Written by: Megan Smith / Treatment / December 23, 2020 / 8 minutes read

In the last few months, I have had several clients take breaks from speech or voice therapy for their own health or for other, unavoidable scheduling conflicts (e.g. surgeries, moving to new homes, or other major life events). In addition, with lockdowns and restricted movement and social interaction for many folks working at home, many of us (myself included) are having a difficult time holding ourselves accountable to the things we want to do.

In addition to this, many of the clients who attend this clinic may have other reasons why practicing consistently is difficult for them. These might include mental health challenges like depression or anxiety, attention problems caused by brain injuries or ADHD, or any number of conflicting demands on their time (such as parents trying to help their children through online or mixed in-person/online schooling).

During this time, I have been thinking more often about the demands that I place on my clients. We know through the principles of motor learning, and through research specific to speech, language, and voice therapy, that consistent practice is one of the most critical components to achieving the goals that we set in therapy. If clients wish to see efficient progress, they must do the work. And yet, when we set targets that are too high for clients to realistically meet, we are not doing them any favours. At some point, goals must be tweaked to expect less progress, so as to still be realistic, or the type/duration/degree of practice must be changed to make it more sustainable.

A speech therapist who is considerate and competent should be able to work with their clients to make these changes when they are needed. But there are some core principles that anyone can adapt to their own lives – and can even adapt to goals outside of speech therapy. Through discussions with clients about their home practice, I have developed a semi-standardized list of questions to ask about their practice habits, to find problem areas and create home practice plans that will work well for the individual in front of me. These questions include the following – if you are struggling to maintain a habit, begin by honestly considering these.

This question will tell you whether your practice is sufficient. Some clients may not practice often, but are satisfied with their rate of progress and therefore are not motivated to increase the amount of practice they do.

As an example: I do deadlifts at the gym about once a week. I feel happy with my rate of progress, and am not motivated to increase the frequency with which I do deadlifts. I stretch a few times a week to maintain or improve my mobility, and I am dissatisfied with my progress in this domain.

Typically, when we feel guilty about not having completed something, it is because we have failed to meet our own values. What is it, specifically, that bothers us about having failed? This will give us information about why we are motivated to do the work in the first place.

I am not pleased about my failure to stretch, because I notice postural changes associated with working from home in 2020. I want to have a strong and healthy body. I wish I was doing more to work towards this goal.

It is important to be honest with ourselves when we answer this question. “I did not have time” might be partially true, but the real and honest answer is “I prioritized something else.” At other times, we may have a reason that feels more compelling, like “I had no one to practice with.” We may even find that we are beating ourselves up for something that is relatively outside of our control, such as “I have really been struggling with my depression this month.”

I often skip stretching in the morning because I want to sleep in before work, and often skip stretching after work because I feel tired at the end of the day.

Some strategies, like scheduling a Zoom date with a friend or rescheduling an activity that has a time conflict with our best practice time, can totally remove an obstacle. Other bumps in the road are not so easy to manage, and these include our own thoughts and feelings as well as any comorbid problems. These types of obstacles may need to be worked around rather than changed.

I don’t think that I will ever consistently and reliably not want to sleep in or not want to relax after work, so I will need to find a way to make my stretching work for me despite those obstacles.

This may be the hardest question of all, but we may be able to generate some ideas alone or with the help of a sounding board (in the form of a friend, family member, or professional). When working through this alone, consider the answers to the question, “What stopped me from doing my practice?” and try to generate different strategies to reduce the size of that problem.

I can try to shorten my stretching routine, to make the demands on my time and energy less intense. I could also make this a Zoom date with a friend/partner/family member, to help me feel like I am stretching to gain energy rather than using up all my energy to complete the routine.

If you are interested in the process of establishing a new habit, stay tuned for next month’s progress on the elephant and rider model for making a new change. This model gives many ideas for ways to modify our expectations to make changes successfully!

If you would like to speak to one of our clinicians about your communication goals, and determine a program that would be right for you, feel free to reach out to us by phone (647-795-5277) or email (info@torontospeechtherapy.com). Interested parties can also book their initial consultation through the online booking system.