Speech pathologists: 5 best practice ways to improve your advice to clients

In one capacity or another, I’ve been a professional advisor for almost 20 years. Although advice-giving is a core part of what speech pathologists do, few of us are trained formally in how to do it well.

Bad professional advice can lead clients to make flawed decisions. It can also strain relationships and tarnish your reputation.

It’s sometimes assumed that advice-giving skills emerge organically, with experience and through a painful process of trial and error. But giving good advice is a skill. And, as with most skills, you can get better at it with the right knowledge, systems and practice.

So where should we look for the right knowledge?

Recently, Harvard Business School Professors David Garvin and Joshua Margolis reviewed the research about advice-giving in business and developed a framework of best practices. Applying their guidelines to speech pathology practice, here are 5 evidence-based ways to improve the quality of your professional advice:

1. Before you start, check you’re the right person for the job

Ask yourself: do you have the time, expertise and experience to help? Are there alternative and/or additional sources of guidance to advise the client comprehensively given his/her needs? Do you have a conflict? Would a second (or third) opinion help the client make a decision?

2. Develop a shared understanding with your client

(a) Set the scene: allow clients enough time to explain their challenges, ensure privacy and choose a place free from distractions like buzzing phones or the next appointment.

(b) Listen actively and without prejudice – resist the urge to jump in with your preliminary view.

(c) Go wide, then deep: ask open-ended questions to broaden your understanding, then shift to more detailed probes.

(d) Agree on the scope of advice sought. Is it:

(i) one-off advice for a single decision (e.g. “Do I have a clinical issue?”, “Should I be treated now, or later?”);

(ii) counselling on how to approach a complex situation (e.g. “How do I prioritise my child’s many communications needs?“);

(iii) coaching to enhance skills (e.g. identity mapping to generate and pursue meaningful, client-centred goals); or

(iv) mentoring to provide guidance to aid long-term success (e.g. acting as a sounding board for an adult who stutters or an accent modification client facing specific challenges at work, e.g. with an important presentation).

Don’t overstep boundaries or give unsolicited advice – especially advice that is outside your scope of practice.

3. Craft alternatives

Make it clear to the client that you are an adviser – not the decision-maker. If possible, help the client generate several, evidence-based, viable choices. Spell out the rationale, principles, assumptions and evidence behind each of the options and your advice. Be prepared to challenge assumptions if the facts or situation changes (or if the client changes his or her mind).

4. Help the client make the decision

Ensure all options are evaluated, including the risks and benefits of no treatment. Communicate clearly and in Plain English. Make sure the client understands your advice. Don’t jump straight to a conclusion, e.g. that a child is a “speech” or “language” kid or assume that your client will choose the treatment you consider to be the most logical or evidence-based. Pause frequently for client/family reactions. Make sure the client knows you are available for further clarification and elaboration if and when needed (i.e. that they don’t need to make a decision on the spot, and can think about other options, risks and benefits and come back with questions or concerns).

5. Help put your client’s decision into action

Reaffirm and support the client in making an informed decision, even if the decision is ultimately not your preferred first choice. Document it. Again, convey your availability for additional guidance and support to help the client to pursue his/her goals, including during treatment.

Bottom line

Speech pathologists advise clients in several ways, from face-to-face and tele-health consultations, assessment reports, management plans, home programs, email and SMS responses to queries, therapy and training activities, outcome measurement, discharge recommendations and referrals to other health professionals. Giving professional advice competently requires us to look at our competence and impartiality, the scope of advice sought and our role in giving it, the technical content of our advice, and the process through which we evaluate different options and give our advice. Skilled advising requires creativity and collaboration with clients. We need to understand clients’ problems fully to generate evidence-based, client-centred solutions over the whole term of the professional relationship. Garvin and Margolis’ framework for advising is a useful tool to do this methodically.

Principal reference: Garvin, D.A., & Margolis, J.D. (2015). The Art of Giving and Receiving Advice, Harvard Business Review, January-February, 61.

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Speechies in Business

Speechies in Business is owned and operated by David Kinnane, a Certified Practising Speech Pathologist, lawyer, writer and speaker in private practice in Sydney, Australia.  You can read more about David’s professional background, qualifications and experience here.David also co-owns and co-manages Banter Speech & Language, an independent private speech pathology clinic, and Bodkin Wood Legal & Advisory, a law firm specialising in allied health issues.