Speech and language therapyArt or Science?

Jane StokesSenior Lecturer

Speech and Language TherapyUniversity of Greenwich

What exactly is it? The therapeutic relationship The measurement of change in

communication The negotiation with the client, the family,

the keyworkers Drawing on evidence from research to

deliver the most effective practice

Some of this is art – some of this is science

Tacit and explicit knowledge

Some knowledge and skills are explicit – how to carry out an assessment of the muscles and nerves of the mouth

Some are tacit – difficult to describe and measure rapport, partnership with clients, values based work, impact of communication difficulties, empathy, personality factors in success of therapy, motivation to change

Tension between practice wisdom, intuition, common sense and knowledge based on research

The term therapy Comes from a biomedical frame of reference – usually

signifies an attempt at remediation, following diagnosis Phrases like packages of care, treatment programmes,

diagnosis, intervention all derive from a medical model Imply person-fixing, rather than context-changing

(Martin 2009 ) But much of what we do is not health related but more

akin to education and this terminology is inappropriate Also does not fit clearly with concepts of quality of lifeMartin D (2009) Language disabilities in cultural and linguistic diversity

Professional artistry This term recognises the uniqueness of decision

making The complex and messy challenges common in

what Schön called the “swampy lowlands of practice” (1987)

The nuances of how people make sense of their world are often expressed through artistic expression rather than through objective, scientific methods

Schön (1987) Educating the reflective practitioner

Scars of battle?“Speech language pathology as a profession has fought many battles over many years to have its practice recognised as scientific at the same time as internally debating the legitimacy of the scientific paradigm –the battle has left its scars in the language we use to describe what we do”(p 109)Ferguson (2009) The discourse of speech-language pathology in Journal of Speech-Language Pathology 11(2) 104-112

If we view it as purely science we lose the art

If we view it as purely art we lose the science

What is therapy? Difficult to sum up an entire profession in tidy

little statements Hard to stand outside the act of therapy because

of the relational aspects of therapy where the therapist becomes a part of the very process he or she is trying to observe ( Stedmon and Dallos 2009)

But it contains the following elements – some are more artistic than scientific..

Stedmon and Dallos (2009) Reflective practice in therapy and counselling

Therapy comprises the following..

Theoretical knowledge

Observation skills

Measurement skills

Monitoring change

Connection between people

Art of communication

Practice wisdom

Therapy is..C ommunication between people

O bservation skills

M easurement skills

M onitoring change

T heoretical knowledge

A rt of communication

P ractice wisdom

Communication, observation, measurement, monitoring, theoretical knowledge, art,

practice

C O M M T A P

ReferencesFerguson, A. (2009) The discourse of speech-language pathology. Journal of Speech-Language Pathology 11(2) 104-112 Martin, D. M.( 2009) Language Disabilities in Cultural and Linguistic Diversity. Bristol: Multilingual MattersSchön, D. (1987) Educating the Reflective Practitioner: Toward a New Design for Teaching and Learning in the Professions. San Francisco: Jossey-Bass Stedmon, J., and Dallos, R. (2009) Reflective practice in therapy and counselling. McGraw-Hill.