“It’d be great if…”
“In a perfect world…”
But typically, when we discuss ideals, we quickly follow up with:
“But that’s not realistic.”
“Too bad that can’t actually happen.”
“Wish it could really be that way.”
When it comes to clinical practice, I think we default to the latter group of statements far too often. We significantly limit what we believe is actually possible, because the things we know are good in theory are just too hard to apply in the “real world.” It’s easy to sit through a graduate class or a continuing education session, but it’s another thing entirely to apply that information day-to-day in the therapy room. Think about some examples:
We learn about the importance of evidence-based practice, but “realistically,” there is not a vast amount of high-quality evidence for many of our practices in this relatively young field.
We discuss the necessity of being sensitive to culturally and linguistically diverse populations, but “realistically,” we can never learn to speak every language or understand every culture.
We understand that the Code of Ethics exists for the purpose of maintaining best practices, but “realistically,” ethical dilemmas are not always so black-and-white.
So what’s the point then? Why do we have standards that we can’t live up to in practice? Why are we taught things that we are doubtful we can ever actually apply?
That, right there, is the problem. It’s the question we’re asking. We look at a client or a situation, and we ask, “Can I do this?”
“Can I find any evidence to guide my clinical decisions with this unique and difficult case?”
“Can I effectively treat this client whose language I do not speak?
“Can I maintain my personal and professional ethical codes when a ‘sticky situation’ arises?”
The problem with these questions is that from the moment we decide to become speech-language pathologists, we have already answered all of them. In accepting the responsibilities that come with being a part of this field, we have already said a huge, resounding “Yes” to every ‘Can I?’ question. No matter how challenging the situation may be, yes, we can do it, because we must.
One of my professors recently challenged our class to change the question. When faced with difficult situations that make us uneasy, or cause us to doubt what we can handle, we have to start thinking of it differently. Instead of asking, “Can I do this?” we should ask, “How will I do this?”
“How will I follow the levels-of-evidence hierarchy in order to implement EBP, even when the current existing evidence base is not extremely strong in this particular area?”
“How will I be creative and use resources to effectively treat this client whose language I do not speak?”
“How will I ensure that I maintain my personal and professional ethical codes and engage in best practices, even when a ‘sticky situation’ arises?”
“How will I do this?”
Many people are familiar with the famous quote from Spider Man, “With great power comes great responsibility.” While a few ‘Cs’ behind your name may not seem like power to most of the world, as members of this field, we know differently. SLPs have the power to help others, facilitate communication, and cause change, and I would say that is great power. We have been given the power, and therefore we have accepted the responsibility. We have said, “Yes,” to every tricky situation and every obstacle, whatever it may be, no matter how challenging. We have said “Yes,” because it is our responsibility to do so, based on the power we have been given. We can, because we must.
The next time you are faced with a tough case and are tempted to ask, “Can I do this?,” remember that you have already answered yourself. Can you do this? Yes, you can, because you must.
So, start asking yourself and others something different. Start changing the question. Start asking, “How?”
Kelsey Roberts is a student in the master’s speech-language pathology program at Abilene Christian University in Abilene, Texas.