Decades ago, it was “common” to see SLPs pull out workbooks for therapy sessions---particularly for cognitive communication therapy. We now know that was wrong. The research in our field over the past 30 years has proven that using generic workbooks with generic tasks are NOT best practices.
Even with this in mind, it's troubling how many times per week an SLP grad student says to me "but my supervisor uses workbooks". It's especially troubling since clinical supervisors are supposed to be the ones that we look toward for wisdom and guidance (perhaps old habits die hard OR they aren't as up to date with the latest research, idk).
But what do you do when you KNOW that using workbooks in speech therapy IS NOT what is BEST PRACTICES? Can you actually call out your supervisor? Ummmmm. No, I would NOT recommend calling out a supervisor. But what I would recommend is making the issue more about the patient. Because it actually is ALL ABOUT THE PATIENT.
Think more about what can be done to ensure the patient gets what they need out of the session.
If you are an SLP student, look below for possible ways to get your own supervisor to move AWAY from workbooks with a patient. Let me know in the comments what other ways you recommend.
- Ask if you could try something "different" with the patient
- Ask to monitor the patient's generalization skills with a more FUNCTIONAL activity.
- Involve a family member in a therapy task (this will more than likely exclude a workbook)
- Allow the patient to pick the therapy activity (most likely they WILL NOT choose a workbook)
- Consider a community outing (or change of scenery) with the patient... because who would be doing worksheets in the hospital cafeteria?
- Share a functional therapy activity you've found with your supervisor. Several can be found HERE.
- Mention a recent book, journal article, or Continuing Education course (relating to functional and person centered care)
If all else fails, HIDE THE WORKBOOKS!
Good luck and remember you can be the change you want to see in our profession. Just because you've had a clinical supervisor that did things a certain way, doesn't mean its always the RIGHT WAY. As a student clinician, or intern, or Clinical Fellow, search for the most current, BEST PRACTICES on your own.
As always, have some great therapy sessions!
-Dana T(he Neuro SLP)
Related References:
Guideline Development Panel, Brown, J., Kaelin, D., Mattingly, E., Mello, C., Miller, E. S., Mitchell, G., Picon, L. M., Waldron-Perine, B., Wolf, T. J., Frymark, T., & Bowen, R. (2022). American Speech-Language-Hearing Association Clinical Practice Guideline: Cognitive Rehabilitation for the Management of Cognitive Dysfunction Associated With Acquired Brain Injury. American journal of speech-language pathology, 31(6), 2455–2526. https://doi.org/10.1044/2022_AJSLP-21-00361
Brown J, Ackley K, Knollman-Porter K. Collaborative Goal Setting: A Clinical Approach for Adults With Mild Traumatic Brain Injury. Am J Speech Lang Pathol. 2021 Nov 4;30(6):2394-2413. doi: 10.1044/2021_AJSLP-21-00078. Epub 2021 Sep 16.
Hoepner, J. K., & Keegan, L. C. (2022). "I Avoid Interactions With Medical Professionals As Much As Possible Now": Health Care Experiences of Individuals With Traumatic Brain Injuries. American journal of speech-language pathology, 1–19. Advance online publication.
Morrow, E. L., Turkstra, L. S., & Duff, M. C. (2021). Confidence and Training of Speech-Language Pathologists in Cognitive-Communication Disorders: Time to Rethink Graduate Education Models?. American journal of speech-language pathology, 30(2S), 986–992.
Riedeman, S., & Turkstra, L. (2018). Knowledge, Confidence, and Practice Patterns of Speech-Language Pathologists Working With Adults With Traumatic Brain Injury. American journal of speech-language pathology, 27(1), 181–191.
Tippett, Donna. (2012). Current Concepts in Treatment Planning: Patient Centered and Evidence-Based Practice in Speech-Language Pathology. Perspectives on Gerontology. 17. 27. 10.1044
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Turkstra, L. S., Norman, R., Whyte, J., Dijkers, M. P., & Hart, T. (2016). Knowing What We're Doing: Why Specification of Treatment Methods Is Critical for Evidence-Based Practice in Speech-Language Pathology. American journal of speech-language pathology, 25(2), 164–171.
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