Are you a therapist who feels the deep need to work across the lifespan? 

Or do you feel the need to be able to work with any client who gets referred to you, whether that’s early language, fluency, speech sounds, literacy, AAC etc?

Are you a therapist who feels bad or guilty if you have to refer a client to another Speech Pathologist because you aren’t ‘good’ or experienced enough in a particular area of therapy?

If you are answering yes to any of these questions, I am going to now ask you why.

I’m going to do this because I strongly believe that just because we can work across the lifespan, we don’t need to. 

Just because we can work on a variety of therapy areas, we don’t have to. 

More importantly, we shouldn’t feel ‘bad’ or ‘guilty’ or feel any ‘shame’ in saying “this isn’t my area”.

I truly believe this is one of the many ways we add to our imposter syndrome, dampen our confidence and make our Speechie lives so much harder. 

My first job was early intervention, 0-5 years. That’s all I did for 18 months. No adults, no literacy. Just paediatrics. 

My second job was in a school, kindergarten to Year 3. I was upskilling teachers, focusing on literacy, speech sounds and lots of language therapy.

In both these jobs, my limited caseload scope meant I developed my skills FAST. I knew exactly what PD I needed to attend. What I needed to focus on in my supervision sessions and what resources I needed to have. Having my blinkers on aided not just my skill development but my career trajectory. 

It helped with my confidence and I was able to gain more expert-level skills. 

Now in private practice, I focus on autistic and ADHD kiddos. 

I am hopeless at AAC device trials and applications so I get a Speechie who is ace at this to do it for me. She does what she does best and I focus on what I do best. 

If one of my kiddos starts stuttering, I would refer them off to a stuttering expert. That way they can get the targeted intervention they need with a therapist who is up to date with the latest research and therapy techniques.

Same with my mentoring. I am not your person if you want to upskill in AAC. I am not your person if you want to talk about dysphagia or tube feeding. Picky or selective eaters, absolutely. Nil by-mouth transitioning feeders, no. 

By being super clear on what I can and can’t do, I continue to build my skills more easily. I get continual practise in these areas, so I can implement my learnings, tweak and adjust more easily. 

I think as therapists it’s brilliant we can do so much. We can work with babies, toddlers, children teens, adults and the elderly. We can work across different workplaces, funding models and therapy areas. However, the more general our caseload, the more general our skills are. The more general the PD has to be. The more resources we have to have on hand. The more supervision we need because it takes us longer to master skills across the domains as we just don’t get the exposure and practise we need in a short time frame. 

There are definitely pros to working this way but there are also a lot of cons. 

So if you are starting to feel drained, pulled in lots of different directions and losing confidence, maybe the place to start making changes is with your caseload.