ourselves, but if we can not help the client or ourselves effectively express and integrate emotion surrounding change, then it is quite prudent to seek the help that will allow for successful integration. /// So the gist is: Put the client's and your needs to be safe, happy, and strong and to live with ease foremost. /// I have written in considerable detail about such matters in the resource book for students and practitioners published last year, MIND MATTERS. SETTING THE STAGE FOR SATISFYING CLINICAL SERVICE. A PERSONAL ESSAY (now available as a Kinle edition as well as in soft-cover). /// Thank you, Allison, for your very basic questions. I hope at least some of what I have written here directs you well. Ellen-Marie Silverman