How is it that speech-language pathologists have years of undergraduate and graduate work, hundreds of clinical practicum hours, a full year with supervision, and we can still be years into our career feeling a lack of confidence about what we do?  Now with the additional learning curve of telepractice, the confidence of speech-language pathologists might be at an all time low.

Here is a post on the SLP Reddit group that makes the point:

Dealing with Low Self-Confidence As An SLP

“I am in my 3rd year working in a school and am finding the stress of it overwhelming at times. I am constantly second guessing myself and just always have this feeling like I don’t know what I’m doing. I spend my entire weekend stressing out over the coming week always wondering if I am really doing what the kids most need. Even when I am doing what I know they need I feel like it is just a drop in the bucket because there is not the time to see them but more than once or twice a week… I keep thinking I will feel more confident as I get more experience but I am 3 years in now and am feeling less confident.

I’m just wondering if anyone else experiences such a lack of confidence and what you do to manage it and feel successful and like you are making a difference.”

Speech Language Pathology Reddit Group

Can you relate?

We can.  But here’s what you need to know.  There are three really good reasons why you might be feeling unconfident or anxious in your job as an SLP.  Knowing what these three things are brings understanding.  With that, we can get past it.

3 Things That Bring Down the Confidence of Speech-Language Pathologists

1. Dragging Grad School Habits into the Work Environment

Remember grad school?  I didn’t think so.  What a whirlwind!  Part of the design of grad school is to give us exposure to the full buffet of communication deficits.  It does the job of introducing us to most disorders and giving us experience with some.  But we are at the mercy of an incredible learning curve. 

Here is a pretty savvy research study on SLPs in which they compared the teaching style of programs with the learning styles of the last three generations.  The chart about Generational Characteristics on page 2 is pretty cool. 

Anxiety During Clinical Education

New experiences, situations, and responsibilities encountered can produce anxiety and fears when student clinicians begin their clinical education. In the correct amount, these feelings can be motivating and improve learning; however, too much fear or anxiety can have the opposite effect and impede the clinical learning process.

Speech-Language Pathology Student Anxiety, Expectations, and Needs During Clinical Practicum

In my grad program we had to read so much each week that I didn’t pick up another book until about two years after I finished school. It is intense, and probably needed.  However, many of us carried this toe-dipping, surface-level, learning style and level of stress and anxiety over to our jobs.  You have permission to set it down now (if you are working already!).  Just go to work. Go to work like your non-SLP husband, wife, or partner does.  Know you worked to make a difference, set it down, and come home.

2. Limited Time to “Think Deeply”

Knowledge and/or experience about a subject can raise the confidence of speech-language pathologists. We either need to learn a lot about it, work with it for a long time, or both.  With the speed of our work.  With kids dropping onto our caseload with disorders like Agenesis of the Corpus Callosum or DiGeorge Syndrome, this can be challenging.

With new computer systems to learn…with new research coming out that we are supposed to be reading, how, if ever, can we think deeply?

Here is another post from an SLP on Reddit that sums it up quite nicely:

Deep thinking SLPs

“I know the phrase “deep thinker” can mean a lot of different things. In my case, I love ideas, philosophical conversations, and nuance…This is part of why I am drawn to language, because it’s so symbolic and the confluence of language/linguistics/culture/the mind is fascinating to me.

However, since beginning my training as an SLP, I’m realizing some of the things I love about language are antithetical to the job itself. We try to be objective, and there is the (necessary) goal of giving someone a diagnosis so that they qualify for services. There is a lot of planning, following test manuals, etc. Sometimes I worry that my nature will be in conflict with being an SLP, and that I will have to turn off this more philosophical side of myself.

Am I being unrealistic? Can you think of any jobs that would be better suited for me, or does the day to day of SLP lend itself to this more than I can see? I also considered being a lawyer or therapist.”

Deep thinking SLPs – Reddit

This doesn’t mean that we can’t build confidence as an SLP by thinking deeply.  We just need to choose our topics wisely.  We will talk more about this at the end.

3. What We are Expected to Know is Immense

Using a speech referral system as an example, there are 27 ways a child can be unintelligible and 9 ways they can have suppressed language.  These don’t even include secondary diagnoses!  So the answer here is to give yourself some grace.  Commit to the career and continue to learn.  Once you have learned something, share it with someone.  Drop any notion that you will know everything and feel comfortable reaching out for help from someone with the knowledge you need.

The confidence of speech-language pathology students regarding communicating with people with aphasia

How to Build Confidence as an SLP

There is a lot out there about boosting confidence, and maybe I am a bit jaded, but I am not sure that many of the suggestions help boost the confidence of SLPs. A google search will give you lists of 10, 12, 25 ways to boost your confidence.

All of them researched. 

All of them intended to make you feel better. 

I can’t argue with any of them, but I have trouble remembering to do any of them when things aren’t going well. 

I can’t stomach any suggestions that are coupled with how to “fit them into your day.”  They haven’t seen a healthcare worker’s or educator’s schedule. 

I see most of the suggestions as falling into three camps:  Psychological. Kinesthetic, or Intellectual. 

This is a list I tailored to increase the confidence of speech-language pathologists. Let’s start with psychology.

1 Suggestion from Psychology to Increase Your SLP Confidence

There is one piece of neuroscience that I learned that has had huge implications for my job and I think can change the confidence of speech-language pathologists everywhere.

We are all negatively wired.

The mind has a very important job.  It has to protect you and ensure your survival.  Everything else is secondary.  This means that a massive amount of our programming keeps us on the lookout for bad things happening.

That’s why when negative things happen, they seem so much more important than all of the positive things going on. 

If you are at a party, have 19 amazing interactions, and one person comments about your clothes, which do you remember?

You are driving home for your 40-minute commute.  3999 people drive well and one person next to you is texting.  Who do you remember?

A product you want to buy has 99 5-star reviews and 1 3-star.  Which do you read first?

We are “negatively wired” and we don’t want this to change.  I don’t even know that we can. It’s important to our survival. But there is one thing we can do:

Balance out Negativity with Positivity

Again, I don’t believe we can ever become un-negative but we can add some more positives to our life to balance out the mixture.  I think that on my “best days,” I am probably just coming in even with negative and positive thoughts. 

I think this is part of the power and science behind giving gratitude because you are verbally acknowledging that something positive occurred.  That takes practice.  Seeing the negative is easy and acknowledging fears and doubts is important.  But how can we even the playing field?

• Thank
• Compliment
• Praise (yourself)
• Gamify your day – For every 10 progress notes I write I get _________ .

Don’t turn it into a battle against negativity.  Just add some positives to your day to even things out.  This way, things will appear less dire and more manageable.

3 Ways to Leverage Your Physiology to Boost Your Confidence

So what is kinesthetic research?  If you aren’t familiar with researcher William James, way back at the end of the 19^th Century he posited the idea that if we change our physiology, we can change our outlook and psychological state.  Here is a question for you:

“Do you smile because you are happy or are you happy because you smiled?”

The truth can be both. Many research studies have shown that by holding your face in a smile, you become happier. The As If Principle: The Radically New Approach to Changing Your Life by Richard Wiseman   So these suggestions are ways in which you can act first, to produce the desired outcome:

Slow Down Your Speech

The rate of your speech telegraphs to your own mind and those around you whether you are confident or not.  A person in a position of authority speaks slowly.  An unconfident person who does not feel they know what they are talking about or is unsure speaks quickly.  They are basically speaking apologetically. 

Try this in your next IEP meeting.  State only what is important, in a slow decisive manner.  Here are two examples:

“After working with Peter across four sessions,

Completing tests on five areas of language,

It became clear that he is not communicating at the same level of his classmates and will benefit from services.”

Versus:

“Wow! Testing takes awhile doesn’t it? Thank you for letting me pull Peter out of class and test him so much.  It took awhile but I finally figured out what was going on and then took a while to write up the report because I wanted you all to know how good of a little worker he is but really struggled with so many parts of the language tests that I feel, I mean, I think it’s important to get this little guy into speech therapy and…”

Stand up, Stand tall

What posture do you hold when you are scared? Where is your head? What is your line of sight? How deep are your breaths? Now compare that to an image of Superman.  Unfortunately, in this modern world, our posture when we sit in front of the computer pulls us forward and down.  It restricts our oxygen and lowers our gaze.  These are all the kinesthetic signals the body needs to be on the lookout, be unsure, and be watchful. 

We can reverse this by standing tall with our head back and breathing deeply. This isn’t “fake it til you make it.”  There is real, fascinating, science behind it. 

As an aside,  I was hit by a car while riding my bike and tore all sorts of bad things in my back.  I was experiencing back, shoulder, and neck pain and went through a process called myofascial release.  Basically, I adopted a protective posture when I was about to be hit. I tore muscles that cemented me into that position when I healed.  Myofascial release was basically a process of retearing the muscles (yes, ouch!) so I could stand up straight again.  One positive outcome is that my mood dramatically improved!  The chiropractor explained that I had been continually holding my body in a position of fear. 

The cool thing is you don’t need to get hit by a car to figure this out. Just stand up tall! And improve the confidence of speech-language pathologists on your team by sharing this idea. No slouching!

Smile

There are some really great and bizarre studies in the book: The As If Principle by Richard Wiseman where they trick people into smiling and record mood changes.  For example, they told people they were part of writing study for paraplegics and had to write with a pencil in their mouth.  The people who had the pencil sideways reported better mood and disposition. Bang-for-your-buck this is the easiest suggestion to do. Just hold a smile and count to 6!

Boosting Your Intellectual Confidence

Fear paralyzes us.  In SLP terms this can mean not starting an evaluation because we aren’t familiar with the disorder. Dreading going to the Life Skills classroom because you “stink” at AAC.  Knowledge breaks us free from this paralysis. 

Here is the important point:

Learn Sequentially, Not Simultaneously

I know, I know. This goes completely against who you are as an SLP.  Being thrown into grad school and tackling 6 different disorders each semester. Going to your first job assignment and learning the districts/schools/Medicaid software simultaneously.  Now?

Just stop.

Put everything on autopilot and singularly focus on one thing.  The one thing that scares you the most or will have the greatest impact.  Decide that this is the semester that you will: _________________

• Learn about AAC
• Kill it with taking data
• Eat your lunch without working simultaneously and walking for 5 minutes around the school after you eat
• Master your email

Give yourself permission to become better at the job you are being paid to do.  Then, set that down and move on to the next thing for a few weeks or months.

And a Bonus! Increase Your Student’s Confidence in Speech Therapy

Many of us learn best through teaching.  Well, it just so happens that your students also benefit from the strategies above.