Working together with other therapists

In today’s blog post we’re welcoming a guest contributor, Gemma Moore.  Gemma works for the NHS in Portsmouth and is a specialist in hearing impairment.  Gemma and I have written this post together.

There are various reasons why more than one therapist may end up working with a child.  We’re not going to go into those today.  However, when it happens, it’s really important that the therapists work together, in a complementary way.  Generally, therapists want to work together!  However,  this can sometimes be challenging.  There are several reasons for this:-

• Any 2 therapists can have slightly differing opinions. This doesn’t usually mean that one is right and the other is wrong but it can make it harder if you are initially focussing on different things.  Add in the equally important opinions of the child’s parents and their school or nursery and sometimes there can just seem to be too many opinions!
• There can particularly be a difference of opinion between independent therapists and NHS therapists. This is because of a difference in what can be provided in different situations.
• The logistics of keeping in touch can be tricky. I’ve never met a speech therapist who isn’t busy and we can be challenging people to get hold of on the phone!  Email collaboration can be tricky as certain information shouldn’t be emailed due to confidentiality.  General busyness can just mean that you don’t speak to each other as often as you should.

However, the benefit of another therapist’s opinion can also be a fantastic thing.  Two heads can really sometimes be better than one and I have often learnt new things and grown in my skills and knowledge from working with another therapist.

Gemma and I have been working together with a few children for a year or so now.  The first thing to say is that we are good friends.  We trained together, shared a house for a while after we left university and now we are godparents to each others’ children!  Obviously this has really helped us with working together, as we have a level of trust in each other that is hard to replicate with a therapist you have never met.  Nevertheless, we hope that some of our experiences of working together can be helpful to others.

We’re going to talk briefly about 3 different children (all names have been changed!)

Ben

We have both worked quite closely with Ben who has quite significant speech and language needs.  We agreed with his parents to see him on alternate weeks, so that he was able to have weekly therapy.  Initially we set joint targets and then we would send brief emails after each session or two (often just a line or two) about anything the other should know about.  We spoke on the phone every few months to review the targets.

More recently, I have continued to work directly with Ben at home and Gemma has taken the lead in working with the nursery to help transfer what he has learnt out of home and into other settings.  Again, we speak every few months to update the targets and share ideas.  We share assessment results and we both attend multi-disciplinary meetings.  I think this is particularly useful, especially for a child with more complex needs, as having everyone together in the same room really helps to get a rounded view of a child in all settings and collaborate on how best to help.

Ruby

Ruby is a child that I see weekly.  Gemma sees her once a term.  Because I am the therapist who sees her most frequently I tend to take the lead in setting targets and deciding when they need to change.  Gemma calls me before she goes into school and I update her on what I have been doing and why.  Although I do liaise regularly with the school staff, they are not often able to sit in on my sessions, so Gemma always does her termly session with the TA and demonstrates strategies and activities for them to follow up on.

Daniel

Again, Daniel is a child I see weekly.  Gemma sees him once a month.  Daniel has difficulties with both speech sounds and his understanding and use of language.  Although I do target all areas, I tend to focus primarily on his speech sounds during my sessions.  Gemma tends to focus more on functional communication, such as setting up visual support strategies for nursery.  Again, we speak every few months and make sure that we agree the targets but we each take the lead in implementing different ones.

Finally here are our top tips on working together with other therapists (especially between NHS and independent therapy):_

• Be clear with parents and school staff about who is doing what and why. Then they understand the plan and know who is the best person to ask about their query.
• Explain your thought processes to the other therapist. Sometimes the first thing you see from the other therapist is a list of targets and at times you aren’t immediately sure why those things have been targeted.  Ask and then really listen to the answer.  If you feel that something else is important, explain why you think this.  Talk to parents and school staff too.
• Agree how often you will contact each other and how and put it in your diary so that it happens.
• Assuming that you have the parents’ consent, always let the other therapist know if you have completed any assessments and share the results.
• Share reports.

What are your experiences of working together with other therapists?  What tips do you have that we can all learn from?