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Kate Grandbois: Welcome to SLP nerd cast your favorite professional resource for evidence based practice in speech, language pathology. I'm Kate grant wa and I'm Amy
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Kate Grandbois: Welcome to SLP Nerdcast. We're so excited for our topic today. We are here to talk about something that is under discussed in the field of speech language pathology, and yet at the same time, something that is critically important [00:02:00] for every single thing we do as speech language pathologists. We're here to talk about counseling, and we have two content experts here with us to make the conversation even better.
We're very excited to welcome Dr. Corrie Clark and Kate Mellillo. Welcome Kate and Corrie. Hello. Yeah. Thanks for having us. We're very excited to be here. I was thinking why I listened to this podcast.
Amy Wonkka: We're so happy to have you here. Thank you so much for sharing your time with us today. Um, like Kate mentioned, you're here to discuss counseling with a focus on children and adolescents and executive functioning and relationships. But before we get started, can you please tell us a little bit about yourselves?
Kate Melillo: Sure. I'll go first. Okay. So, um, I'm Kate also. Um, I am a speech pathologist in North Carolina. Um, Cori and I co own Be a Problem Solver Services, which is our private practice. [00:03:00] Um, and my focus is on executive functioning and social skill building. Um, and our practice is actually both mental health. and speech services.
So it's a little bit of a unique combination. You don't see that a lot. Um, and I'm, I also write a lot of social emotional learning content as my other job. So I'm, I'm in this world all the time. And I'm Dr. Corey Clark. I am, um, a licensed clinical mental health counselor. Um, I specialize in working with, uh, children and adolescents and, um, I also teach, uh, a, a clinical mental health counseling program, uh, called the Chicago School and I, I am also the president elect of the Association for Child and Adolescent Counseling, um, and so a lot of my focus is on, you know, the unique work with, uh, counseling children and teenagers.
Oh, and we're also married. [00:04:00] We are also together. So if you hear us having a marital argument, that's great. That's what podcasting is the perfect platform for side chatter. Um, so that's, that's wonderful. And I, I want to circle back. I were tickled that you listened to this podcast. It's always funny for Amy and I to hear that kind of thing because we hang out in a zoom room and then we send these off into the ether.
Kate Grandbois: So it's, it's always nice to hear that. Um, and we're, as I already mentioned, we're so excited to have this conversation, it, you know, counseling touches everything we do, and your practice is unique, and it sounds wonderful blending these two areas of competency, um, and we're very excited to get started. I do need to read our learning objectives and disclosures.
I will try and do that as quickly as possible. Learning objective number one. Describe key knowledge areas, attributes, and skills of child counselors To incorporate into speech sessions as they [00:05:00] intersect from the competencies for counseling children and adolescents.
Learning objective number two, describe three relationship based counseling strategies that can be easily included in speech sessions. And learning objective number three, Identify how the mental health strategies discussed intersect with executive functioning treatment in the relationship based model of executive functioning.
Disclosures, Corey's financial disclosures. Corey is the co owner of Be A Problem Solver. Corey is the co owner of Be A Problem Solver Services, PLLC, which is a mental health and speech therapy practice, and Be A Problem Solver Education, LLC, a parent education service where Corey received a salary for a speaking fee. Corey is a faculty member at the Chicago school where he receives a salary. Corey is non financial disclosures. Corey is president elect of the association of child and adolescent counseling. Kate's financial disclosures.
Kate is the co owner of be a problem solver [00:06:00] services, PLLC and be a problem solver education, LLC, where she receives a salary and a speaking fee. Kate is a research strategist at 3C Institute where she receives a salary. Kate's non financial disclosures. Kate has no non financial relationships to disclose.
Kate, that's me, Kate Granbois. I am the owner and founder of Granbois Therapy and Consulting LLC and co founder of SLP Nerdcast. My non financial disclosures, I'm a member of ASHA SIG 12 and serve on the AAC Advisory Group for Massachusetts Advocates for Children. I'm also a member of the Berkshire Association for Behavior Analysis and Therapy.
Amy Wonkka: Amy, that's me. My financial disclosures are that I'm an employee of a public school system and co founder of SLP Nerdcast, and my non financial disclosures are that I am a member of ASHA Special Interest Group 12, which is AAC, and I also participate in the AAC Advisory Group for Massachusetts Advocates for Children.
All right, we've made it through the disclosures and the learning objectives. On to the actual content. Um, [00:07:00] Kate and Corey, why don't you start us off by telling us a little bit about the first learning objective? So I guess both what are some clinical competencies for counseling children and adolescents, but also why is it important for SLPs to be aware of and to develop these competencies?
Cory Clark: Yeah, so I'll start. Um, this really, for some context, this really started in the last five years where I, as a, um, counselor saw that counselors were being trained to treat adults from a more general model. And I found that working with, um, and teenagers was a very unique process. And I think that really started from working, uh, Kate and I met, uh, working at a preschool and, um, I had a, you know, background in working with kids in that way.
And, and I saw that a lot of people were going into the field, just kind of treating kids like little adults, you know, and it was, there was an [00:08:00] incongruency there. So I was really interested in what makes working with kids and teens unique because I knew there was. A uniqueness there, but I wasn't quite able to pinpoint it.
And so, the last five years, I've really been focusing on interviewing experts in the field of, uh, child and adolescent mental health and identifying what makes working with kids and, and, and teens unique and what are the basic best practices and working with, with that population. And so, that is, is where I, um, published and, and, and focused a lot of my dissertation research.
best practices for working with kids and teens. Um, and really what it comes down to is really the foundation around child centered therapy. And so what that means is child centered therapy is in its nature very non directive. Um, it is very much based on the Carl Rogers, uh, person centered counseling [00:09:00] model, which is unconditional positive regard, having congruence and empathy for the, for the person.
And And because of that, there's not really a lot of, like, specific behavioral goals in, in, um, child centered therapy, um, but a lot of research supports that a lot of behavioral change and, um, good, uh, coping skills and good development happens from that. Uh, play based child center therapies. So, um, that is sort of the foundation of, of a lot of the, the, um, best practices for working with kids and teens.
And so, you know, looking at, uh, What kind of the model that I came out with initially, um, there's attitudes, actions, knowledge and skills. And I broke it down to those four kind of domains. Um, and so go ahead.
Kate Melillo: Oh, so before we jump in, because are you about to jump into those domains before we jump into that.[00:10:00]
I just want to touch on why this matters for SLPs and why we see like a really big crossover with executive functioning skills. So, you know, I think like if you're listening to this, you're like, well, what does that have to do with what I do on a daily basis? Um, however, like at our practice where.
Counseling and speech therapy all the time. I mean, and I think a lot of SLPs, especially when you're new, you go in and then you're like, Oh, I didn't like now a kid is crying in my office. And I didn't expect that. Right. Like, or they're dumping out like, Oh, well, my home, my mom told me this, like, they're just telling you everything.
And actually, it's funny. I remember in grad school, I had this one professor who's like, you're going to be so surprised. They're going to come in and tell you everything. Cause you're like the sort of, you know, side person in their life. A lot of times, like you're like this extra [00:11:00] support person. Who's not the parent.
And there's no other, like, side person. Like, you don't have this other, um, stake in the game at, like, you know what I mean? Like, they are kind of coming to you, like, friendly, right? Like, I think, like, the SLP role tends to be really, um, warm, empathetic. The things that Corey just described, but like Kate said, like, we don't get a lot of this training.
Um, even though we're doing this relationship based therapy. All the time. Um, and so in terms of where we see it a lot is this like crossover with executive functioning and that's a lot of times because, um, executive functioning at its core is really regulation, right? It's, it's how our brain can regulate itself so that it then can like plan tasks, organize tasks, um, Execute tasks, right?
Like impulse control, working memory. Um, [00:12:00] and a lot of that comes down to emotional regulation. Like I always say, like I describe to my clients, like when you're in mental health. is not in a good space, like your executive functioning skills become scrambled eggs. And so it's really hard for, for students to be regulated, right?
Like cope and release emotions and then be like, okay, let's, let's work on pronouns. Like it, it, it just doesn't work like that. The human brain doesn't work like that. And I think a lot of times we go into sessions and we have an agenda where like, these are the goals. That's what you learn in grad school.
You're like, these have to be like good functional goals. They must achieve them. The insurance company must approve them and you must do them like, you know, and then we skip over this other stuff. Meanwhile, like, you know. Little Johnny comes into your office and he's like, Oh, my [00:13:00] grandma died this weekend.
Like, you know, I mean, and you're like, but he's the, like, you're the person he trusts. And so he's told you this information. And then you can't be like, well, let's do some grammar, you know, like it, it, it doesn't jive.
Cory Clark: Yeah, and I, I often say that, um, I am a, I'm the person for a lot of kids, right? And teens.
And what that means, what I mean by that is, is a lot of times a kid will have a person that they deem supportive and safe to say those things to. And it might be a counselor, but it might not. It might be a speech therapist and, um, or another professional. And when you're the person, right? Or one of a few persons, um, it's a.
Really big responsibility and as far as how you handle those moments where they say, my grandpa died or this and that happened, or I'm feeling X, Y, Z. And so it's important to capitalize on, on creating that space, um, for, for young people. [00:14:00] And, you know, so, so that's where I'm, I'm going with a lot of this is these best practices, um, are not just.
Really just counseling. It's cross discipline in that way, so that you can hold that space. wherever it comes as a professional.
Kate Grandbois: I also want, I want to piggyback on some of what you've mentioned. It's making me think of a lot of the content that we've produced recently, particularly as it relates to self acceptance.
Uh, for example, this has come up a lot in our conversations related to stuttering therapy, uh, or self advocacy. Um, and, You can't really work on self advocacy and self acceptance without counseling and this is what we are now considering to be best practice based on evidence in the field of speech pathology and you cannot uncouple those things.
I think there's a specific. Uh, flavor to working as a speech language [00:15:00] pathologist because you are working closely with someone who is, their existence is living with a communication disorder. That is a communication disability of some sort. That is, that's why we're in their lives. So I don't, I, I wholeheartedly, I'm thrilled to hear some of this, you know, some of these threads being woven together because it is so ingrained in the fabric of what we do.
Did you like that little, that little similarity there, the threads in the fabric? I just came up with that on my own. Yeah. Yeah.
Cory Clark: So going into kind of my, um, more into the background around attitudes, actions, skills, and actions. Um, I think. I looked through the best practices that I've been working on over the years, and there's a few that I want to highlight today that are really relevant, Kate and I feel, to the speech therapy world.
Um, and so, Starting with attitude, um, [00:16:00] specifically, there's three that I want to highlight and, and they are the, the first one is something that a lot of experts mentioned, uh, when asked about, you know, what's important when working with, with children. And that is to meet children where they are. And I heard that over and over again over the years.
And I was like, what does that mean? And essentially what they're saying is. You can't go into a session, a speech session, therapy session, um, with a item by item, minute by minute, breakdown of here's what we have to do, here's what we're going to do that entire time. Because kids will come in and throw a curveball or a wrench in that plan real quick.
And it's important to be able to be flexible, um, to what, flexible for what, The child or teenager needs to work on or needs to address right like Kate just said if they come in and mention something about their, you know, family member passing away. You can't just be like, well, we got to work on preposition.
So we're going to move past that. Right. [00:17:00] Um, you have to, you know, And, you know, like I say to a lot of my kids, like, think like a palm tree and say, all right, I'm going to bend to this and go, okay, uh, let's pivot. Let's hold some space. Let's reflect and, and, and be supportive and empathetic. Um, so it doesn't mean throw all plans out the window, but it means.
meeting children where they are and what they're giving you that on any given day. Um, that attitude is, is very important. And secondly, um, all behavior is communication.
Kate Melillo: Wait, I want to go back just for a second. So I wanted to say about that mean children where they are, the, you know, we said a couple of negative, really negative examples, but actually The positive example can also help propel your goals forward.
So for example, if a kid comes in and they're like, Oh, I'm actually going. You know, like miss Kate, I'm going camping this weekend. Well, I, you know, [00:18:00] we'll take that and make my examples and therapy about the campaign, right? Like it becomes more relevant. Um, and so it, it doesn't have to be like a big, catastrophic, traumatic event that you're kind of being empathetic to.
You're really just like tying into the kid's life and like, great. That's a vocabulary builder. I can talk about planning, right? Like there's executive function. We're going to do working memory. Like there's so many things that can be based off those examples. And I think that, you know, interestingly, I've, I've had the experience where I explained this kind of model to like a newer clinician.
And, you know, like I've had job interviews and stuff, like interviewing people to come and work at our, our practice. And they're like, I don't think I can do that. Like, I don't think yet I can, I can, like, that seems like an advanced skill. Um, now granted, I like what Corey and I are saying is, is a clinical, [00:19:00] is your clinical judgment, like your clinical sense.
And that does come with time. So I don't want to make it mean like, this is so easy on the fly. Think of 10 examples that you can use when the kid says one sentence like that. I get that that is like a really hard skill to do. Cool. But I think as SLPs, we can kind of hold this in our mind. Um, and we'll talk about at the end, some examples of how I incorporate, like how I get this going.
All of my students know, um, what I'm going to ask at the beginning of every session before they come in. So they're ready and I'm ready. Right. So I've primed it so that like the structure of my sessions is ready for that acceptance, right? It's, it's, ready for whatever's snowballs come my way. Um, and we can talk about that a little later on, but I just wanted to say, I just wanted to note that I get that this is like, uh, takes a little bit of practice, especially if you're used to going in and being like, you know, this is what we're doing today.
Um, it's [00:20:00] definitely a change in that. And you're in your own attitude, which is also what Corey's found in the counseling world as well.
Cory Clark: Yeah, I think, yeah, I think everyone has their own, uh, uh, preference in terms of how they want to go into a session. And also it's based on what your, um, specialties are and how you run your, your practice.
Um, for me, being flexible is just, that's what I prefer, you know, and I, I don't have a lot of agenda in, in, um. A lot of my sessions don't
Kate Melillo: like to plan anything.
Cory Clark: I don't. I'm just like, I just want to walk in and say, how's it going? Yeah, I love it. But there's plenty of professionals that I work with that are like, no, I need I need an agenda.
I need this. It's very structured. Um, so, you know, for some, it'll be natural. Some not as much. Um, but. The, the second thing I, I want to highlight is all behavior is communication and um, that sort of attitude and understanding is important with kids and teens because there's a, there's a saying in the, in the child [00:21:00] counseling world, um,
so it's important to listen with your eyes because when you're working with young people, they're going to be giving you a lot of information content wise, particularly when how they talk, what they're saying, um, what it's about, you know, what you're working on, but also, um, Non verbally, what are they giving you?
What are they saying? Um, what is their body doing? And both of those things have to happen at the same time, listening with your ears and with your eyes. Uh, because kids communicate so much, in particular, and teenagers for sure, um, with how they're, how they're sitting. Are they fidgeting? Are they, You know, do they need to move?
Um, do they need a break? Are they listening? Are they focused? Um, what is their affect? All of these things are happening in real time. And it's important to be attuned to that because otherwise you're going to miss really important cues as far as how they're able to be present with you and how they are in that moment.
And if you can reflect some of [00:22:00] that, That's really, really valuable learning for them and awareness. What does
Kate Melillo: reflect some of that mean?
Cory Clark: Um, I noticed that, you know, you're, when I ask you to do this, you start to fizz it around in your chair. It seems to me like you may be a little nervous. You're not sure what to do, right?
That's a reflection of like, Maybe they know they're doing that, maybe they have no idea. But, and sometimes it's, you know, not accurate. Maybe it's a reflection that they'll correct me on. It's also a good opportunity for them to advocate and say, No, it's this or that. Um, but regardless, you know, listening with your eyes involves that real time kind of, interaction where you're listening to what they're telling you without words.
Kate Melillo: I also think it's ironic because it is what like we teach when we're teaching perspective taking skills, right? And social skills were like, look at the other person. What are they telling you? You know, like look at their body language. Like what did that, what did it mean when they started to walk away when you were in the middle of your sentence, right?
Like it's so I think too, like [00:23:00] we're sometimes go into the sessions, like not doing the things that we're trying to teach. And I, I, I like that, you know, in the counseling world, there is this piece of reflection because it, it, it brings everybody together, right? Like you as the clinician and the student, right?
So you've got both parties being like, Oh, I recognize there's a behavior here. And I I'm, what am I trying to say or communicate to this other person?
Cory Clark: Yeah, and the third aspect of sort of attitudes and understandings that I want to highlight is that all children must be and teenagers must be viewed holistically.
And what I mean by that is sometimes it's easy to fall into kind of a The trap where you are looking at one particular aspect of development, whether it be, you know, from the counseling world, like a emotional development or something with relationships, um, [00:24:00] but you have to think about young people in terms of all aspects of their development and, you know, in particular, I often kind of.
Disregard or discredit certain things, not intentionally, but be like, oh, that, you know, looking at how they're doing emotionally at school is very much tied to their social life and their social development and also what's going on at home, right? And also physically, um, their physical development, how is that impacting their social life, especially with like tweens and teens and all of that, right?
So you have to consider all these, you know, domains when you're working with, with young people.
Kate Melillo: I think we hear this all the time. If you have a middle school student with articulation errors, you are not just like, Hey, let's fix those errors. It is impacting them socially, right? Like those friendships are coming into play.
Um, and I, so I think this like core best practice of the [00:25:00] holistic child is so important because, and I think, I do think like Some of these things are becoming more mainstream in SLP, where we are starting to look at, hey, how does this affect you in these ways? And maybe you're making, you're working on some like, um, social, like, strategies to, you know, help, not just with the articulation disorder part of it, right?
So like, you're, you're, you're using multiple domains there, um, to help that kid. But I think that, It's different than what we thought of as like the traditional Western medicine model where we're like, let's just treat these one this one symptom and make it better. Like we really actually need to be looking at everything because that's going to round out a kid's mental health, and the way they interact with the world.
Cory Clark: And I, so the next. area, the domain that I want to talk about are knowledge bases [00:26:00] and understandings, um, of counseling with children and teenagers. Um, and the first one I, I really want to focus on is, is the most common, um, issue I hear. And when people come to see me in counseling, they will say that, um, they've tried counseling before or they've tried some sort of, um, therapy service before.
And the parents or guardians or caregivers were left feeling like I had no idea what was going on. Uh, they never told me, they just kind of went back into the session and I didn't know what was happening. And then they were left frustrated, like, I don't know what the goals are, what's going on, right? Or they didn't understand them.
And so they come to me, like, will you let me know, like, what's going on, like, you know? And, um, I always tell them that although I'm, you know, I'm not going to say exactly what the content is of the session, like there's privacy there. You will always know what my treatment plan is and what my background [00:27:00] is and what my training is and how I intend to use that to support your child or teenager.
Um, so the, the first really knowledge base that I wanted to focus on is, um, how to involve family or caregivers or guardians in therapy services. Um, it's so important to involve. Other stakeholders in a sense, but family members in, uh, as appropriate, because kids and teens operate in a system, uh, they're part of a system, and you have to be able to translate what you're doing to, um, how it can be reinforced at home and other settings, um, so that involves communicating a lot of those goals and a lot of those things to parents and to, to, um, family members.
And that can be tricky, um, depending on what the situation is in, in your service, um, but you have to be able to, to translate that, um, or else you risk losing the [00:28:00] connection you have, um, with, with the family, um, and they'll pull, you know, maybe prematurely pull them from services or feel like it's ineffective.
Or, in a lot of cases, think that you're not doing effective work because they don't really understand what, what the goals are.
Kate Melillo: Well, and I was also going to add, because a separate, a separate best practice is also the developmental models and how to apply them, and I want to just integrate this into the sharing with the family, because the other thing we hear quite a bit is, you know, families will come and say, Like, I didn't know what was going on and not really for, for speech.
I actually have a lot of parents in my sessions. I, I, I just prefer that. Sometimes if it doesn't work with the kid, I'm like, okay, you got to get out because you're, you're entering this session parent. Um, but I like the parents to hear because a lot of times I'm giving homework to the family and which is more counseling ask, right?
Like, I'm like, this is how we're going to integrate this because we do hear a lot. Oh, I've tried that before, and it doesn't work. [00:29:00] Um, Cory hears that in counseling all the time. Yeah. And the, uh, the developmental piece that I wanted to point out is, you know, we are in this field, we're experts at these developmental theories.
Like, we know all of this, like, background information that a layperson parent doesn't know. So a lot of times parents will come and say, like, you know, Oh, my kid is like now climbing the bed with me. It, they don't sleep anymore, blah, blah, blah. And maybe that in that kid's life, you know, they're going through a developmental transition, which we know about.
And we have other parents come and tell us like their eight year old did the same thing. And we're like, okay, now we can show that that's fairly common, but not every. You know, person is going to know, like Erickson, Piaget, Bandura, like they're not going to know that. And a lot of times SLPs, uh, we get like a little bit of that.
And I feel like it also depends on your grad school program, right? Like where the focus was on those things. And they're so varied that maybe you [00:30:00] don't know as much about that. Which is why it's like, we're talking about this because that's something to share with parents. Um, hey, let me find out more information about that for you.
That's helpful. Or make a referral, which we'll talk about at the at the end here, but I I'm pointing that out because I think that there's times when families feel like they're just. navigating this alone. They're the only person that it's happened to. Um, and that it's just, that's just usually not true, actually.
Like usually it's happening to a lot of people, but nobody's telling them that. And so when they come in your office, they're like, hello, professional person, do you have the answers for me? Um, you know, and so it's a good, it's a, it's always a good idea to involve the family as much as you can.
Cory Clark: Yeah, and the next, uh, understanding that I want to highlight, I just want to have a caveat about, um, and that is, it's important to understand the basic foundations of play therapy, and the caveat there that I want to [00:31:00] distinguish, I do not expect this.
I did not expect every therapist to be a registered play therapist. I did not expect speech therapists and other professionals to be play therapists, um, that has a separate and distinct, uh, licensure and, and process and credential. But, the foundations of play are important to consider in working with kids and into teenage years, um, because they allow, um, Young people to express themselves in their natural, in the natural form, which is play.
And, um, and so a couple of important points about play therapy, um, they, it's important to accept children exactly as they are and allow themselves to express themselves freely, um, and have a sense of permissiveness to do that. So, you know, thinking about where your, your practice is, whether it's telehealth or, um, an outpatient setting or a clinic somewhere.
You have to think about what is that setting doing for them to be able to express themselves, [00:32:00] um, and you have to ask yourself, like, what, what does that look like for you and your practice? Um, it's important that they have that space. They feel free to express and be themselves with whatever they're, you know, intending to do.
Um, and as a therapist, you reflect what they're doing, like listening with your eyes, and um, allow them to gain insight into their own behavior. So that looks like, it can feel very, um, odd at times, because, you know, you're almost like narrating their life, like, like a, you know, bird's eye view, if you will.
You know, someone's like playing and they're like, they hand you something rather than just, you know, like they're handing you a figure, you know, and they start, they want you to play with them. My instinct as like a father is to take my son's, you know, figure that he gives me and then I'm going to create like a game with it or a story or whatever.
Let's play therapy a lot of times in most modalities. You're not going to do that. You're not going [00:33:00] to direct them and, you know, say, Oh, now I'm going to create a story. You're going to say, Oh, you want me to play with you. You're really excited for me to play. No, you're giving me that. Okay. And then you sit down and you let them dictate what the play is.
Because they're communicating that way. Right. And so in, in a, in a speech sense and that speech therapy, in a sense, it's being able to reflect what, um, your client, what your, your person is, is giving you in a way that allows them to gain insight into their own behavior and their own affect and feelings.
Um, and that's really, really healthy and important for their development.
Kate Melillo: Well, and I think speech therapists, speech therapists are doing this, right? Like if you think about like. the fundamentals of like early intervention really, you know, here's, you're at a kid's house and you're like, here's the farm that you have.
I'll just use the good old farm example, where, you know, you're like, Here's the cow. What does the cow say? Right. So you've got a lot of opportunities there for [00:34:00] like vocabulary building and all of that other like syntax stuff that you want to target. Um, and I, I, I wanted to point out that so play therapy gets the rap of being for little kids.
Um, but court. So we haven't mentioned this yet. We didn't say this because this isn't really that relevant yet, but so we're also both trained improvisers. And so we do a lot of improv with our clients, especially tweens and teens. Because I think that the other thing about play therapy is that it's about that acceptance.
And those improv games, that is what they are, right? Like if you've ever heard the concept of yes and it's, I accept the idea that you've just given me and I'm going to build on it. And that is what, that's actually what you're doing when you're in your little farm scene. That's what you're doing, right?
It would be weird if the kid was like, here's my cow and the cow wants to drink. And you were like, [00:35:00] ah, that cow's actually on a rocket ship going to the moon like that. Right. And that doesn't make any sense. That is one of the fundamentals of improv comedy. And so we use that a lot. And I think, um, it's confusing to parents, parents will, how many times have you heard, Oh, all they do, they go to that therapy and all they do is play.
Um,
Cory Clark: It's like saying, oh, I went to therapy and all I did was talk. And it's like, that's, that's right. You know, playing is communication. But, but that's not a common, I don't think, understanding that like, You know, and play therapy is very evidence based, and it's very, um, it's very clear how to do it once you learn it, um, but it's very misunderstood because we use the word play all the time, like, let my kid play, and my kid's playing in the other room, um, but, you know, I use so much improv with, with kids and teens where, you know, I'll have a figure and it looks like a superhero to me, like, But they'll hand it to me and say dad or whatever.
I'm like, okay, this is [00:36:00] dad, right? Like you accept what they're giving you and in that way They're telling you their story and you get to hear it from their lens not you know What your instinct is tell you like no, this is a figure of Batman, you know, whatever, right? So you have to be able to roll with that again be flexible and meet them where they are and reflect And I think that's essential
Kate Grandbois: I, the only thing I have to add to that is some of my own experience.
I've been trained. I had to go through this very specific training in child led play and it was hard. It was so much harder than I expected it to be because of exactly what you said. I'm like, Oh, playing. I can get on the floor. I can do some Legos. I can get out the cow and the chickens and you know, make some animal noises and make it fun.
I can play. I know how to play. I'm a pediatric therapist, but really taking the child's lead and filtering your own responses and not coming up with [00:37:00] directives and not asking a ton of questions and really letting them direct where the play goes is a Harder than you think. So if anyone is listening, and I just, I think it's a, it's a great exercise.
What you're, what you're proposing is a really great exercise to really think about what play means from a therapeutic evidence based lens, because it might not be That colloquial casual. Oh, we're just playing. We're just on the floor. It's very different and it's gonna feel hard It can feel challenging.
That was my experience
Cory Clark: It's and it's so hard that I mean it's important to note There are some modalities that are more directive play therapy but You know, without getting into the nuance of that, um, there's a misunderstanding that like, oh, if I play UNO with a child, that's play therapy and that's, that's free play.
That's, that's playing a back and forth game that has set designed rules. Um, so that's not play therapy. That's playing a game, right? So there's all these. You know, misunderstandings [00:38:00] based on the language really. Um, and play therapy is, is a distinct process. Um, and I always say the most exhausted I am after a session is a non directed play therapy session because, uh, 45 to 55 minute session is, It goes by, you know, it's, it's exhausting.
Kate Melillo: Well, and I would say too, like, I don't know if you guys, have you read the Declarative Language Handbook by Linda K. Murphy? I love that book. It's a really good resource. It's not a play therapy book, but I use it a lot. And Cory mentioned terms that were declarative language. Like, I see you're doing this.
What happens next, you know, um, Tara Sumter, too. She has her reflexive questioning guide. Like, those are also those reflexive questions. And it is, Kate, like, to your point, so hard to, like, bite your tongue and be like, But didn't you mean this? You know, and, or, like, weren't you going to do this with this? Or, like, you're trying to guess the kid's plan.
And that's actually not teaching [00:39:00] them the skill for that, like, future thinking, right? Those executive functioning actions of, like, Oh. You wanted to see what I was going to do. And then when they make a choice that's like, I don't, I don't know if that was what we were going for here. Then you're, you have the opportunity to discuss it and see how you could have done it differently.
Whereas if you had done the directive play, you would not have gotten to that point. Um, it's also why we love those improv games because they're They're totally impulsive. Like you don't actually know what the kid's thinking. We can't know what anyone is thinking, you know, um, which is a big, that's a big like nugget there between the counseling and SLP world because we, since we do tend to go in with like, here's our strict, you know, plan that we've got, here's our goals and counseling.
It's a, it's really a free for all. You're there to share what, It's going on with you. Um, and as [00:40:00] SLPs, I think we, we tend to, I don't want to say like disregard it, but we're just not as, you know, it's not our area. We're not as skilled at looking for those clues. But when we do something like a child centered play therapy session.
We open up the door, right? If we, if we allow kids to kind of lead, um, and also not tell them what they're supposed to do,
Cory Clark: what we thought they were
Kate Melillo: going to do,
Cory Clark: right. And if, and if you're listening like, well, I'm not a play therapist, how would I know how to do that? And I do not expect even every therapist, every counselor to be a play therapist again.
It's about. Um, understanding the foundations of what, what play can mean in counseling or can mean in therapy, um, and what it looks like and how you can reflect in a way that allows for that development, right? That's, that's incorporating play in, in therapy. That's, that's what this is about. Um, and the last kind of thing I want to mention about understandings and, um, knowledge bases [00:41:00] is atypical versus typical child development.
We all learn development of models in school and we learn, you know, the basics, but it's easy to forget some of the more kind of subtle pieces of development. For example, you know, someone will come in. And I'll hear, um, you know, uh, concerns from a parent or guardian around how their child is just so rigid about, you know, a sense of justice, like, it's not fair that my sibling gets this, or why does this peer or classmate get to do this and I don't, and it causes problems, and I'll have to kind of remember, oh, there's a very specific point in child development where that is just front and center in their development, like, I, this, deserve this, and this, and like, and there's very black and white thinking that is common, uh, as part of development.
So, sometimes, you know, the therapy session involves me kind of walking through [00:42:00] typical kind of phases that, that kids are going through that is commonly seen in certain ages. Um, and so it's important to kind of think about, okay, Is this behavior or is this issue, um, part of like common social development or is this something that's like, ooh, that they're 14 and still kind of chronologically still kind of struggling with this thing that is usually seen chronologically at age 8.
And, um, we're doing that a lot as professionals in speech, I'm sure, but it's easy to kind of get lost in the nuance of that. Mm
Kate Melillo: hmm.
Cory Clark: All right. So, um, moving into. best practices and skills from a counseling sense. Um, I've mentioned a lot of these before, but the first one, you know, basic counseling micro skills is what, what I'll say.
Um, what are micro skills? These are the little, not little, but subtle behaviors that a counselor or a [00:43:00] therapist does in sessions to allow someone to feel heard, to feel supported, to feel that they're not judged. And so, you know, the main things I want to highlight are It's important to reflect, like I've mentioned before, um, what you're, what you're getting and, um, encourage rather than praise, uh, so, you know, I always have to stop myself from saying like, oh, that's
Kate Melillo: good job,
Cory Clark: good job with that drawing you made, right?
And that's, that's praise. Um, encouragement is your work. You worked really hard on that. You were so focused when you were doing that, right? That is encouraging them and their behavior in the process rather than the end product. Um, so, uh, another important piece is being creative, um, and in sessions. Um, so.
You know, being able to tailor what you're working on, um, as far as your goals and sessions to be, you know, being creative around how that looks. Um, we get, we settle into our, our favorites kind of [00:44:00] activities or interventions. And sometimes we can get frustrated when we're like, oh, that didn't, it's not working.
Right. And it's important to be creative, um, as far as how you. adapt to, you know, what a, a young person is giving you in sessions. Um, and, you know, staying up to date on, on the, um, at most evidence based practices in your field, I think is another piece that you have to always incorporate, um, like doing this, like staying up to date with, with your, what you listen to and, and trainings and, you know, specialties.
Um,
Kate Melillo: I would say like, so this like resonates with me for my just SLP practice where. I get in like ruts of I use the same material or there's a trend I'm seeing with a lot of kids at the same time. And so I'm like saying the same thing over and over or something like that, right? Like you're just like, you get in these like cycles of like, oh, I'm really hot on this game right now or [00:45:00] whatever.
Um, I don't know if that resonates with everybody. Maybe people are just like way more creative than me, but I don't think that it's, it's not just about like, there's some really creative, like type B SLPs. You know, like if you like a teacher's pay teachers who make like amazing materials and I'm like, wow, that's incredible.
But beyond that, I think it's about creativity in the way you think like using. practices that you wouldn't normally do or even like leaving the room that you're in. Like, you know what I mean? Like just thinking outside the box a little bit, um, which again, I know is a stretch because sometimes they're so limited and what the timing that we have for a session, like the space that we're in for a session, those are all realities.
So I'm not trying to like, give you a blue sky pipe dream here, but I think that it's, That's where it really resonates with me because I feel like I, I personally, I feel like I do a good job keeping up with evidence based practice. And then I'm like, how can I even implement this? Like, this is going to be hard for [00:46:00] me to do, even though I know it's the right thing.
Um, yeah. Yeah.
Cory Clark: And that sort of leads into my, my last kind of domain around. Clinical skills, and that is, you know, actions in and out of sessions. And the first one is about, you know, again, making sure you're have the right supervisor, the right CEUs, the right education over time to match what your people are giving you, right?
What they're presenting to you. Um, and then making referrals appropriately as, as you need to. Um, we see it a lot with our practice with it being a speech and counseling practice. Um, know, What an appropriate referral to counseling looks like, or to OT, or to physical therapy, or to feeding therapy, or, no, makes sense, speech therapists, but, um, other professionals.
Because, you know, for example, a common kind of stuck point is, if a young person's anxiety has gotten to the [00:47:00] point where it's so severe across settings, they can't really learn very effectively at school, or in a speech therapy session, because they're so Uh, and a heightened state of tension and anxiety.
Uh, they need more support and getting to a place where they can, you know, be regulated to learn. Um, and so knowing how to, to refer, knowing where to refer, getting to know your area, I think is really important. Um, so, you know, researching that and, and kind of making a few calls if you need to, to see what's open in your area, what's appropriate referrals is important.
Um, and then I've mentioned this before, but the last one is, you know, empowering others to have a larger role in their child or teenager's life. So again, that's involving family as needed, um, as appropriate. To, you know, allow them to reinforce the things you're working on, um, is, is really important in working with young people.[00:48:00]
Kate Melillo: Um, okay. So I wanted to talk about like, we just, Corey just told us like so many things and there's actually like a billion other best practices that he researched. And those are like just the highlights. So I realized if you're like falling asleep now, you're like, okay, thank you. That's enough. Um, yeah, yeah.
Sorry. You're boring. Nobody's falling asleep.
Kate Grandbois: We're on the edge of our seats over here. We're listening
Kate Melillo: with our eyes. Yeah, there you go. There you go. There you go. Um, but I think so taking all that I've mentioned it before. Um, I, I read this, I think it was, I'm in Tara center's community for executive functioning and I, somebody posted like something.
It was like, um, once you see executive functioning, you can't unsee it. I don't know who said it. So I'm trying to give credit to the person who said it, but that, that is like, My whole life because a lot of times really every session kids are coming in and I'm like, oh gosh, like there's so many, it's not just those like surface [00:49:00] goals, those symptom things that I need to address.
It's really how the entire brain is functioning as a whole. And that's why I mentioned at the beginning that like, when your mental health is, is not in a good. space, your, your executive functioning becomes scrambled eggs, then you can't do a lot of other things. Right. So there's sort of this like hierarchy, um, where you, you're needing, like Corey just mentioned, making those referrals appropriately so that you get services in an order that makes sense to you.
Like there's a lot of times where I get parents coming in and saying, Oh, I want executive functioning therapy for my kid. But then I learn like, The parents are going through a recent divorce and, you know, the kid lost a bunch of friends because he had to move due to that, right? Like, so there I'm like, Oh, let's pause this for a minute.
Like, I get that. Maybe he's not firing on all cylinders, but there's other reasons for that. And so we see this crossover with counseling and executive functioning all the time. [00:50:00] Um, You know that exact. Oh, I haven't even mentioned the word anxiety yet. I don't know. Have you, have you guys see this? I see, I, I work with a lot of teenagers and like tweens and the level of anxiety that I see on a daily basis is, is really striking.
I mean, and there is also new literature about this, right? Like we know that the mental health stigma. Um, state of tweens and adolescents in the past five to 10 years has significantly, anxiety has significantly increased. So it's, it doesn't surprise me anymore, but it's almost like I immediately have to take that consideration into my treatment plan.
Um, because honestly, sometimes I have to parse apart with parents, like, Ooh, this trouble with executive functioning is actually anxiety, right? And, and they go, so they're so closely related that what the behavior looks like, right, [00:51:00] that what the kid is doing, um, that the parents like, well, What do you mean?
Like if he, okay, prime example, my kid doesn't want to go to school in the morning. And I'm like, yep. Okay. So what, why is that? And they're like, well, they, because they're ADHD. And so they don't like, they can't get their backpack together. They can't do this. They can't do that. Well, few sessions in, then I'm finding out like their first period is math.
They don't want to go be going to math class. They are procrastinating for that and that is actually a symptom of anxiety. And so I'm having to like really juggle like this. We have to address that anxiety piece because yes, they probably do need help getting that backpack organized. Let's be honest.
Like a middle school boy backpack. I don't know if you guys have seen them, but they're a nightmare. Um, there's a lot of crumbs, unexplained crumbs and crumpled papers. As a parent
Kate Grandbois: of two tweens, I can confirm the crumbs.
Kate Melillo: [00:52:00] It's a real
Kate Grandbois: problem. It
Kate Melillo: is a huge problem. It's not always like the kid has, you know, this like severe executive functioning disorder.
Sometimes they do. Um, and every middle schooler could use executive functioning help. Let's be honest. But the, the brain regions between, um, That prefrontal cortex and limbic system, like they're going, you know, I don't know if anyone wanted a brain review today, but executive functions live in that prefrontal cortex and those emotion responses that emotional regulation lives in the limbic system and they interplay, right?
And so if the kid is having a ton of anxiety, uh, or. Depression, a lot of fear, a lot of times, a lot of fear in the tween space, right? Because it's a new, you've got hormones, you've got new friends, you've got transition to middle school, like there's so many factors at play. Um, so to bridge this kind of gap, we try [00:53:00] really hard in our practice to like, build on these relationships, which goes, this is where those best practices that Corey talked about come in.
Those are all relationship building practices that I think we need to do a little bit better job of incorporating into our speech sessions so that we can parse apart. Is this anxiety? Is this actually executive functioning? Is this, you know, a pragmatic language disorder? Right? Those, those kids with, um, ASD, ADHD, you know, disruptive behaviors a lot of times, like if you have kids on a BIP, or you know, does everyone know what a behavior intervention plan?
You don't know sometimes, like, what's the origin? of this, right? A lot of times, um, on my case, so to get kids who are just like simply misunderstood, uh, and some of their behaviors are, they are from ADHD, but they have never been addressed with actual executive [00:54:00] functioning strategies. They are often just like, go in this other room, be pulled out to this other class that will help you.
And then they throw a chair in that other class. And they're like, why didn't this help? You know, like, Ooh, well, what, probably if you, you can't unsee the executive functioning. So part of the relationship building is also getting that team. Corey and I just talked about this with the family. The other thing we didn't mention is like related caregivers.
You know, um, we, at our practice, we have it so that like, if. A lot of times, Corey and I will see the same client for different things. And so, like, we're talking to each other with permission, right? Like, getting those, um, other providers on the phone sometimes can be really helpful. Because I've also found that when I have a kid come to me for executive functioning therapy, but they're also receiving counseling somewhere, they, a lot of times, tell me things that they don't tell the counselor.
And I'm like, You know, and [00:55:00] it goes back to what I said at the beginning, where like, the counselor seems more threatening, maybe, right, like, I'm supposed to go there and tell them all these deep, dark secrets, but if I go to Miss Kate, I'm just like, well, you know, like, I stole a candy bar, you know, like whatever it is, like, I don't know.
I live in like 1955. So like, I'm like, go to the corner store. Yeah. And I love that milkshake. I don't know. Um, but we're trying to like get the everybody on the same page. Um, So when we're trying to bridge these gap in sessions, this is what one of the things that I do at the beginning of every session. I, and some people I've heard a couple of people mentioned this, like in my SLP circles, I do a high low and a Buffalo at the beginning of every single session.
Um, so. My kids know that I'm going to ask this. I actually love it. It's great working memory. It's like excellent working memory. That's right off the [00:56:00] bat, like executive functioning, and they don't even know I'm targeting it. And I'm like, what's your high, low Buffalo? So high, something good that happened to you.
A low, something not good that happened. And a Buffalo's weird, funny, silly, interesting, kind of out of the ordinary. And I, you know, every single tween or teen will be like, I don't know. Whereas I've seen this kid for a year and they know exactly what I'm going to ask at the beginning of the session, I'm like, nope, we've, we've got a good thing going here.
You're going to tell me all about your life. Um, you know, I've heard like there's some, there's like a rose and a thorn is another one that people use. So that's like a good thing and a not good thing. I, I tend to like the buffalo just because it makes a little more fun. Um, I like the buffalo. I've never heard the buffalo before and I like that a lot.
But I set the precedent that the session is going to be about the kid, right? So like, those kids know that they're one going to be asked that question. And two, that I kind of expect them to to share [00:57:00] something meaningful because like I said earlier, I will take that information to inform how I target those goals that day.
And I, again, realize that that's, this is a little bit of an advanced skill. You do have to have like kind of a lot of things in your toolkit in order to be able to do that. But once you get good at it and make that the expectation, it becomes easier, right? You've got. This opens the door for like all of that play stuff.
Like our first example of a strategy is small world play. I don't know if you guys call it small, small world is kind of like the dollhouse or the farm or in there. I've never heard it called small world play, but I like that. I used to work at, Corey and I, another fun fact, I used to live and teach abroad, and I worked at the British School of Beijing for a couple years, and in the UK curriculum, that's what they call it, is Small World's Play.
So you're a little. I love it. I know, it's such a good little name for that.
Cory Clark: Right.
Kate Melillo: Um, that, and, and Corey too, we [00:58:00] haven't talked about SANTRE, which is a whole other certification for, for counseling. But SANTRE is basically miniatures.
Cory Clark: Yeah, a lot of minifigs.
Kate Melillo: Yeah, like minifigs in the, in a SANTRE. And that is like a, cause, The reason they do that is it's a blank slate
Kate Grandbois: like
Kate Melillo: we were talking about earlier with play therapy.
It's like a totally there's no predetermined thing. It's just whatever you're creating that sand tray. So when you're one, I start the session with this high low Buffalo. And then if we're using this example of small world play. I, this leans into heavily what we were saying earlier, you've got a lot of improvisational problem solving and perspective taking.
I tend to, um, I, I really love the phrase reading the room. I use it a lot. Like, I try to give my, and we'll talk about this with social dilemmas too, but I try to make sure that like, Even if my kids like my students on my caseload don't have like [00:59:00] glaring pragmatic issues. I'm still incorporating this in a small world scenes because they're just there.
There's that is like the integration of life, right? Like that is taking the communication skills that you've been practicing and and throwing them into some sort of like realistic scenario. Um, so I love small world play for, for those social nuances and targeting some of that. And then you get that extra piece of counseling where you can reflect and empathize, right?
All the skills that we just talked about before.
Cory Clark: Yeah, and I want to talk about one exercise I love to do that's, it's more of an art therapy blend, but it's an excellent crossover between mental health and executive functioning kind of therapies. So what I do is, I saw it from an exercise for particularly with those with ADHD, but it can work well with any, any young person.
Um, [01:00:00] So I, I get a video from YouTube, just find something, a short, maybe five minute ish, uh, video of how to draw a basic. thing, right? Like how to draw a dog, how to draw an elephant, or a house, whatever. And I will put it on with the instruction, uh, that me, myself, and the, um, child or teenager are going to draw it together.
Um, we each have our own paper. We're going to draw this house or this elephant together. And that's it. I'm not going to stop the video. We're just going to draw. And I, at that point, I've done it, uh, a bunch of times, right? I do it over time. And so I, can just do it, or it's, it's, I'm not great, it's not perfect, but it's, I can do it.
Um, but it's their first time ever seeing this video. And so, we just draw it, without stopping, and then when it's over, it's done, right? It's simple, right? Like, we're just drawing an elephant, for example. But what we do is, in processing it, it's important to then say, Okay, a lot of [01:01:00] kids, for example, will get frustrated because it's too fast.
And so what do they do? They either quit, or they start purposely messing up, or they put an X through it, or they're scramble the crumple the paper, right? Um, or maybe they do it, but they're working through a lot of, um, frustration tolerance or a lot of negative thoughts during, right? And that mimics a lot of school, a lot of school behaviors where if they get lost in math or lost in something, um, it mimics that process.
And so it allows me to work in real time to process. Okay. What was going on in your head when you started to, you know, get, get behind and drawing that elephant or, um, what do you think I was thinking while I was doing that, right? Perspective taking. Um, what kind of allowed you to keep drawing even though it was getting harder and harder to keep up, right?
Um, I noticed you put the pen down and quit after about three minutes. What was going on? What happened, right? Um, it allows you to [01:02:00] process with them. Kind of what barriers they had, um, you know, what kind of thinking traps they had or distortions, um, and kind of really make a plan for, okay, next time, what can we do that where you can work through that?
And then we'll do it again, right? Um, either next session or whatever, um, to, to work on that process so they can translate that across settings.
Kate Melillo: Well, and that's executive functioning one on one, right? That second piece of like here, next time we're going to make a plan for how to do this and we're going to apply these steps So that you can be successful because then, you know, maybe the kid has an issue with initiation, right?
Like you're making a plan to get over that hump. Maybe it was the emotional regulation or making a plan to get over that hump. Those are all those executive functioning skills that a lot of times we see behaviors for, and they're misconstrued or misdiagnosed as possible language disorder. Or Pragmatic disorder when in fact, like they're really lying executive functioning.
[01:03:00] Um,
Cory Clark: although one time I did that and uh, This is teenager. No, they drew the most amazing elephant i've ever seen in the entire world And I was just like, uh, let's process it. That was just amazing. Good job I didn't know what to I don't know how to like do my process after that. They just
Kate Melillo: Great artists.
Yeah.
Cory Clark: Yeah
Kate Melillo: So the last, the last kind of example here, which I think a lot of SLPs use, and there's, there are a lot of resources for this, are social dilemmas. You know, any of these like social cards, we also have, um, like some of the teen talk cards. We really liked those at our practice too, which are a little bit more open ended than the dilemma itself.
Um, and I'm sure every SLP has seen these vignettes of a social dilemma. Like, what would you do? The. The thing that I think makes it a little bit lean into the mental health piece more is if you can start incorporating more of the emotional language that goes along with these, [01:04:00] because sometimes we're focused on the problem solving outcome.
And so we want the kid to quote unquote do the right thing. Um, and I know in like the neurodiversity world we're, we're, Leaning away from that and saying, like, well, what is your perspective on the situation? What was the other person's perspective on the situation? As opposed to this is the right way to do it.
This is the wrong way to do it. Um, but I think that one of the important things is pointing out those emotions that come with what happens with the social dilemma, right? Like, um, There's that the concept of those like upstairs downstairs thoughts, which I think is Dan Siegel. I want to say it's Dan Siegel who it could be.
I would have to check that. But I think that's because that's on the what's that workbook? Yeah,
Cory Clark: it's upstairs and downstairs brain.
Kate Melillo: Yeah, yeah. Um, so if you're not familiar with his work, that's a he's a really good resource. He's got like workbooks that go along with those. [01:05:00] Like emotional thought processes, and in the SLP world, we're, we do tend to look at that perspective taking piece, um, but there's more involved in it than that, right?
Like, why did that person, like, why did that person do that action? Well, they were feeling XYZ, right? And so I think that there's a really big crossover opportunity there. Um, and also we have not talked about this, which is self monitoring. And self advocacy. So self monitoring is like, well, what I would do in this situation is this.
Um, and then I'm like, how do we feel about that choice? Right? Like providing that, or we can give social dilemmas, have them play them out, role play, and then self monitor. Those responses. Um, I use a scale of negative two to positive two. In my practice, I do not like a scale of one to 10 when I'm self monitoring, um, because [01:06:00] the one to 10 I feel like what's the difference between like six and seven.
Right? Like to me, there's like not really a difference. Like, how well did I do on this scale? Six or seven is kind of the same thing. Whereas in the scale of negative two to positive two, a zero is actually meeting the expectations. A one is doing better than that. A two is doing like amazing. Negative one is like, I did not meet the expectations and a negative two is like, I totally blew it.
And so that scale allows a lot of my students a little bit more. One, wiggle room, right? Because they're not like judging between a six and a seven. But two, they're like, well, now I know I didn't actually do the thing I was supposed to do, right? Like, or what I did was unexpected. Um, other people might think that the, their perspective is that was a little strange and maybe that's okay for them.
Like that, that's, maybe that's fine for them, but it, it is a, an actual skill to be able to go back [01:07:00] and self reflect and then use the self advocacy to say like, Hey, next time I needed X, Y, Z, right? Or I would prefer if you said something like this to me, whatever it is, I'm in this social dilemma. So the last part is when to refer.
Cory Clark: Well, we've covered a lot of this. I don't want to kind of go too far into it that we've already done, but it's just really important to know your area. Like I said before, to know how to know where to refer. Um, for things like when the anxiety is getting too heavy to really, you know, carry out sessions.
Um, when trauma has been noted that you didn't know before, you know, early on. A lot of times you don't know, um, when you start services with someone and then it comes up, you know, throughout. Um, or if, you know, someone's behavior is, you know, Getting to the point where they're so aggressive or disruptive at school or at home to where it becomes unsafe to, you know, to, um, [01:08:00] do therapy services or, um, you know, just hearing about unsafe things at home.
Um, it's important to refer. So, you know, connecting with local counselors in your area is important. Um, creating relationships, creating a referral list if your practice doesn't already have one. Um, of where, you know, you can refer to where they won't be turned away, right? And it's really hard, um, nowadays to, to.
To find places that are accepting, uh, new, new clients, uh, that see kids, aren't
Kate Melillo: full.
Cory Clark: Yeah, they accept the insurances they need, you know, so it's important to know what's available, what's possible in your area.
Kate Grandbois: You've shared so much with us. I could talk to you for a whole other hour. I already, I'm already thinking of all of these additional questions about how to approach this in a school environment, about, but we don't have time to go to any of these, these Avenues that my brain maybe that's my executive functioning really failing me here wanting to go off on all these tangents You've just shared so much helpful [01:09:00] information And reaffirmed so much of of my own personal perspectives of how important counseling is So much of what we've said on this show in the past in our last few minutes Do you for?
For the SLP or the special educator who's listening who might be somewhat familiar or somewhat new to this general area, do you have any, you know, final thoughts or words of, of, um, words of wisdom and, and suggestions for next steps?
Kate Melillo: I, so I think the biggest takeaway here is to, for SLPs to like, I challenge you kind of to go into your next session and change the way you think about how you deliver the session, right?
Like, change your mindset around like how you're going to approach those goals today and make it more about the relationship with that student and not about the goals. Um, because that that's really like the crux of what we're saying [01:10:00] here, because I think you'll see things like the executive functioning stuff like bubble up, like, you'll see things like the other goals, um, come into, you know, in front of your face.
If you just made it about the kid and the relationship that you have with them, which I think is definitely. A mindset shift. Um, it's not the way that everybody approaches their session. And yes, it could be your, you know, maybe it's preference, but the evidence actually does lean this way. Um, and a lot of new research and social skills and social emotional learning.
So that would be my challenge to everybody after today.
Kate Grandbois: Thank you so much for being here. We really appreciate all of your time. I have learned so much. Um, I'm sure our listeners have too. Everything that you've mentioned today will be in the show notes. So anybody who's listening while they're driving, walking, whatever, what have you, um, all of those links will be there.
Thank you again so much for your time. This was really awesome. Thanks for having us. Thank you. [01:11:00]
Amy Wonkka: Thank you.
Kate Grandbois: Thank you so much for joining us in today's episode, as always, you can use this episode for ASHA CEUs. You can also potentially use this episode for other credits, depending on the regulations of your governing body. To determine if this episode will count towards professional development in your area of study.
Please check in with your governing bodies or you can go to our website, www.slpnerdcast.com all of the references and information listed throughout the course of the episode will be listed in the show notes. And as always, if you have any questions, please email us at info@slpnerdcast.com
thank you so much for joining us and we hope to welcome you back here again soon.
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