Growth vs. Mastery: Which One Do We Choose?

One of my favorite parts of this job in the “therapy world” is that we never live the same day twice. Our clients, and us as clinicians, are dynamic individuals who on any given day have varying thoughts and feelings that impact how we show up, and in turn how we demonstrate progress. The way we teach our clients, the growth they show, and the development we see is what brings us joy. Therefore, imploring a growth mindset approach as a clinician is essential to the success of our clients.

One can say our professional requirements give us a nudge, as SLPs are required to complete 30-hours of continuing education over a 3-year interval to maintain our certification. This may seem like a lofty requirement, but we can look at this as an opportunity to continuously grow ourselves professionally. We will never know all that exists to treat within the wide scope of disorders that fall under our hat. We must also remind ourselves that success isn’t being an ‘expert’ at everything. Having a deep understanding of this, we can welcome the beauty of a growth mindset in that we possess the desire to learn, embrace the challenges we face, persist in finding solutions, and happily learn from others and their feedback.

A most recent anecdote came as a result of a continuing education course I completed: “Feel More Confident Using Minimal Pairs” by Rebecca Reinking MSLP, CCC-SLP, CPSP from @AdventuresInSpeechPathology, which focused on the implementation of a minimal pairs approach. I have several clients on my caseload, one in particular with whom I had tried everything with minimal return. Here’s where I see a growth mindset play a role. I recognized my strategies were not being effective, so I took the time to dive into this webinar and trial the successes this SLP was sharing with me.

To give a bit of background to the webinar, minimal pairs therapy is an intervention approach for children with speech sound disorders. It essentially targets sounds that only differ from their production by one phonological feature. This approach is often used to treat phonological impairments as the clinician can target patterns of speech sounds instead of individual speech sounds. This webinar provided me with such a “light bulb” moment. It’s incredible how something I’ve been doing for so long can be improved so drastically with a slight alteration in my approach. I have so many clients who present with the phonological process of velar fronting, which is substituting the /t/ and /d/ sounds for /k/ and /g/ sounds. This webinar presented me with a total “aha” moment for how to teach production of the sounds.

As I mentioned previously, I had one client in particular who I had tried every trick in the book with to elicit those /k/ and /g/ sounds, including countless ‘tactile cues.” After watching this webinar, I tried one more visual which included keeping the teeth together for the /t/ and /d/ sounds and opening the mouth wide to see the tongue move backwards for the /k/ and /g/ sounds and voila! This client was able to produce minimal pair words such as “cap”/ “tap” and “dough”/ “go” from that moment forward with minimal clinician assistance. That subtle alteration in my approach made a huge difference and the proud look on this client’s face was priceless. I truly believe that with this moment I was able to not only help my client reach success in her speech goals, but also show her how trying new strategies and persisting with her therapy was bringing about success in her overall communication.

One part of my job that hinders this growth mindset are the insurance carriers. They often fail to recognize that response to interventions for pediatric clients cannot be defined by a strict timeline. This is especially true for children who are presenting with developmental delays and or disorders, such as my client. The progress we make cannot be done in the 4-8 visits (which they often only give). Additionally, insurance carriers are looking for ‘mastery,’ but we are working with developing clients who are trying to ‘catch up’ to a bar that continues to rise.

The outcomes of developing this mindset transcend the therapy room, as our clients continue to attain goals, they might also change courses in their plans of care, and work towards newly developed goals while sometimes skipping some steps in between. When progress isn’t linear, or doesn’t follow a neat pattern, it may not always be easily measured objectively. Being a primarily insurance-based private practice, many of these insurances expect us to “master” goals by providing objective data for growth, but what is really considered mastery?? As an adult who is happily welcoming that growth mindset, I feel as though we never truly master anything. Yet, it is expected of us to report on our clients mastering their goals in order for insurances to continue covering their services.

This one webinar may seem simple to some, which I can agree it was, but it also was truly an eye-opening experience which allowed my client to demonstrate progress necessary to report to the insurance company. It confirmed the power and the need for clinicians to develop and implement a growth mindset in their practice. Implementing this mindset can lead us to use skilled intervention techniques that are reimbursed by insurance companies. Moreover, it brought up so many questions about why the insurance companies are so driven by numbers to measure progress when the biggest successes are not always measured by percentages of accuracy. While I feel like numerical data has its place, it is evident progress can be measured in so many other subjective ways. Our clients often demonstrate this progress through their improved self-esteem and successful communication moments where they can express their countless thoughts and ideas. My hope is we will forever be motivated by our growth mindsets, and that the power of our clinical judgment is allowed to drive our treatment approaches and measure significant functional outcomes for our clients, without such a fight for coverage of services.

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