One part of being a speech pathologist that I am particularly passionate about is providing client centered care. What does that mean exactly? 

Have you ever been to a provider and you feel like they “just don’t get it” or they solely view you as a number or stereotype? For example, maybe a provider makes a recommendation with good intention but that recommendation does not align with the actual phase of life you’re currently in or who you are as an individual? 

A quote from Sir William Osler, one of the founding members of Johns Hopkins Hospital, has really impacted me as a clinician: “It is much more important to know what sort of person has a disease than to know what sort of disease a person has.” [For the context of speech pathology, we can think of “disease” as an impairment in cognition, communication, or swallowing]. It is important to get to know the client as a whole person versus putting them into a box of “this client has ___ type of impairment therefore they must be this type of person.” Just because clients share symptoms or a diagnosis does not mean they are similar as individuals. Understanding a client’s values, culture, family, and motivations are essential to providing client centered treatment. When a client feels seen and understood, therapeutic rapport begins to blossom. 

Client centered care involves:

• Collaboration between the clinician and client
• Developing goals together (versus only the clinician setting goals)
• Capitalizing on the client’s strengths
• Identifying life activities and interests that are relevant to that particular client

I want my speech therapy treatment to connect to real-life activities as much as possible. Decontextualized tasks such as completing a worksheet are not inherently bad and may be used at times, but we need to make connections to a client’s real life as much as possible. Giving a client a worksheet to complete without context versus completing an activity that actually relates to a client’s daily life is a stark contrast. One other aspect I make sure to incorporate into treatment is “explaining the why.” When treatment is relevant and clients understand why they are doing something, this maximizes the client’s motivation and participation in treatment. 

For example, if reading bedtime stories to their children is an important part of a client’s routine, we will incorporate that activity into treatment based on their goals. For a client who has dysarthria, maybe we target using strategies to make their speech more intelligible (easier to understand) when reading aloud and have the client bring in some of the bedtime stories they actually read to their kids to practice those strategies. One of my favorite pieces of feedback to hear as a clinician is when clients learn a strategy in our session then they tell me that they were successful with using that strategy outside of our session in their daily lives (this concept is called carryover). The best part is, it’s not just about using a strategy, it’s about using a strategy in a context that truly matters to the client.