Why Seek Therapy

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Re: What should we do with these clients?

From: Ellen-Marie Silverman
Date: 05 Oct 2012
Time: 11:21:32 -0500
Remote Name: 76.230.146.138

Comments

[[I am wondering what, as clinicians, are we to do with clients, particularly adults, who are not "willing to participate," and are only seeking therapy for the reasons described? At what point is it the responsibility of the clinician to discharge these clients from therapy, and should we even make that call? To what extent, if at all, should we attempt to push a client who we feel is "unwilling" to participate in intervention?]] Alyssa, I am glad you asked these questions that I believe many may ask themselves, especially after reading this paper. You really echo a basic concern! >>> Let me respond by stating that I believe your questions reflect the need to define for yourself the role and responsibilities of a speech pathologist. You may start by looking at ASHA's Code of Ethics for practitioners, and in there (I can't say at the moment where.) you will see a directive to put the client's needs first and foremost. With that directive in mind, we carefully determine who may benefit from the services we have to offer now or later. We make a reasoned decision about whether or not someone presenting themselves for therapy, group or individual, can benefit at the time from our offerings. We then present our decision about whether to offer treatment prepared to explain how we arrived at the decision we did and, if our recommendation is not to offer therapy at the time, alternative recommendations. This may become an exchange with a potential client that reveals significant additional information that may cause us to reverse or modify our original decision, but it may not. This can be a very difficult task for those of us who feel empathetically and want to relate compassionately to people who are suffering because they can not speak as they wish consistently. We are graduate students preparing to be speech-language pathologists or speech-language pathologists because these are some of the very people we want so much to help. But we can not help someone unready or unable to do their share of the work to achieve their stated goals by accepting them for treatment simply because they have a problem our profession trains us to address. We can only hurt them as they fail to benefit from what we have to offer and conclude they can not be helped or that we and the profession can not help them or anyone with the same problem they have. So, sometimes saying "No" can be the best help we can offer. /// This is a rough, brief schemata of how we may relate to clients seeking our service. We accept those we believe will benefit. We do not accept those we believe will not, at least in the present. Instead we make suggestions we believe will help them meet the needs that they have identified. And, sometimes, denying treatment to those unable to benefit from it in the present may be the best help we can offer. /// When we make our clients' best interests our over-riding service goal, we assume the responsibility that is ours as a professional --- to thoughtfully decide who will benefit at the present time and who will not. We function as knowledgable gatekeepers of a service that will be helpful to those prepared to utilize it. And we work in a collegial way with those we select as clients, partnering not "bossing them around" in an authoritarian manner. /// Alyssa, thank-you again for asking such a basic question. Best wishes, Ellen-Marie Silverman /// P.S. You may want to look at a book I published in 2009 for clinicians entitled, "Mind Matters. Setting the Stage for Successful Clinical Service. A Personal Essay." It is available at Amazon and elsewhere. E-MS


Last changed: 10/22/12