Respecting the Therapeutic Journey

Toronto Adult Speech Clinic Review

Respecting the Therapeutic Journey

What clients and therapists alike can learn from my first one-star Google review


Recently, Toronto Adult Speech Clinic received its first Google Review. Now, to say this review was an unflattering one is a bit of an understatement. Upon first reading the review, I felt hurt and wondered how so much of my intention and message could be misinterpreted and then misrepresented by someone who left their first appointment with a smile on their face.

The review can be found by simply performing a Google search for “Toronto Adult Speech Clinic,” so I won’t re-post it here, but I will share the overall message of the review.

This client felt that as a speech-language pathologist, I betrayed them. They accused me of making their concern larger than they felt it was to make a quick buck. Throughout the review there were more inaccuracies than I could count, and I caught myself getting defensive when reading it. In some cases, this client had recounted the exact opposite of what I had told them.

After sending the client a clarifying e-mail and some individual reflection on the session, I realized that while this was the first instance of such a misunderstanding, it is not an unlikely occurrence when working with many of the populations I see at TASC. In fact, I thought back to my clinical placements and first jobs working with adult clients, and remembered my speech therapist supervisors warning me of these kinds of situations.

Not being prepared to hear that development could be made in areas of one’s communication can trigger clients to have emotional responses that prevent them from being able to process information in an effective way. This is similar to other medical situations where a client or patient or family member receives emotional news and has difficulty recalling what was said beyond generalizations and their own emotion-driven categorization.
This emotional override of our cognitive faculties such as reasoning has been well documented in scientific literature. In his journal article “How Emotions Affect Learning,” Robert Sylwester wrote: “Our emotions allow us to bypass conscious deliberation of an issue, and thus to respond quickly based on almost innate general categorizations of incoming information.

Upon thorough reflection, I arrived at the realization that this one-star review was more than a cautionary tale, it was a reminder. It was a teachable moment on working with the adult population- more precisely- high-functioning adults.

So whether you are reading this blog post as a potential client or as a speech-language pathologist who works with the adult population, there is something for everyone to learn from this one-star Google review.

The first take-away from this session is for the other speech-language pathologists out there:

Be as detailed in your documentation as possible.

When I was in training to become a speech-language pathologist, I always received positive feedback on the narrative style of my notes. I like to capture the tone and mood of my sessions in my notes and use direct quotations wherever possible. This was helpful in debriefing and providing clarification to this particular client after the fact. I knew exactly what lines were recalled incorrectly from our session because I had the actual wording in quotations on my notes from the session.

The second take-away (perhaps the most important) is for speech-language pathologists and clients:

Never forget that communication is a personal and intimate part of who we are.

As the way we express our identity to the world around us, our communication is the way we can control how much or how little of ourselves we share with the people we meet and interact with on a daily basis.

For therapists, this means that we have to be cognisant of where a person is in their understanding and acceptance of their own concerns with their communication. As a therapist, I choose to approach this by always starting an initial meeting letting a person tell me about their concerns in their own words without input from me. Then I let them guide the conversation by asking them more about how they arrived at their awareness of concerns, if anyone else has reported similar concerns, and how important they feel their concerns are to their social and professional lives.

For clients, this means doing your best to reflect on your motivation for seeking speech therapy and how ready you are to confront these concerns before booking an appointment with a speech-language pathologist. When you sit in front of a speech therapist to get a professional perspective on your concerns, you have to be prepared to hear that your concerns are valid. You have to be prepared to have your concerns affirmed and hear that there are things that a speech therapist could do to support you in reaching your communication goals. Know also that It is okay to not be ready and to take your time coming to terms with your own communication goals.

The third and final take-away is for clients seeking speech therapy: 

You have a right to a safe and respectful place to share your concerns.

I built TASC on the foundation of having a safe, inclusive, and non-judgemental place that is driven by my own passion and desire to help everyone communicate their authentic Self. It is important as a client to feel that you can advocate for yourself regardless of which healthcare professional you’re seeing or why you are seeing them. Ask questions, challenge assumptions, and seek clarification wherever necessary. That being said, respect and honesty go a long way in advocating for yourself over attacks and accusations.

In the case of this particular client, we both ended the session that had been full of light-hearted comments, laughter, and even a successful demonstration of my ability to help them, with a smile on our faces and a handshake. Nevertheless, I always end a session telling a client to contact me with questions or concerns any time prior to their next session.

But if a client is not ready to receive constructive and respectful feedback on their communication, recall bias and their own emotional response to hearing their concerns voiced by someone else will inevitably “colour” their memory of the session. At that point, there is not much that can be done other than to acknowledge their feelings and clarify any misunderstandings-as I did in this particular case.

In the end, with the above take-aways in mind, all we can do is our best as both clients and therapists to be respectful and understanding of each other regardless of whether or not we embark on a therapeutic journey together or decide to take different paths.

Jordan Scholl