Friday, October 20, 2017

The "B" word

I read an article earlier this week, which informed me that I was almost at the point where I would be considered “mid-career.” I quickly dismissed this with disgust since for one, grad school was just yesterday, and furthermore I still consider myself young, hip and fresh in the field. Who wants to play pop up pirate with a “mid-career” therapist? 

I thought about it for a bit, and decided it meant that maybe, just possibly, I might be able to share a few choice words of wisdom about what I’ve learnt along the way as I hit my 8th year (see not that bad) of practice. I’ve spent all of those years building a private practice. However in Barbados, where you’re one of four speech pathologists it means that you’re also a school SLP, medical SLP, community SLP… and the list goes on.  Needless to say I’ve learnt a few things in each area thus far. The key topic that pops up weekly in conversations with colleagues and interns is “avoiding BURNOUT.” Yes that dreaded "B" word that can creep up on even the best of us. 

Disclaimer: I in no way consider myself an expert in the field. I still struggle with clients, still have mini panic attacks when I think about scheduling and caseload management, still suffer from imposter syndrome sometimes, still have to google SLP terminology or “phone a friend,” still some days fantasize about marrying filthy rich and sailing away from paperwork mountains on a massive yacht…but I digress. The important thing is that I’m still here, and still loving what I do every step of the way.

What are my tips for waking up every most mornings still excited to go to work?

Unleash your creativity (or at least Pinterest’s creativity)

Sessions can get boring very quickly, not only for your clients, but for you as well. I don’t know a single therapist who has said “I can’t wait to use those same flashcards in therapy for the 10th time!” Fortunately for our field the SLP world has taken over technology, and the internet is filled with a plethora of blog posts, pinterest ideas, TPT stores and other wonderful places, that place creative new ways to hit your targets at your fingertips. Also remember you’re not limited to your therapy room (I feel claustrophobic in clinic after a while). Take it outdoors, to the playground, to the supermarket, even to the corridor or another room. A small change of scenery goes a long way. Speaking of a change of scenery…..

Get Away

Yes I said step away from the laminator and book a trip somewhere. It could be to a convention or continuing education course, where you have the opportunity to network with likeminded professionals and come back to work with fresh ideas and new skills to use with your clients. It could also be just a quick trip somewhere to clear your head and regroup. I find that I get the best ideas and make the clearest decisions for my practice when I’m as far away as possible from said practice. Sometimes we get so bogged down and caught up in everything that is happening with our caseload that we don’t have time for brainstorming or problem solving, and we end up digging ourselves into a burnout hole. Trust me…step away for a bit.

I cannot tell you the last time I have filled out an insurance form, written a receipt, or touched a laminator. These are all things that had to be done on my own when I first started work. However, as soon as I could find someone to delegate admin type work to, that was quickly passed off so I could focus on doing therapy. I’m also working on passing on certain clients and tasks to my newgrads, as soon as I decide that they are competent enough to manage.  I will admit that it is extremely hard to do, especially if you’re used to managing everything, but it definitely makes life easier. You do not have to oversee every visual timetable printed!

Share your knowledge
I’ve been a clinical supervisor for just about four years now, and though there are some interns who make me pull my hair out, having them always makes me see my work from a fresh new perspective. Furthermore, they usually come with the latest research and therapy ideas, and provide new insight into what is current best practice in the academic world.  I’ve also realized that every time I talk about, and demonstrate how and why I do what I do I fall in love with the field all over again. This also applies to teacher/parent/paraprofessional training. Sharing your knowledge and skills allows for great moments of self-reflection, critical thinking, and problem solving. Most importantly you are equipping new minds with the tools needed to go out and make an even greater difference in the world.

Jack of all trades, master of burnout  
This should be the title of my article. When I left grad school I was so excited to learn everything about everything in the field. In the first years I did Hanen, PROMPT, SOS Feeding, Auditory Verbal, AAC courses, Dysphagia training, and the list goes on. My thinking was that I didn’t want anyone to show up at my clinic, and I didn’t have the skills to help them. Sounds heroic, but not at all practical. I felt like I was dying from information overload, like I wasn’t particularly good at anything, and I started to feel unfulfilled in the field. After a few years (maybe about 6….it was tough) I decided to focus on key areas which I was passionate about and be amazing(ish) at those. The main ones for me have been Autism and Augmentative and Alternative Communication (AAC), which both tie in quite closely. I’ve also been more interested in feeding, but I haven’t delved into it fully. I’m not going to say I don’t do the odd modified barium swallow when needed, or work with a speech sound disorder. However they’re not my primary areas of focus, and I’m hoping that soon I can delegate those too.

Ask for Help
When I first moved home after grad school I found out what it was like to work in a country with very few therapists, and limited resources. To say it was tough would be an understatement. Remember this was before pinterest and TPT days! I reached out and started doing lots of networking via twitter, where I learnt 100 times more than what I learnt in grad school and picked up quite a few mentors along the way (Mentors are absolutely essential to your practice). It makes no sense (nor is it ethical) fumbling around in the dark and not seeking best practice for your clients. Reach out to the #slpeeps on twitter, the many facebook groups now available for various clinical populations, or the ASHA Special Interest Groups, and ask for whatever support you need. It also doesn’t hurt to email an old lecturer, or someone who did a presentation at a conference/webinar you attended. Trust me it works.

Take off that cape sometimes
Yes I mean you superwoman(man)! I see you balancing that million client caseload, making sure everyone has their visuals,  that IEPs and progress reports are submitted; trying to figure out how you’re going to stop in before gym to make sure those parents are really doing family meals for dinner, and sneak out before you have to give advice again on how to get the older brother to do his homework. I know you’re putting your phone on bluetooth on the way to pick up groceries, so you can explain the results of last week’s evaluation, and yes of course you’ll give a talk this weekend at his preschool’s PTA meeting….but wait did you even eat lunch today??
After a few more of those panic attacks I mentioned, I had a conversation with myself one day and said “You cannot be everything to everyone!” It’s impossible, and as much as we want to do everything in our power to help our clients, we have to be something for ourselves….Even if that means saying no sometimes. This does not make you any less of a therapist or any less of a person. It shows that you know your limits, and value your sanity.  This is still a work in progress for me, but trust me I’ve gotten so much better at saying “no” in so many ways, I’m no longer feeling like the most overworked person in the world and my life has been a better place because of it.

I hope these words of wisdom from an “almost mid career therapist” will help to make some impact on your practice. One more quick tip to leave you with....

Never, ever forget to have fun; when it stops being fun it means we have to do something to find our magic again. 

Feel free to share what works for you as well.