8 Recommendations for New SLP Graduate Student Clinicians

1. Wear a watch during therapy. Your first semester of clinic is a good time to dust off that old timepiece you haven't worn since 2004 and put in a fresh battery. When working with a child who may be easily distracted, consider wearing the watch on the wrist that is furthest from the child. I unfortunately learned this firsthand and precious therapy minutes were lost as a consequence. If you simply can't stand wearing a watch, make sure you have another time-keeping device with you (aka a cell phone), but be aware that it may be distracting and seem unprofessional for you to keep pulling out your phone.

2. Dress professionally and comfortably. Dress for the occasion. You'll likely want to be business casual (uncomfortable heels for ladies and low cut shirts are not recommended), but consider that if your client is a small child, you could be doing therapy on the floor.

3. Minimize possible distractions. Children, with their curious nature, are often easily distracted. In addition, certain diagnoses can further influence a client's distractibility. For example, dangly, shiny jewelry can be distracting. Lots of toys in view around the room could affect your other clients. After a short time, you will begin to better understand your client and can adjust the therapy setting accordingly.

4. Take breaks (and learn to recognize when they're needed). As student clinicians, we often feel that therapy must take place for the entire session. While this is the ultimate goal, remember that we are working with real people and they are not always attuned to our therapeutic agendas. Due to my own inexperience as a newbie graduate clinician, my very first client ended up crawling under a table during our third session together. I was terrified and spent the last fifteen minutes of the session trying to regain control and resume therapy, worrying mostly about lost time. After the session, my supervisor and I discussed what had gone wrong. Fifty minutes of therapy is a long time for a three year old and we hadn't taken a break. For the rest of the semester and with my remaining clients, I implemented a two minute break, generally twice during an hour session, or as needed for the specific client. These two minutes of play (during which I sometimes snuck in speech practice) allowed for my clients to rejuvenate and refocus on the task at hand. The goal is to recognize when your client needs a break. If you miss the signs, they could have a "breakdown," just like my three year old client. Unfortunately, breakdowns can be difficult to come back from.

5. Have a back up activity. This is a good practice for the student clinician in case a planned activity doesn't pan out- perhaps the client did not respond well to it, or it ended too quickly. As we become more experienced, we will likely be able to implement back up activities without having to plan in advance. However, until you become experienced, consider that planning and preparation will take more time. 

6. Avoid using indirect language. Research shows that women typically use more indirect commands in speech than men. However, if you say to a client, "Can you tell me what you see?," be prepared for the possible response "no." Now what?... Thus, I encourage you to reconsider the use of such language since you, as the student clinician, need to maintain control of session. In this instance, a direct statement would have been, "Tell me what you see."

7. Laminate materials for later re-use. You don't know where your career will take you and you're just getting started, so save and laminate any good materials. We had access to a laminator at my school, but I decided to purchase an inexpensive one that I could use conveniently at home. It has been worth every penny thus far. 

8. Time each of your session activities. Time management is obviously important, as you are expected to provide therapy for a certain amount of time. I have had activities that unexpectedly were completed very quickly and I had to think fast to come up with something else to do to fill the remaining time. This is less likely to happen if you estimate beforehand how long you expect the activities to take. On my copy of the session plan, I write the expected duration of each activity, including breaks, as shown below.

Activity 1 (10 minutes), Activity 2 (8 minutes), Activity 3 (5 minutes), Break (2 minutes), etc.

This method helps me gauge my time throughout the session so I can shorten or extend certain activities if needed.

I hope you find some of these tips helpful, whether you are just starting clinic in graduate school or are just looking for more insight into the field of speech-language pathology. 

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