What to Expect: Initial Consultation
Author: Kendra Wormald, Reg. CASLPO Speech Language Pathologist
Date: Wednesday, June 26, 2024
I am confident in saying there is likely an area in which a Speech-Language Pathologist can provide support, that you do not know about. A lot of people aren’t aware of the variety of areas a Speech-Language Pathologists (SLP) can support in. Often people think an SLP works with children, to fix their /r/ or lisp or stutter maybe. However, that is but a glimpse into what an SLP can do. A niche part of our practice at WellSaid encompasses supporting communication skills professionally and socially, modifying an accent, gender-affirming voice care, and adult adhd coaching, amongst others. Take a look at the variety of targets and populations we serve here.
After either booking an initial consultation online or with our Director of Service, you will be provided with your clinician’s information including their zoom link. This link will be used for all sessions moving forward, with that clinician.
Write your appointment date and time down somewhere and set a reminder for yourself.
Congratulations, you’ve accomplished the first step in your communication growth journey. Take a deep breath. It is no small feat, and you should be proud of yourself.
You will be sent an intake form to complete before the initial consultation. Here you will be informed of all clinic policies and have the opportunity to share social, professional and health related information. You will also be asked what your goals are.
Providing ample detail here will help your clinician navigate the conversation and use the time you have as effectively as possible. There is a place at the bottom of the intake form to leave questions for the Speech-Language Pathologist to answer during the initial consultation. Take time to reflect on what you’re interested in learning. There truly are no stupid questions here. You are considering a significant time, effort and financial decision, so it’s important to be well informed.
Limitations of Client Location: Being a regulated healthcare professional includes being governed by a College. The College of Audiologists and Speech-Language Pathologists of Ontario (CASLPO) mandates that within our license we are only able to provide speech language therapy to residents of Ontario. To note, there are some limited areas where we can work as a consultant. The client should understand the repercussions of accepting services with a consultant rather than as an SLP, regarding insurance coverage and the loss of the ability to benefit from regulator protections. In short, we need to know where you reside to ensure we follow our College rules and provide the most appropriate service based on your location.
Emergency: We are also regulated to have your address on file due to possible emergencies. If throughout the session you had a medical emergency, with no one else close by, the SLP would need to know your address to direct 911 services.
Be assured, that all information is secured within your client file and all storage and translation of your file follows PHIPA protocols.
An initial consultations accomplishes several valuable steps:
It provides time for you to discuss key information which will help your SLP plan and tailor a comprehensive assessment for you. Your assessment will be specific to your goals therefore it’s important to first have a conversation about what these include and for your SLP to get a sample of your communication.
This time allows you to determine if you ‘vibe’ well with each other. The clinician - client relationship involves trust, honesty, openness, and vulnerability so it’s important that you feel comfortable with your Speech-Language Pathologist, and feel confident in their skill set. The initial consultation is not only for the SLP to get to know you, but for you to also get to know them.
To discuss the frequency of sessions and length of intervention. There are two different approaches you can take for intervention: A session by session approach, or a block of therapy (11 sessions). Your SLP may suggest which approach may support you best based on observation, self report, financial and time limitations, and your goals. However, the decision is ultimately up to you.
To begin an informal assessment. Throughout your 25 minute interaction with the SLP, they are already assessing you, they may observe examples of areas you want support in and also areas you may not have thought of. Depending on how much time you have following reviewing related background and health information, you may have time for the SLP to assess in a more structured way. This may include things like recording a spontaneous speech sample, evaluating qualities of your speech or voice such as pitch, volume or rate.
To initiate referrals. You may be seeking support for an area that is outside of the scope of the SLP, which may lead to them referring you to another healthcare professional. You may be able to work with various healthcare professionals at the same time, or it may be recommended to seek support with one, then come back to speech therapy. Referrals may include but are not limited to: Psychotherapists, Psychologists, Occupational Therapists, Physiotherapists or an Ear Nose and Throat doctor.
To ask YOUR questions. Throughout the meeting you’re encouraged to ask questions. These may revolve around information shared within the session - such as asking the SLP for clarification, questions pertaining to progress and effort required and the clinician’s experience.
You will never have to share anything that you don’t want to. If asked a question that you’d rather not answer you’re welcome to just say ‘pass’ or ‘next question’.
Some examples of questions you may be ask include:
Lifestyle/Habit Questions: How do you prefer to communicate with others, how often do you raise your volume, how frequently do you use your voice throughout the day, what are your communication responsibilities at work (1:1 meetings, presentations, virtual vs in-person etc.), how much water do you drink during the day?
Medical History: Do you experience anxiety - generalized or situational, do you have irregular teeth formation or mouth closure, a deviated septum, history of concussion, do you have Autism Spectrum Disorder, ADHD, or a learning disability?
* To note, a diagnosis is not necessary in order to receive support. If a skill you struggle with impacts your life, even in the slightest, it is worth considering steps to improving it.Hobbies/Interests: During therapy your SLP will likely have you read passages. Choosing topics that are of interest to you can facilitate engagement and focus.
*The area of professional communication will be used to provide a tangible example of part of an SLP - client initial consultation. Let’s call our client Peter.
Peter completed his intake form prior to the session. He reports that his boss and co-workers have a hard time understanding him and often ask him to repeat himself. He works at a bank.
Peter shared valuable information here by providing feedback that he received from frequent communication partners in his life. Prior to your session, ask trustworthy others to provide you feedback on your communication and reflect on previous comments you may have received.
The SLP then asks follow-up questions related to this report.
a) Do you find that you speak at a fast rate, or that your rate changes throughout your sentences?
b) Do you feel out of breath when you're speaking, or as though you’re trying to ‘catch’ your breath?
c) Do you find it challenging to express yourself in a direct way? Do you use more words than needed to explain yourself?
d) Do you feel any physical tension within your body, primarily around the chest, shoulders and throat, while speaking?
e) Do the above answers change based on who you're speaking to or what you’re doing such as a conversation with a co-worker during break vs. delivering a presentation to stakeholders?Peter states that he’s never really thought about his breath before and says he’s a fast speaker but that’s just who he is.
The SLP prompts Peter to consider the pros and cons of speaking at a quick pace.
The SLP uses these kinds of questions to promote reflection and discussion around what may lead to his reduced communication effectiveness in the workplace, as well as draw possible connections between thoughts and behaviors.
Peter shared that he feels as though he needs to rush and not take pauses because silence is uncomfortable and he’s concerned the communication partner(s) will stop listening. He’s tried to slow down his rate but then he loses focus on what he’s saying.
Peter’s reflection unfolds possible underlying explanations for his communication behavior of speaking quickly.
The SLP provided possible reasons for why this happens: Often, if you tell someone just to slow down - it may stick for a few sentences but likely they return to their original rate. However, we can shift this thought pattern which will impact our behaviors. For example, intentionally taking time to pause and speak with a consistent rate will help your listener better process what has been said, and it will allow time for an effective breath which can promote calmness, word finding and a supported vocal quality.
The SLP follows this comment by sharing some information and research to support what the client is saying and their understanding of why certain communication behaviors occur.
Just in this brief interaction, the clinician has learned valuable information about the client and the client may have also learned something as well.
There is a lot of information shared during the initial consultation. Your SLP will send you a summary of what was discussed including goals, background information and payment and session approaches. You are encouraged to take time to reflect on the session and review the summary. You are always welcome to follow-up with your clinician with any questions that may come up after the meeting.
To speak with a psychotherapist or one of the speech-language pathologists at Well Said: Toronto Speech Therapy, schedule an initial consultation by clicking the link below or calling (647) 795-5277.