When and How to Refer Out as a Speech-Language Pathologist

 As speech-language pathologists our scope of practice is huge! It is absolutely impossible to be an expert or specialist in all areas of our field. However, many speech-language pathologists are never taught when and how to refer out. They are also never taught about other options like specializing. Instead, many are supporting clients/students/patients that they have little to no experience or interest in supporting that might be better served elsewhere. This leads to stress, burn out and resentment.

When taking on a new client, ask yourself these questions

• First and foremost, if you have a say in the clients that you take on (e.g. private practice owner or a setting that allows you to specialize/choose), ask yourself the following question:  Am I interested or passionate about supporting this client? If yes, keep the client. If not, refer out. If you don’t have a say, go to the next question. 
• Do I feel comfortable working with this diagnosis? (ex: hard of hearing, voice, fluency) If yes, keep the client. If not, go to the next question. 
• If I don't feel comfortable, can I easily get mentorship or guidance?  If yes, keep the client. If no, go to the next question. 
• Can I approach my employer for continuing education or bringing in a specialist?  If yes, keep the client. If no, go to the next question. 
• Do I have the capacity to learn everything I need to know to help this client on my own right now?  If yes, keep the client. If not, refer out. 

How to Refer Out or Get Support

• Get to know other speech-language pathologists in your area and their specialty areas and if they are taking clients. 
• If working in a school or county setting, get to know the other speech-language pathologists employed there and the areas they can offer you mentorship or guidance in.
• Be honest with the parents.  Most have no idea how wide our scope of practice is.  Help them understand why you may not be the best fit for their child and where they can go instead.
• Get your employer on board. Honesty is the best policy.  Help them see where you need support, mentorship and guidance.

Special Circumstances-- School/County-Based Speech-Language Pathologists

School-based or county-based speech-language pathologists cannot refer out. However, you can ask for guidance, mentorship and continuing education from your employer. Meaningful Speech founder Alexandria Zachos wants to share a story with you: 

I spent nine years working in the public school system in the state of Illinois.  I was the only speech-language pathologist in a Kindergarten-2nd grade building when I was hired. I lacked experience in every area and I had no one to turn to to ask questions. One day a new student moved into town with a thick IEP. He stuttered and it impacted every minute of his school day. I had never observed or worked with anyone that stuttered up until that point. I was clueless. I began researching but recognized immediately that I would not be able to learn what I needed to make a difference for this child now. He needed me. I went straight to my special education director's office and explained the situation I was in. I requested that he bring in a stuttering specialist to both evaluate the child and also mentor me. Guess what?! He did. I found the specialist and I did the leg work, but he paid for her to come. It was transformative. Today, I love working with fluency clients and see many in my private practice (although I don't often discuss it on social media or online since my focus here is gestalt language processing).

Consider other options, settings or specializing

If you’re currently working in a setting where you are taking on clients that you are not comfortable or interested in, you might be considering other options. Starting a private practice is becoming increasingly more popular for professionals in the same position. You may be thinking about specializing and starting a niche practice so that you feel passionate, comfortable and confident with all of the clients you support. 

If this sounds like you, join us on July 31, 2024  at 5pm PT/6pm MT/7pm CT/8pm ET for a 1-hour webinar on Starting a Niche Private Practice. Meaningful Speech team members Jessica Teixeira (@jesstheslp) and Alexandria Zachos will share their own SLP niche private  practice stories, guide you on how to get started and answer all your questions! If you can’t join live, no worries! A recording will be available to you for a year and access will be granted on 8/1/24. You can sign up for the webinar HERE. Also, if there is anything you’d like to see covered during the webinar, please fill out this form prior to the webinar.

BONUS (if purchased before 7/31/24): Speech-language pathologist and marketing/website guru Hannah Boeck from Cued Creative has a 15-minute video for you on how niching down can have a positive impact on your digital marketing.

Want to learn more in-depth information about how to support gestalt language processors?

1. There are many free podcasts, webinars and articles to get you started. A comprehensive list of resources can also be found on our website. We just released a new FREE masterclass on echolalia and child-led therapy that is perfect for anyone starting their learning journey or on the fence about purchasing our courses! 
2. Consider taking the Meaningful Speech course to learn more about how your child or client processes language, how you can help support them from echolalia to self-generated (original flexible) language, child-led therapy, and neurodiversity-affirming practices. Looking for something shorter? We have a 1-hour introductory course perfect for extended family, daycare or school staff.
3. Consider taking our AAC + Gestalt Language Processing course. It will teach you how to identify, evaluate and support gestalt language processors who use AAC or who you think might benefit from AAC.
4. Look for a speech-language pathologist (SLP) who "gets it" and can help you in supporting your child's language development. Check out our registry for SLPs who understand gestalt language processing and child-led therapy.
5. Are you a school-based or private practice clinician looking for intake forms for new clients/students or creative visual reminder posters for your space? Check out the Meaningful Speech Marketplace. 
6. Want to learn more about starting a niche private practice? Join our webinar on Wednesday July 31st at 5pm PT/8pm ET or watch the recording if you can't make it live by signing up HERE.