What are some challenges that you faced when you encountered your first client?

Hello, I am a graduate student studying to be an SLP. I have a question that I am hoping I can get insight on regarding working with individuals who stutter. When you met your very first client who stuttered, was it difficult to navigate the assessment and treatment? Given that this area of speech-language pathology is incredibly specialized, how did you receive the training to competently navigate these sessions as a beginning clinician? Thank you for your time.

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What are some challenges that you faced when you encountered your first client? — 3 Comments

  1. Hi there,
    This is a very valid question. For a newly qualified clinician, your first client in any area can be a bit scary… and exciting! The important thing is allowing time for the assessment process, and gaining information from all relevant sources, so that you can confidently put together recommendations for a management plan for the individual client that relates to their specific needs.
    I was fortunate enough to have a clinical placement in my final year of study (I’m in the UK, so this may not completely apply to your situation as student experiences may differ slightly in different countries) that included time with a supervisor who was a specialist working with children who stutter. This meant I got to observe her first hand working with children and families, as well as having some supervised interaction myself with the children and families which allowed me to grow in experience and confidence working with this client group while I was still a student. This led to my interest in this specialist area and meant that I sought out opportunities for further education and knowledge via relevant short courses, attendance at Clinical Excellence Networks (Groups for SLTs with an interest in a specific area, again, possibly a UK thing, but I’m guessing you’d be able to access something similar) and asking to shadow sessions with specialist therapists. I have also completed more thorough specialist training in order to develop my specialist skills, but as a beginning clinician there are lots of short courses (including online options, see for example The Stuttering Foundation or the Michael Palin Centre) around that allow students or newly qualified clinicians to gain additional training to start their journey working with people who stutter beyond that taught on their SLT qualification course.
    I would add that supervision from a more experienced specialist clinician is also crucial, as for all areas of SLT for newly qualified clinicians. You can learn a lot from observing others and having the opportunity to discuss case management decisions.
    Hope that helps!

  2. I would add to Jenny’s excellent response and say always let the mantra: “Do no harm” be your guide. I have seen a great deal of harm occur from inappropriate therapy for children and adults who stutter. Don’t be afraid to say: “I don’t know,” or “I need help,”. I have worked with people who stutter since the 70s and I still run into situations where I wonder if I am pursuing the right approach. Be part of a community of therapists, who are concerned about appropriate treatment. Reach out to colleagues, supervisors, professors and work together. It truly does take a village. When you see your first client who stutters, listen to them. Develop a therapeutic alliance and most importantly, establish hope.

  3. This is a great question! I will never ever forget my first individual who stuttered that walked into the treatment room where I was working. I live in the United States, so I had just completed my Clinical Fellowship Year (CFY), meaning, my first year post graduate school, which I had done in the public school setting. After that first year post graduate school I decided to make a switch to the medical setting, and I was working in an outpatient clinic that was attached to a hospital. About a month into my job, and a month after receiving my CCC-SLP (Certificate of Clinical Confidence) from the American Speech-Hearing Association, in walks my first client ever who stutters, an adult in his 50’s. I will never forget what I was wearing, what he was wearing, the room we were in, all of it. I had over-prepared for the evaluation and I was so ready: I had my method picked, my interview questions ready, my materials, recorder, timer, all of it handy; even the extra batteries in case the recorder ran out of the already fresh ones. He sat down in the room, introduced himself, said he is a person who stutters and has gone through intensive therapy programs including one he relocated his family crossed the country for. He had done things like DAF (delayed auditory feedback), basically had tried everything and before I could get many words in he asked me, “and what’s going to make you any different?” He taught me so much with that question. A question that I will remember for the rest of my career; the rest of my life. My answer to him was raw and honest- I couldn’t act like I had years of experience, nor could I act like I fully knew what I was doing. I have met SLP’s that do that- don’t ever do that.. it’s not honest. I said to him, “I am young and fresh in the research. I do not have years of experience to offer you and that is something that makes me different, but what makes me the most different is I will devote myself to studying, adjusting what I am doing, and working hard to meet your needs as we work together during this therapy process. I am passionate about stuttering therapy as my brother stutters and I know a lot about it from my studies and I am so excited that you are here.” I ended up treating that man for a year, and I will never ever forget him. He did beautifully in therapy, he helped me learn and I helped him too. So, your first experience isn’t a negative. It’s a positive. It’s a learning experience. ALWAYS remember- the person sitting in front of you is a human being just like you are. Be raw, honest, and vulnerable too, yet professional. You have the educational background to do this for a living.. you do! You can be an effective clinician, you can! But never act like you know what you are doing when you don’t, and never take on a client that you are not ready to take on when you aren’t ready. Seek out guidance when you need it from your mentors, they are your biggest fans and cheerleaders, and I still seek guidance from mentors, even in stutters- we all do. You’ve so got this! You are going to do great in this field- it’s the best field ever!

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