First Class Clinicians
Last week I met a skilled clinician who had recently relocated, transitioning from running a private practice in an urban environment to working in a rural school district. After our conversation, she shared the following sentiment: “I was encouraged by your own strong feelings that school-based clinicians aren't second class therapists and shouldn't be viewed that way.”
The inherent desire for humans to categorize, sort, rank, and assign hierarchical meanings likely has neurological and sociological underpinnings. We may be biologically motivated to determine “best” from an array of choices, and “highest status” within a group. We teach students about semantic categories, superordinate/subordinate, superlatives/comparatives, etc. Ironically, we also appear to have sorted and ranked ourselves.
According to American Speech Language Hearing Association, approximately 53% of Speech Language Pathologists work in educational settings from Early Intervention through Adult Community Transition. Public schools serve children across socio-economic, racial/ethnic, ability/disability levels, and more. Federal regulations are designed to ensure the provision of services for individuals with special needs. Children’s needs range from mild speech sound disorders to complex medical conditions, and school-based clinicians serve children, who are medically fragile, living in hospital settings.
SEE ALSO: Summer Hearing Health
School-based clinicians do not necessarily choose an area of specialization and are required to research and design intervention for an ever-changing caseload. It is perhaps this sense that we are “generalists” that may cause us to be viewed with a jack-of-all-trades mentality, and its corresponding master-of-none.
It could be that the hierarchy of specialist to generalist comes from a physician-based model of tiers of elite level specialization. A medical provider who specializes may be perceived as more capable than a general practitioner. Some people may then view medically based clinicians who serve one population type as the most skilled. Valuing specialization is about valuing expertness. Specialists may have one single defined area of expertise. Sometimes this is the best match for a presenting need, and sometimes it isn’t.
What if school-based clinicians actually have multi-faceted expertise? Using the physician metaphor, school-based clinicians are a combination of both emergency room surgeons and family-based general practitioners. We handle any situation that appears before us. We may be the first provider who interacts with the client and family.
Traits of school-based clinicians include:
• High levels of flexibility
• Understanding of family and client needs/resources
• Ability to assess and provide therapy across the range of communication disorders
• Implementation of therapy in varied settings and delivery models
• Partnership with clients for functional and academic goals
• Collaboration with related professionals
• Consistency in completion of comprehensive documentation
• Research, data, and information gathering of current practices
• Adherence to state and federal guidelines and regulations
• Belief in the fundamental right for individuals to have access to communicate thoughts and ideas
If this list appears similar to a list for any other work setting, it should. School-based clinicians have complex and fast-paced days. We strive to ensure client progress. In some situations, we may feel affected by subtle assumptions about our worth and validity. Remember to believe in the value of your work and how you show your skill and training daily. We are all first class clinicians.