From: Scott Yaruss
Date: 10/11/00
Time: 9:33:25 AM
Remote Name: 128.147.90.204
Hi - You've raised an important point -- we always need to be aware of our scope of practice, and this is an issue that always comes up in the realm of counseling.
My opinion on the issue is this...according to the ASHA code of ethics, we should not be treating in areas that we are not comfortable with; plus, according to the scope of practice, we should not be treating outside the field of communication disorders (which is growing increasingly broad). If I am not comfortable dealing with the issues my client brings up, or if they are outside the field of comm dis, then I should not be dealing with them in a professional setting (i.e., in treatment). If, however, my client raises issues that I feel competent to deal with, then it is appropriate for me to do so.
Thus, it's hard to define a clear line in the sand, beyond which we should not be treating, since it is related to the clinician's abilities and the client's needs.
Some clear examples of issues that are outside the scope of practice include the client's feelings about people that are not related to their speech (this often comes up in cases of divorce, family strife, or anger at one's parents that is not related to speech) -- many times, I have had to encourage my clients to bring issues back to speech and language. If the issues they raise are related to speech, then I discuss them in terms of how the feelings affect their speech...that's what I know how to do, so to do anything else would not be ethical...
So, to answer your client -- counseling itself does not go beyond the realm of the SLP, provided the SLP is competent at addressing such issues -- it is the TOPIC of discussion that maybe outside our realm, and on that, we need to maintain a constant vigil.
Hope this helps... S