Potential Offensive Behaviors by Professionals
Hello, I am a speech-language pathology graduate student in California. I am not sure if this question is rude or inappropriate, but I am wondering if anyone has seen professionals exhibit subtle or not-so-subtle offensive behaviors that might not have been intentionally hurtful, but were (e.g., body language, insensitive terms, etc). If so, would you maybe share a few things about them? I am personally concerned that I may negatively affect my future clients who stutter because of any microaggressions I might unintentionally show. I understand that stuttering has an emotional component involved, so the very the last thing I want to do is offend any of my future clients or make them feel badly about their stuttering behaviors. Can someone provide me with some insights of what NOT to do with my clients? Thank you very much for your time and attention.
I had a situation last year with a health professional. I had an appointment with my primary care physician and as is customary, I was called in to the doctors area by a nurse. Without really greeting me or anything, she directed me towards the scale. (I absolutely hate being weighed in front of others.)
As we approached the scale, she asked me to verify my birth date. I began with December 12, and I stuttered on the “12” so it sounded like “ta-ta-12.” She laughed. I then continued with the “13” which sounded like “tha-tha-thirteen.” The nurse laughed again, so I asked her what was she laughing at. She said “well, you seemed confused about your birth date.” I said no, I obviously know my birthdate. I just stutter.” At first she said nothing, so I said “you laughed when I said my birthdate.” She then said “well, it wasn’t a trick question.”
I was hugely offended and momentarily unable to respond. I did eventually say, “I stutter,” and she laughed again.
She never apologized. I couldn’t believe this had happened with a medical professional. If she so casually made fun of me, an adult, what if it were a child or teen, who might not have had the courage to speak up?
I wound up contacting the CEO’s office regarding this situation, and I was put in touch with the head of the medical associates practice. I shared what happened. He apologized, and assured me that their group does not stand for this type of negative behavior. I was then put in touch with one of the nurse educators and actually went out to lunch with her and a colleague of hers. They wanted to know what happened. They apologized.
Long story short, from that scenario, we went on to create a 10 minute PSA training video about stuttering and interactions with health professionals that became a mandatory part of all new hire training during onboarding of any new employee – receptionist, nurse, nurse practitioner, medical assistant all the way up to doctors.
I was thrilled that I had the stamina and courage to stick with this and that something positive had come of the situation.
Pam
Hi Pam,
I will start off by thanking you for sharing your honest feelings and experiences. I really appreciate your insight. I can’t believe a healthcare professional laughed in several instances while you stuttered. Your experience with the nurse couldn’t have been easy, especially because she continued to giggle/laugh after you explained that you stutter. I take disability/speech matters very seriously, and try to go out of my way to avoid offending others. So, hearing of this behavior really makes me feel appalled and angry. However, I am so thankful to hear that you had the stamina and courage to continue with the education process. Given the amount of depth that you provided in this message, I know that everyone must have learned from it.
I will make sure to go out of my way to detect this type of behavior as a clinician.
Thanks again.
Hi kt_9379
What an honest and important question to ask! From your question I know you’re going to be an amazing clinician. <3
As a child, stuttering was not a good thing, and should be hidden. Which also implies that my parents didn’t take me to an SLP until I was around 16. This didn’t last long, as this SLP physically abused me. A few years later i tried again and this time I had a nice lady. We spent a year practicing saying the days of the week in one breath, but as I am a saxophone player, this wasn’t really helpful. She would let me talk and she learned about the hurt by other people telling me I was not good enough and that stuttering was my fault. After one year of drinking tea I told her I wanted to try another SLP. Than she threw the bucket of guilt back in my face, telling me it was my fault and that I was just lazy and unwanting to work on my speech. Needless to say I turned by back to speech therapy. I tried loads of other things. All from healing and hypnosis, to wearing a certain stone in my pocket. After I found the stuttering community at the age of 27, I also found fantastic SPL and I joined a group of PWS who had training weekends and speech training through Skype, led by a former SLP/PWS, and now by us ourselves. It was a mix of speech techniques and public speaking, using Speaking Circles.That, together with Mindfulness, NLP, more knowledge about you can reprogramme your brain to conquer fear, and relaxation techniques, helped me so much. I also keep learning about different programs and pick what fits me, as programs consist of many parts, and sometimes not all parts fit, but a smorgasbord of things can create the perfect dish. ?
Today I have had the honor to meet the most amazing SLPs, who leave no stone unturned to help their clients that I wish I had met years ago. But there are sill a few that are not helping. Because of my experiences (please read my paper for this conference) my trigger is to hear I'm not working hard enough on my speech. Or worse, that I'm not good enough, covering my whole being. Or that stuttering is bad and fluency is good.
See, I come to you for help. But what help that is might be different for everyone of us. Some want fluency, some want better communication skills, some want relaxation, some want self-esteem, some want you know more about stuttering and some want to you educate others. So don't go by the book and assume one size fits all. Try to get the know what your client wants and its background. Take your time for that.
When things don't go as you hoped for, it's not automatically the clients fault. It can be the chemistry between you and your client. It can be that it's the wrong timing. It can be that the client may be looking for another kind of clinician or therapy. Don't ever play the blame game. There is blame. Not the client, not the parent, noone. Try to keep an open mind and ear, read between the lines, and if needed, don't hesitate to refer to someone else.
You know about treatment. But your client knows about his/her stutter. Work together. Learning from each other, and together trying to find something that works will make both of you grow.
And don't judge the stutter, nor the PWS, by the amount of stuttered words. A client who hardly stutters can be the one who needs therapy the most, and v.v. Don't minimize the covert PWS, and don't penalize the person who stutters a lot. Progress can be measured by the amount of stuttered, or even spoken words. You rather want a PWS who stutters more, but found his voice, than a PWS who stutters less because of guilt, shame and the positive feedback only when fluent.
I so love your question, if you weren't an ocean away, I'd see you. 🙂
Stay safe and keep asking
Anita Blom
Hi Anita,
Thank you very much for taking the time to type out such a thoughtful response to me. I honestly, truly appreciate it. It hurts my heart to hear about healthcare professionals participating in misconduct with their clients/patients (I teared up when reading your post and your paper for this conference). So, I am very sorry that your first two experiences with SLPs were abusive. I am glad that you encountered amazing SLPs after your initial experiences–they really seem like they supported you the way you wanted afterwards. I really am hoping that I can be as sensitive and kind as those wonderful SLPs you encountered. I really take the lives of my clients seriously, so your response truly answers my question well. Thank you, also, for describing the potential desires of PWS clients, because I did not know about the possible goals that they may have other than achieving fluency or emotional support.
Thank you again.
With all respect the worst thing you could do is take the person on as a client if you don’t believe you have the skills to be able to help that person. Treating adult stuttering is a somewhat specialist area and failed therapy can lead to a rejection of future therapy that might have been more suitable. It also may lead to that person resigning himself/herself to the belief that I can not be helped ultimately possibly leading to a less than otherwise would have been expected life experience. As a general rule people who stutter tend to be very sensitive people. Having said all that, if you become a stuttering specialist and you really know what you are doing then you will likely need to be hard on the individual as your role will be to change not only his/her speaking behaviour but also many aspects of their thinking behaviour as stuttering tends to be like a vine that wraps itself around every aspect of the way the person lives their life. The best clinician I ever had (in a 3 week stuttering treatment intensive) was very hard on my and I ultimately benefited from that. To be honest, and with all respect, I sense that you have some issues around upsetting clients or even other people for that matter. I think you should work on that and in that regard something like EFT (Emotional Freedom Technique) may help you and your future clients.
Hi John,
Thank you for your response. You are right–taking on a client who stutters without the knowledge and experience truly just might end up severely affecting another person’s life. Your explanation on these repercussions of failed therapy really makes sense. Therapy of any kind really puts the patient/client in such a vulnerable position due to the power imbalance and goals addressed, and I understand how far-reaching these negative effects can be. I definitely have concerns with upsetting clients, because I take their well-being very seriously. Thank you for your suggestion with EFT, I will look into that.
Thank you again for your thoughtful response and suggestions.
Good and courageous question :
– Not to let the patient feel that stuttering is bad
– Understand your patient as he/she is to adapt your therapy and advice
– Do not focus only on techniques but also on how stuttering is lived by your patient
– Create a genuine bond so that he/she does not feel like a “meaningless” patient (example : when you go to the doctor, most of the time it is not recurrent, so there is no link. The goal is to avoid that)