Home Speech-Language Pathology Making Treatment Transitions Easier for Clients

Making Treatment Transitions Easier for Clients

by Jasna Cowan
Mother and son looking sad

Mother and son looking sad

As speech-language pathologists, we learn very quickly that saying goodbye becomes part of our job. I’ve seen thousands of children and I still have a hard time saying goodbye. Although goodbyes can be difficult for us, the clients and families we serve may feel even more stress and loss. I’ve noticed over years of working with families that there is a process I call the “goodbye phenomenon.”

You may notice a parent acting differently than they usually behave. A parent or caregiver with great attendance may start missing appointments, might seem less friendly, or has less to say during sessions. I work with children of all ages, but I notice this phenomenon more often in my work with early-intervention families.

When a student is ready to “graduate” from services, how do you handle resistance from parents?

SLPs are often the first teachers for these young children and we help guide the family through identification of an issue. When any transition in services occurs—whether an early-intervention client moving to school district services, a family moving away, a child no longer needing treatment or a child transferring to another provider—I strive to be proactive in making this process smoother.

Below I list several approaches I use to set up positive closure with families. I call this method HARP:

Heart: Remember that the way a child, parent or caregiver might act as you get close to a transition of services isn’t personal. People deal differently with goodbyes or feelings of loss that come up during this time. I remind myself to empathize with everyone in the family and their own process of transition.

Acknowledgement: Acknowledging the elephant in the room—the transition or ending of services—is essential. Give the parent and child reminders about the final session. Ask the parent or caregiver how they feel about how the transition process is progressing. Sometimes just talking about what’s happening can help everyone feel better about the coming change.

Restate (and validate): Address any questions and doubts that the parent or child asks. If a parent says, “I just feel worried,” or “I’m not confident about the transition,” I rephrase what they said before answering to show the parent that I understand their concerns. I might say something like, “So you feel overwhelmed by this experience?” And if a parent has concerns about something you don’t know how to answer, try to find an appropriate resource or person who can answer the question.

Plan: Make a specific end plan for the last few sessions. I like setting up a “graduation” activity for the final session. I make a diploma or certificate indicating the completion of classes to make the experience positive. Let the parent or caregiver in on your plans and special activities for the last few sessions.

Everyone deals with goodbyes differently. I find providing continuity of support throughout the entire transition process really helps clients and their families. Being proactive and talking about what will happen can help everyone avoid stress in the SLP-family dynamic. Change is inevitable and many times it’s a sign of growth for both our client and ourselves.

Jasna Cowan, MS, CCC-SLP, is the founder and director of Speech Goals, a private practice in San Francisco. jasna@speechgoals.com




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