How Not to be a “Karen” SLP – Part 8 Remember, You’re In Your Client’s Home!

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Today’s post is courtesy of an off-hand comment made by a parent late last week.

Honestly, I have to just shake my head sometimes at some people I’m supposed to call my colleagues.

At the request of the parent and the COTA (with whom I have an amazing working relationship), I recently was asked to take over case management of a 7-year-old child with CCN. The specifics aren’t really important in this case – just that this child is seen at home, has a trach and a feeding tube, is non-verbal, and does not currently have homebound school services (the lack of services not provided by the local school district is worthy of several posts on its own!). The family considers therapy to be the child’s educational services, although that is changing with some dogged determination from the COTA and now from me. The child himself is quirky and funny and has some remarkable knowledge of the world despite his lack of access to formal schooling and his medical issues which tend to keep him at home. The family is blended culturally. Mom is ethnically and culturally from another country and English is her second language. Dad is the rare native of the area where I live. The kids are being raised mainstream culture.

I’ve only been working with this family for a couple of months. I know more from the COTA than from mom about the relationship both had with the previous SLP. And, all I knew from the COTA is that mom and the SLP didn’t see eye to eye.

That’s not an issue in and of itself. It happens. We don’t get along with everyone we meet in life and the clients and families we support are no different. If that was where it stopped, then no harm, no foul. As it happens, I’m currently working to have an adult client reassigned or discharged myself mostly because of their unrealistic expectations for change and also because they are very open about some of their beliefs which are in complete opposition to mine.

But, mom let something slip late last week that concerns me greatly. Keep in mind this particular client is seen at home because of his medically fragile status. Mom reported the previous SLP told her (mom) that she (SLP) couldn’t work with parents in the therapy space.

So, wait? What? You can’t work with parents in the therapy space which happens to be a bedroom in their family home?

My first thought is, seriously??!! What an entitled comment! My second thought is then you probably shouldn’t be working in home health. Go find yourself a clinic- or school-based position where you’ll have your own defined therapy space. And then, you’ll probably complain that parents or caregivers are never involved.

Unfortunately, knowing the SLP, I believe what mom told me. There have been a few instances like this with this particular SLP. She has come across to me as very Karen-like in my interactions with her.

One of the huge advantages to home health is you get to work with your clients/patients in their family home. You know, where you can see what your client needs in their usual environment. Where you can provide suggestions and supports specifically tailored to the person’s environment.

Not to mention that the family has welcomed you into their home.

I would love to ask this clinician how she’d feel if someone said the same thing to her. What the SLP said was this: sorry, but you’re not allowed to watch me work with your loved one in your own home. I think my answer would be exactly what the family’s and the COTA’s answer was: time to find another clinician.

I also can’t help but think this SLP would never have said what she said if she weren’t white. I’m not sure that anyone else would feel entitled enough to make such a blanket statement to someone else in their own home.

I’m not saying there are good reasons for asking to work with a client one-on-one. There are. I’ve asked for the opportunity to work through issues in a one-on-one setting, including within the family’s home. I’ve asked either in the moment or during a conversation if it would be OK if I could have a little space and time to get through an issue (usually behavioral). But, I’ve never made a blanket statement that parents weren’t welcome in the therapy space. In fact, I go out of my way to tell parents, nurses, and other caregivers they’re welcome to join in our session any time they like. I want people to know what I do in therapy isn’t magic and, yes, they can do it, too.

As always, thank you for taking the time to read my post. I look forward to your questions and comments!

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