Setting down the clipboard. Chalking up the hands. Working at skillfully using my fingers as tools. Using questioning and listening in the clinician-patient relationship to flow therapy in a new direction. Letting the patient guide the therapy.
All things that I experienced. And I would like to share with you, today; how it all came together. I would like to list out the highlights of what I took away from my experience. And how I am glad I didn’t miss it for the world.
I had long awaited for this day, for Walt Fritz to come to Albuquerque for his “Foundations in Manual Therapy: Voice and Swallowing Disorders” (formerly-named “Foundations in Myofascial Release for Neck, Voice and Swallowing Disorders”) course. Walt has traveled all over the country, and all over the world to present, but he had not yet come to this region, so I was thrilled for the opportunity. His course been listed as one of the premier courses to take for head and neck cancer patients by leaders in the field. I was expecting to only apply this modality to this population, and was pleasantly surprised that the benefits of manual therapy are not isolated to one diagnosis.
I will say that I thoroughly appreciated the following:
- An evidence-based review. The research behind myofascial release and manual therapy principles, and how it applies to the field of speech pathology was detailed. I enjoyed becoming educated about the history of myofascial release’s roots, and different manual therapy approaches.
- A patient-clinician interaction focus. A robust discussion of the rationale of the reasoning behind the model of interaction utilized in Walt’s approach for guiding treatment was discussed. At the core of the patient-clinician interaction is the importance of:
- the description patient’s complaints,
- our questioning model in order to open-endedly query what the patient is experiencing,
- reactions to the treatment,
- responsiveness,
- familiarity with the sensations experienced with this modality,
- the patient’s connection with relevance,
- if what they are experiencing during the modality is helpful for them during treatment,
- and so much more. “Taking it where the patient wants to take it” — that is the goal of the approach.
- Decision-making breakdown. The importance of not letting our ego guide our decisions in treatment, but the patient’s experiences be the guide was a meaningful topic of relevance, and something that I took to heart. In addition, this included the dropping of expectations that needed to occur in what I brought to the table in coming to the course, and instead having an open mind about a different way and manner of doing treatment. The science between the muscle experience (sensations in pain, dysfunction, weakness, etc.) and the brain connection was described with the manual approach as well — directing treatment decisions and playing into outcomes.
- Hands-on support. I awkwardly tried to use my hands for the first time as an SLP in a new way, and the help I received was effective — as I tried to navigate using these new (to me) manual therapy techniques. Thankfully, teaching assistants were available for additional support. Walt also made the rounds as we “dug-in,” hands-on. It was a safe space to admit that I didn’t feel as comfortable at first as I would have liked, in using my hands on someone else. As time went on, it became more and more familiar to me and I was able to dive-in with less “fumbliness.” We had ample opportunities to ask questions and process what we just attempted and experienced. By the end of the course, I was ready for Monday morning’s patients on my caseload.
- Time-friendly, outcome-oriented. One of the amazing concepts I took away from the course was the short amount of sessions that were projected to be needed for a responsiveness toward desired outcome to occur, if this is an approach that will be effective for a patient. The results that that transpired before our very eyes, achieved in the short periods of time, in the candidates that Walt utilized for demonstrations, were absolutely jaw-dropping. It was exciting to start considering all of the patients on my caseload that I would plan to apply these techniques upon. To have a different type of approach beyond what I already have in my arsenal will be invaluable to my patients now.
- Application ideas. How to use manual therapy on a patient on a massage table vs. sitting upright in a chair was presented, with the SLP perspective in mind. In addition, quality ideas were relayed on how to best create a do-able and follow-through(able) home program for patients, with manual therapy and in general.
- Learning to wait as the effectiveness of the techniques “sink in.” Walt described it as “watching paint dry” as we held positions that were of relevance and help to our lab partners as we used the manual therapy approaches. It took a level of patience on my part to appreciate the time needed for the manual work “at hand” to fulfill it’s purpose. This was a new experience for me and with practice I became more effective at this. Walt’s class is very application-oriented, and the lab format was helpful for someone like me that wants to practice techniques again and again.
At the conclusion of the course — as I saw the SLPs leave the course, one by one, I envisioned all of the patients that will be helped by using this modality, numbers by numbers, exponentially adding up. Our region now is equippped in a way it was not before. And I am thankful for that. Patients will have access to treatment that was not provided before this day.
And I would say that as a clinician, having hands-on skills from a manual approach is beneficial.
Having the ability to apply these effective and helpful principles to patients this Monday morning, and every new Monday morning — is a hopeful song I want to keep singing.
And it having been a course to impact the voice, that sounds just about right.
——
nicespeechlady.com readers can obtain a 10% discount on Walt Fritz’s “Foundations in Manual Therapy: Voice and Swallowing Disorders” courses by using the code “NiceSpeechLady” at checkout.
Wilson Nice, M.A., CCC-SLP, is the owner of nicespeechlady.com.
Nice created nicespeechlady.com as a platform for medical SLPs to have free access to practical clinical resources on nicespeechlady.com. She also enjoys blogging and writing news articles on medical SLP issues. Nice works full-time as a home health SLP.
nicespeechlady.com resources:
Articulation — free speech therapy materials for adults
Swallowing — free speech therapy materials for adults
Receptive Language — free speech therapy materials for adults
Expressive Language — free speech therapy materials for adults
A/AC — free speech therapy materials for adults
Co-Occurring SLP Diagnoses — free speech therapy materials for adults
Cognitive-Linguistic — free speech therapy materials for adults
Voice/Resonance — free speech therapy materials for adults
Pragmatics — free speech therapy materials for adults
Fluency/Stuttering— free speech therapy materials for adults
Other — free speech therapy materials for adults
Disclosure: Foundations in Manual Therapy: Voice and Swallowing Disorders is a sponsoring advertiser of nicespeechlady.com.