Speechies in Business

Helping Speech Pathologists in private practice focus on what matters most: their clients

David Kinnane

Speech pathologists: How not to get suckered in business

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Have you ever found yourself saying yes to an important business contract or buying an expensive resource and later regretted it?

Most speech pathologists I know are pretty smart. We also tend to think the best of people.

Optimism and trust are great qualities when working with clients and their families. But they can leave us vulnerable when negotiating business contracts with people trained in human persuasion techniques. Behaviour studies show that people use predictable short cuts (or rules of thumb) when making decisions. Salespeople and others can take advantage of these pre-programmed responses at your cost.

Knowing key persuasion strategies used in business can save you from being manipulated. They can also make you a skilled persuader yourself in business negotiations with other people.

Key persuasion strategies with real world examples

  • Price indicates quality shortcut: People assume expensive items are high quality than cheap ones. Example: When I started my clinic, I bought lots of expensive assessment tools that, in hindsight, were not as reliable as cheaper options. Given limited time to research, price played a factor in my decisions – something I am still paying for. On Speechies in Business, we found that some of our products sold better when we increased the price! I’ve even had feedback from a person that they would have bought my Clinics Template pack but it seemed too cheap to be good!
  • Rule of reciprocation: People feel obliged to repay others for whatever they have provided to us. Example: Ever fallen for the “free sample” trick? A salesperson offers you a free “gift”; or a website offers you a free download. Unconsciously, you feel indebted to the provider and are more likely to buy something.
  • Rejection-then-retreat tactic: People match concessions in negotiations. If a seller asked you to buy a $4000 program but then retreated and offers to sell you a $40 resource product, you would be more likely to buy it than if you’d been offered the $40 product alone. Example: This is a common tactic used by resource sellers. You baulk at paying for their ridiculously expensive product, and opt for what seems like a much more affordable one instead – sometimes something you may never have bought had it not been for the expensive product.
  • Scarcity rule: Opportunities are seen as more valuable if their availability is limited, e.g. by time, or if you are competing with others. Examples:
    • In every lease negotiation, the real estate agent will tell you how many other people are looking at the property too.
    • “2 day flash sales” offered by education publishers where you end up buying stuff you don’t need.
    • Professional or business webinars with tight deadlines and limited capacity. If you think about it, there’s no real reason for them to be so restricted, other than making the “product” seem more attractive and the purchase decision more urgent.
  • Romeo and Juliet effect: We hate losing opportunities. If something is banned or forbidden, it instantly becomes more desirable. Example: one of my colleagues in Australia seemed to become more interested in the persuasive power of testimonials and solicited reviews after these practices were banned by the advertising rules.
  • The commitment effect: Once we commit to something with words or actions, we will act to stay consistent with our commitment. If we are asked to assume a responsibility for doing something, we will go above and beyond to achieve it. Examples:
    • Volunteering: Have you ever volunteered to get involved in a project, then found yourself doing all the work for no additional payment?
    • Mentorship: Mentors are often prepared to move heaven and earth for their mentees, even at the cost of their own work.
  • Initiation trial effect: If we go through a lot of trouble to attain something, we tend to value it more once we have it. Example: I once paid for a very expensive, very intense professional development program. Even 6 months after completing it successfully, I found myself telling everyone how great it was and defending it staunchly from critics, even if, objectively, the program had some limitations.
  • Social proof principle: We often determine what to do by looking at what others are doing. This can lead to the bystander effect where no-one else acts, so we decide not to either. Example: Countless therapy fads have taken hold simply because “everyone else was doing it”. As evidence-based professionals, speech pathologists need to be very wary of this one, and demand proof of effectiveness before changing a clinical practice to follow the crowd.
  • Similar people effect: We are more likely to copy others in our choices when the  other person is similar to ourselves. Also known as peer pressure, and a real risk in speech pathology because of our (currently) limited diversity.
  • Halo effect: We tend to see attractive people as smarter, kinder and more honest than unattractive people. That’s why so many salespeople are good looking. We also tend to like people who co-operate with us for a shared goal. This can play out as the “good cop, bad cop” dynamic, where we are vulnerable to the person who “shares our pain” against a common “enemy”. Again, real estate agents are good at using this one, complaining about how unreasonable the landlord is, while at the same time making sure the landlord gets everything he/she wants (at your cost).
  • Authority effect: People are swayed by authority and even mere symbols of authority. Examples: Fancy titles (again constrained in Australia by our advertising rules), ritzy clinics, cutting-edge websites, silver and gold embossed certificates on walls, white coats, uniforms, power suits and even stethoscopes can be used to generate authority. Looks can be misleading, though. Sometimes the best clinicians wear jeans and work from home. But how are clients to know?

Bottom line

Be on guard for these techniques when negotiating with others. If you are in business, you are probably using some of these techniques, even if you didn’t know them by name! Make sure you stay ethical. Follow the spirit and letter of your ethics codes and advertising rules. Never use persuasion techniques to the detriment of your clients.

Principal source: Cialdini, R.B., Influence: The Psychology of Persuasion. An oldie but a goodie.

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The Pesky Lisp Fixer

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Don’t you hate those pesky interdental lisps? You know, the ones that won’t stay fixed?

To fix an interdental lisp – those lisps where your tongue sticks out between your teeth when you try to say /s/ – we, as speech pathologists, used to start with simple tasks, like saying an /s/ on its own. Once the child had mastered their /s/, we progressed in tiny hops (like baby bunny kittens) to slightly harder tasks. This traditional approach works.

But it’s SO SLOW!

Many kids – particularly older and more mature kids – hate being treated like babies. And, even after finishing traditional treatment, many kids have difficulties using their “new /s/” on words they haven’t practised and in more natural tasks, like story-telling and conversation. Which is, of course, the main point of trying to fix a lisp!

A new approach

More recent research evidence supports a different route for better results. Once a child can say the sound on his or her own, randomly mixing up hard and easy tasks can have quicker results that transfer more efficiently to real-world, lisp-free speech (e.g. see Skelton, 2004).

(You can read more about why using randomised practice, non-word practice and other principles of motor learning and speech here).

Our Pesky Lisp Fixer program has three stages

  1. Auditory Bombardment: 2 minutes per day – listening and tuning into the sound and practising it on its own. Audio file included!
  2. Our /s/-Syllable Boot Camp: Based on principles of motor speech, the boot camp involves 10-15 minutes a day of high repetition practice of nonsense syllables designed to get the tongue, lips and teeth working together with different vowel and consonant sequences in random order.
  3. Randomised Practice: Once the child has conquered the boot camp, this gives the child 20-30 minute sessions of imitating and naming words with /s/ in them, across all word positions. Again using a high repetition, randomised approach, we mix imitation, naming, and sentence generation tasks, with old-fashioned story telling, using over 200 high quality photographs – no cutesy vector clip art!

This program works best if an adult is around to give clear feedback every now and then – but no more than occasionally. Use it in your clinic or as a home program for your clients.

So download the Pesky Lisp Fixer today from our Teachers Pay Teachers store and get straight into getting rid of those pesky lisps!

download the pesky lisp fixer now!

Speech therapy by telehealth: research-based guidelines for clients and their families

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As we’ve noted elsewhere, travelling even short distances to the clinic can be hard for some families. Speech pathology by telehealth is convenient and the evidence-base supporting its use is growing, especially in areas of practice like stuttering (e.g. Bridgman, 2014).

But telehealth has its disadvantages, too. Compared to face-to-face therapy:

  • families are more likely to cancel appointments at short notice;
  • you don’t have as much control over preparations, resources or whether the parent and client are prepared for your call;
  • parents and clients are more likely to get up and leave the room during therapy; and
  • siblings are more likely to wander in and interrupt (e.g. Bridgman et al., 2015).

Our Telehealth Guidelines are designed to help you explain to clients what you need from them to deliver effective speech therapy via telehealth to their child.

Click here for our Guidelines for Speech Therapy by Telehealth.

Related products:

Principal source: Bridgman, K., Block, S., & O’Brian, S. (2015). Webcam delivery of the Lidcombe Program: Insights from a clinical trial. Journal of Clinical Practice in Speech-Language Pathology, 17(3), 125-129.

The tech-savvy speech pathologist: 5 technology-based ethics challenges and how to tackle them

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When people tell me about the so-called “evils” of new technologies, I tell them about one of my first jobs as a lawyer for a big law firm.

I was working on a big international transaction led by one of Australia’s leading lawyers. Sounds glamorous? My job: to come in on Saturday morning and sit by the banks of fax machines (there were about 30 of them) and wait for an important fax from the client. While I waited, I affixed bar code stickers to documents. Then I photocopied each document and put the copies into blue lever arch folders. I then numbered the folders and dictated a note about what I’d done onto a tape recorder to be transcribed by a secretary. After 12 hours of barcoding, the fax arrived. I snatched it, still warm, and called the senior associate. I then read it out – twice – and went home.*

These days, of course, no one sits by fax machines waiting for documents. We check our emails instead. (Sometimes, several times a minute.)

It’s trite to say that technology has changed the way many professionals do their work. New technologies can make our jobs easier. But they trigger a bunch of ethical challenges, too.

Lawyers, such as Tahlia Gordon, have been talking about these issues in the legal sector for a while. Many are just as relevant to speech pathologists.

Here are 5 technology-related ethical issues we all need to think about:

1. Mobile device and “wearable” data breaches

Issue: Most speech pathologists use mobile phones, iPads and other mobile devices for work. I’ve spotted a few trend-setting speech pathologists wearing Apple Watches and other “wearables”. Client confidential information stored on devices like these can leak or be misused. Devices can be lost or stolen. They can also be hacked, e.g. when using unsecured wireless networks in cafes. Often, the information stored on our devices is unencrypted.

Mitigators: Your Code of Conduct should cover technology use, prohibit work via unsecured networks, require password protection, and encryption of sensitive confidential information. Client consents should be requested and obtained before sending reports and other data to them over unencrypted networks.

2. Social media misuses and abuses

Issue: Lots of speech pathologists use Facebook, LinkedIn, Twitter, YouTube, and other social media platforms, especially in private practice. Ethical risks include accidentally disclosing confidential information, breaches of our advertising rules (see Speech Pathology Australia’s Policies & Procedures Manual, Section 3.03), saying something defamatory in the heat of the moment (e.g. when responding to a “troll”, negative online review or challenging comment, inadvertently forming a speech-pathologist-client relationship (e.g. by giving advice over social media), and being hacked.

Mitigators: Have a robust Social Media Policy and enforce it. On social media platforms like Facebook, adopt House Rules about the types of behaviour that are not tolerated when interacting with your page.

3. Plagiarised and ghost-written online content

Issue: Content-rich blogs can attract clients and establish credibility and authority. However, it takes time to establish and maintain a decent blog, and many speech pathologists simply don’t have the time to do it. Sometimes, it can be tempting to use someone else’s work, presenting it as your own without attribution. This is plagiarism and is unethical. Another option is to outsource your blog to a junior staff member or freelancer or “ghost-writer”. If mishandled, these ghost blogs can damage your reputation: a blog that purports to be written by you but is in fact written by someone else may be deceptive. It can also undermine the trust that a good blog establishes with readers. Ghost-written blogs may also be factually incorrect – especially if written by a freelance writer with a limited knowledge of speech pathology. As the blog owner, you have an ethical responsibility to ensure that the information included in your blog is accurate and not misleading.

Mitigators: Always attribute sources. Use appropriate website disclaimers.  Have a clear editorial policy about your content. Review blog content critically before posting to ensure it is technically correct and not misleading.

4. Cloud-based software

Issue: Services like Dropbox, Evernote, and Google Docs are cost effective tools to create, edit, share and access documents from multiple devices. But using these services can be an legal and ethical minefield when it comes to questions like “Who owns the data?”, “Where is the data stored?”, “Is the data confidential, encrypted and/or otherwise protected?”, “Who can access the information?”, “What happens if the service provider goes bust?” and “Does the service comply with applicable privacy and health record laws?”. Regulators like the Office of the Australian Information Commissioner have published lists of questions to ask cloud-based service providers about privacy. But, in practice, it’s very difficult to get straight answers to these questions from service providers, and impossible to negotiate changes to the service terms of big generic service providers like Dropbox.

Mitigators: Have a well-drafted Privacy Policy and follow it. Don’t store confidential client data in the cloud. If you do, investigate “medical quality” cloud storage systems that warrant that they are compliant with privacy and health record laws, rather than generic cloud-based storage services like Dropbox.

5. Giving free advice online

Issue: These days, any member of the public with an Internet connection is a potential client. The line between general informational advice and speech pathology advice can be hard to draw, particularly if you respond to specific comments and questions made by users in response to content on your site.

Mitigators: Use appropriate disclaimers. Do not offer recommendations tailored to the unique facts of a person’s circumstances online. Instead, invite the person to contact you personally to discuss their circumstances and to explore whether you are in a position to help them prior to deciding whether to establish a speech pathologist-client relationship.

Bottom line

Almost all speech pathologists use technology to deliver speech pathology services to clients. Most of us – me included – probably don’t give much conscious thought to some of the ethical issues that arise from new technologies. We should. It’s tempting to wait for professional bodies and ethics experts to figure out rules to manage some of these issues. But we should use our professional judgment to decide how to use technology ethically in our everyday practice, remembering that our professional ethics are based on values, not rules.

Principal source: Gordon, Tahlia. (2015). 7 ethics nightmares you didn’t know you had. Law Society of NSW Journal Issue 13 (July), 34-37.

* Actually, being a Saturday night in the 1990s, I probably went to the pub.

Speech pathologists: how to talk about what you do for a living without being “salesy”

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“I need a blood test”*

Lots of people have never met a speech pathologist. Some have a rough idea of what we do, often along the lines of: “Oh, you work with kids with speech impediments, right?”

Others have absolutely no idea. And fair enough. There are loads of professions I know little or nothing about.

One of our key professional duties is to advocate for people with communication and swallowing needs. But it’s hard to advocate for some groups of clients if the public don’t know what we do or why we’re qualified to speak on issues as varied as adolescent literacy, Parkinson’s Disease, dementia care, youth justice, stroke rehabilitation, accent modification and professional communication.

Our peak bodies – like SPA and ASHA – do their best to spread the word through terrific projects like Speech Pathology Week, the 900 swallows initiative or the SPA Book of the Year Awards. But every speech pathologist has a role to play in educating the public about what we do: one of the main reasons I post so often to my clinic website.

Despite our collective efforts, I’d hazard a guess that few members of the general public understand our full scope of practice, or the many different ways we help people in different places. Shockingly, I didn’t know the full scope our practice until the second semester of my degree!

Getting the word out, ethically

One of the main themes that crops up whenever I speak to groups of speech pathologists or speech pathology students about private practice is a deep sense of ambivalence about self-promotion. And for good reason. We work with people with health needs who are vulnerable to misleading and deceptive advertising. It’s one of the main reasons the profession in Australia has such a robust Code of Ethics – Advertising policy.

But I think we can do more to explain what we do to others without trying to “sell” ourselves. And it’s a fairly simple idea, borrowed from Michael Port’s research on networking and marketing strategies for professionals:

How to explain what do you do for a living in 5 steps

The next time someone asks you what you do – at a barbeque, a kid’s birthday, a networking event, cousin’s wedding, etc. – don’t say “speech pathologist” and leave it at that. Instead, use Port’s simple 5-part formula, which I have adapted for speech pathologists as follows:

  1. Summarise your key client groups: Who do you help most often: Infants? Toddlers? Preschoolers? School-age children? Teenagers? Young offenders? Young and middle aged adults? Older folk?
  2. Identify two or three of the most critical problems that your clients face: In what areas of practice do you help clients? Language? Literacy? Speech? Voice? Fluency/stuttering? Feeding? Swallowing? Life-long disability/Multi-modal/AAC? Accents/intelligibility?
  3. List some of the main ways you help people: One-to-one or group therapy? Telehealth? Parent training? Client coaching? Advocacy/education/lobbying?
  4. Explain the number one result you want your clients to achieve.
  5. Talk about the deeper benefits your client’s experience.

One of the great things I find when introducing myself this way is the genuine interest many people have in what I do. Rather than just a customary exchange of titles before moving onto the next topic (usually property prices in Sydney), it starts a conversation.

Examples

This is how I apply the formula to explain what I do:

  1. I help children and adults…
  2. who have difficulties with their speech, language, literacy, stuttering, voice, and/or accent…
  3. with evidence-based, tailored therapy in my clinic, via Skype, or through online courses,
  4. to pursue their goals and to make the most of their abilities and potential,
  5. to get the most out of life.

Here’s an example for a paediatric speech pathologist focusing on traditional speech and language services:

  1. I help infants, toddlers, preschoolers and children;
  2. who have difficulties with their speech, language (including social use of language), and/or literacy;
  3. to improve their language, intelligibility and literacy through home, (pre)school and clinic visits, parent training, and home programs;
  4. to communicate with confidence, be understood and to participate more fully at home, in extra-curricula activities and at (pre)school.

Here’s another example for a speech pathologist working in a rehabilitation setting:

  1. I help young adults and adults;
  2. who have had a traumatic brain injury or stroke causing language, speech and/or swallowing difficulties;
  3. with evidence-based treatments and carer training based on principles of motor learning and neuroplasticity in a multidisciplinary rehabilitation setting;
  4. to recover maximum communication skills and to learn compensatory strategies for areas of on-going difficulty;
  5. to regain independence and to go back to work.

Not just for introductions

The great thing about doing this simple exercise is the clarity it brings to what we do. I use my 5-part introduction not only to explain what I do to non-speech pathologists, but as a key part of my “mission statement”, business plan, strategy and even branding for my clinic. Once a year (or so!) I reapply the formula, taking into account new target clients, training and new competencies, and proposed service delivery changes for the coming year.

Bottom line

To advocate for, and to market, speech pathology services, we need professional credibility. For credibility, we need the public and potential clients to recognise our expertise, experience and authority across our scope of practice. Explaining who we help, how we help, and the outcomes we deliver for clients is critical for both public advocacy and private practice success. Port’s 5-part formula is a simple way to articulate what we do for a living to people outside the profession.

Related articles:

Principal source: Port, M. & Wallace, J. (2013). Book Yourself Solid Illustrated. John Wiley & Sons, New Jersey, USA.

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* True story. This happened to our operations manager a couple of weeks ago:

Ring ring.

Gentleman: “I want to book in a blood test.”

Banter Speech: “Sorry? I’ve think you’ve got the wrong -”

Gentleman: “Can I come in later today? I need a blood test urgently. My doctor said I needed to go to…”

Banter Speech, finally twigging: “Oh, sorry. We’re not that kind of pathologist! Let me see if I can find a local pathology lab to help you out.”

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