As I am about to launch into ONLY working in private practice, I started thinking....what are the benefits of private practice for speech therapy? What about it just works for most clients? What are the pros and of course the cons?
Freedom, oh sweet freedom! That is what I LOVE the most about private practice for speech therapy!!! I get to work with children without the headaches of all the RED TAPE! The idea of getting a referral, completing an evaluation and starting treatment within one week is mind boggling for those in schools.
Now, all the red tape has its place and need. Schools and clinics need to help many, many children within the system of federal funding and/or insurance companies. There needs to be systems to calm the chaos. However, the lack of wiggle room and clinical judgement can be frustrating. The therapy process can also be SLOW to start and the quite minimal due to lack of resources.
In private practice, I get skip all the paperwork and instead, create individualized treatment plans that can be updated easily. I can start seeing children immediately.
Most importantly, I can devote all the my time to treating patients instead of digging through mountains of paperwork.
Another reason why private practice for speech therapy is so amazing is the parent involvement!! This piece of the puzzle is so crucial for progress. In private practice, I get to involve caregivers into treatment if applicable and/or re-cap EACH session while providing necessary strategies & practices to target throughout the week.
As much as I would love to believe 30 minutes of speech therapy per week is enough to treat speech and language disorders, it just isn't true. Instead, treatment sessions are more like weekly evaluations of progress, trials of cues and strategies, and time to adjust home practice. The only way for most children to make fast progress is to have parents understand what is going on and then support their child's work throughout the week during functional activities. I just don't see a way around this one.
The problem is in schools is that parent communication is 1-3 times per year through IEP meetings and progress reports. There is really no time for more when a speech therapist may have 60 kids on their caseload!!
In my experience, most children make faster progress in speech therapy private practice and it only makes sense if you think about it. In private practice, parents are more involved which is crucial for progress. Parents get weekly updates and tips on how to help their children throughout the week. The practice continues all week where in schools this communication is minimal.
Also, plans can be adjusted easily depending on a client's progress. If a client meets a goal, a new goal is created! If a client is not on the right path, you talk with the parent and adjust. You don't have set up a meeting and waste time due to scheduling conflicts.
As you will see in #4, clients are usually seen individually, for longer sessions. For most goal areas besides some pragmatic goals such as initiating play with a peer, this is a great thing. Keep reading to find out why.
I love the long, individual sessions that private practice provides. Some therapists don't love this but I DO! In schools, sessions are usually 30 minutes with 3-4 students. To me, it is very stressful trying to target each student's individual goals while managing behaviors. In this model, a lot of time is wasted on planning, brainstorming ways to keep all children engaged so behaviors are minimal, and managing behaviors that naturally occur in a group. This isn't ideal for most speech and language goals.
In private practice, I get to see each client individually for 45 minutes! All my attention is on the client. During these longer, individual sessions, I'm constantly I observing behaviors, assessing progress, and adjusting my treatment techniques easily.
My clients make FAST PROGRESS and I'm not exhausted by the end of day.
To be honest, this is the type of speech therapy I believed I would provide as I was studying for my Master's.
Without the red tape that comes with schools and clinics, I can truly create individualized treatment plans that is ONLY based on the clinic's needs! This means, each plan, from goals to session frequency, is based on each individual.
Some children make quick progress and goals need to be updated more frequently than once a year! I don't have to predict how a child will progress and create benchmarks based on this predictions. Instead, I can update goals as needed.
Some children need to be seen weekly or twice a week to make progress. Some children need to be seen bi-weekly. Some children need a monthly check-in. This can all be created based on a child's individual needs.
As with everything in life, there are always drawbacks. For those considering private practice, whether you are a parent or SLP, I thought it is only fair to include some drawbacks.
One big drawback that can't be ignored is the cost. Private speech therapy can be more expensive if insurance does not cover it....and most of the time, insurance covers minimal to no sessions. For some families, the cost isn't an option and that is okay! There are other resources through schools (if your child qualifies) or resources online such as our membership program.
Now, the initial cost may seem high; however, progress is usually quicker. Therefore, your child is in therapy for a shorter amount of time. This is worth it for many families!
Now, if your child is not in school this one does not apply. However, if your child is in school, the one major benefit of school therapy is access to teachers and the school curriculum. I WILL MISS THIS!
It is great to target speech and language goals using a student's curriculum. What is more functional than that? As an added bonus, there is less "crafting" and plan time.
If a child is not in school (preschool and/or pre-K doesn't count as school), then the home environment is actually MORE functional! Being seeing in a school as an itinerant or in a clinic isn't the best setting.
This drawback doesn't affect parents or clients, but for my SLP readers, inconsistency of a caseload can be daunting, especially for single income families! Also, I'll just throw insurance in here too. Since we continue to tie medical insurance to jobs, lack of access to a group healthcare plan can be not so great as well.
Personally, the inconsistent caseload doesn't bother me! I like the variety and the rush of a busy week followed by a slower week. However, this is something to consider!