The Dark Art of Speech and Language Therapy

This month marks 2 years since I started my blog and although I don’t post so often these days interest doesn’t seem to have dwindled if the number of hits each week is anything to go by. Although overall I am enjoying this journey, there are times when the sheer size of the job can feel quite overwhelming. The range of valuable roles that a Speech and Language Therapist can play in the context of adult mental health is what keeps this job interesting and challenging all at the same time.

I seldom take the time these days to reflect on the breadth of roles I undertake on a day to day basis but I have a had recent cause to consider exactly that. I was asked last week what my “elevator pitch” for my service would be. If I had 10 seconds to sell myself (in a professional context obviously) what would I say?

Mental health and communication are very closely linked. The way a person communicates can tell us a lot about their mental health or even diagnosis, and conversely a person’s ability to communicate can significantly impact on their mental wellbeing. Equally, mental health workers’ ability to make appropriate adaptations to the way they communicate according to each individual’s need can make or break important therapeutic relationships.

Speech and Language Therapy has been described to me as being a bit of a “dark art” as people aren’t entirely sure what we do, and I believe that is because communication is the foundation of everything we do, not only in mental health, but in life. A Speech and Language Therapy assessment can make sure you get the right treatment by gathering information that leads to the right diagnosis. A Speech and Language Therapist can work alongside your Occupational Therapist to help you get a job. A Speech and Language Therapist can work with you to increase your self-esteem and confidence by improving your communication skills or addressing a specific speech or language difficulty you experience. The list goes on.

So what would my “elevator pitch” be?

Communication is a fundamental human right and forms the basis of all our interactions and relationships. Mental health services need Speech and Language Therapists because without the support we can offer there will be people whom services fail by not adequately addressing their communication needs. Without specialist knowledge from Speech and Language Therapists the risk of individuals becoming stuck in a downward spiral of poor communication and poor mental health increases. Services need Speech and Language Therapists because without effective communication what do we have?

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Singing from the Same Songsheet

What happens when you ask a Speech and Language Therapist to talk to a group of professionals including Mental Health Nurses, Social Workers,  Occupational Therapists, Mental Health Officers, Police Officers, Advocacy Workers and Employment Advisers about how they work with and supporting adults with mental health problems?

Firstly, you get a slightly anxious Susan. I am accustomed to speaking to large groups of people so an audience of around 70 was not the issue. My trepidation came from speaking to such a diverse audience. Usually I have an idea of how receptive or otherwise my audience are likely to be; not so on this occasion. So maybe it was fitting that I was speaking at the home of Captain Robert Falcon Scott’s Discovery as I embarked on this journey into unknown, possibly frosty and potentially treacherous territory!

I need not have worried, as what transpired on the day was an incredible conversation where everyone agreed about the importance of recognising and addressing communication difficulties.  If I was to summarise the message from the audience it would be…

  • we cannot do our jobs without good communication,
  • it is an ongoing challenge to communicate well with the people who use or come into contact with our services,
  • we don’t always get our communication right,
  • so how are you going to help us?

So I need not have worried. It would appear that we are all singing from the same songsheet – my job now is to be good conductor and pull this performance off!

But Why?

I love students. No seriously I do. My role as a clinical educator for student Speech and Language Therapists from Queen Margaret University is one of the favourite parts of my job. I love students because they ask questions. They create a situation where I am required to provide clear, rational and evidence-based reasoning for my clinical decisions. And on that basis my favourite question is WHY?

Laura is a post-graduate student who has just completed a placement with me in Tayside. She has graciously agreed to write a guest blog on her thoughts and experiences of Speech and Language Therapy in Mental Health which will feature when her academic and personal calendar allow, but until that time I wanted to share with you one of the big WHYs of Laura’s placement.

But WHY are we working with him? This isn’t Speech and Language Therapy.

Many Speech and Language Therapists work to a pretty high degree in professional isolation. By that I mean that they either work just with their client and/or that person’s parent/ spouse/ carer, or they have a well defined role within a multi-disciplinary team to tackle the communication aspects of a client’s disorder. I say this from a perspective of personal experience as I have worked as a member of many teams where teamwork is merely making sure we share information and don’t book people in for appointments at the same time! Unlike the fields of Physical Disability or Stroke Rehabilitation, in Mental Health the majority of work carried out by all team members is entirely verbally mediated. So what happens when an individual has communication difficulties that create barriers to therapeutic interaction? In this situation, the team member who can communicate most effectively with that person is most likely to affect positive change and that person may be the Speech and Language Therapist.

Laura is right; I am not doing specific communication skills development work with this client at this point in time – I have in the past and I am sure I will in the future. What I am doing is using my understanding of his subtle and complex communication difficulties to adapt and deliver a psychological based intervention that other members of the team have found it impossible to engage him in effectively. This is an intervention that will benefit his mental wellbeing and keep him positively engaged with the Community Mental Health Team; and that is what being part of a team really means to me.