Ep #76: Working with Assistants as an SLP, OT, or PT

Episode 76, Working with Assistants as an SLP, OT, or PT.

Welcome to Clinicians Creating Impact, a show for physical therapists, occupational therapists, and speech-language pathologists looking to take the next step in their careers and make a real difference in the lives of their clients. If you’re looking to improve the lives of neurodiverse children and families with neurological-based challenges, grow your own business, or simply show up to help clients, this is the show for you.

I’m Heather Branscombe, Therapist, Certified Coach, Clinical Director, and Owner of Abilities Neurological Rehabilitation. I have over 25 years of experience in both the public and private sectors, and I’m here to help you become the therapist you want to be, supporting people to work towards their dreams and live their best lives. You ready to dive in? Let’s go.

Hi there, friend. I hope you’re doing well today. I’m really excited to talk to you about this topic today because, truthfully, it really comes at a point of reflection for both myself and our organization at Abilities, and it’s a topic that I actually have a lot of passion about.

And I will start by saying, while this episode may be most relevant for those of you who are SLPs, OTs, or PTs, if you are a clinician in general that works with others and you use them to help to implement your goals that you have with either clients or patients, I do think that this episode may be of use to you as well.

So before I start, I just want to give you a little bit of history of my own evolution in my career in working with rehabilitation assistants, and that’s what I’ll use as a general term for assistants moving forward. So, if I am to start, not necessarily right at the beginning of my career, but if I think about the start of my evolution of my career with Abilities, which is now more than 16 years going, the first person I actually ever hired at Abilities was actually a rehabilitation assistant.

I did that in November of 2007, so that’s giving you context of how long this is. And I’m really happy to say that while not everybody stays with us as long-term, Stephanie, who is that first rehab assistant that I hired, still actually works at Abilities today. She is an amazing human. If you know her, you know that as well. And she has taught me so much about how to be a better boss and ultimately how to be a better leader as well.

And yet, I know that for so many clinicians, we’re never actually really taught how to work effectively or efficiently with assistants. It’s not something we learn in our actual educational process. And then, for those of us like those that are speech-language pathologists, occupational therapists, or physical therapists or physiotherapists, then we work within the dictates of a health college, we are rightfully concerned about our duty to the client when we use assistants as part of our treatment planning.

So, what I notice is when we don’t feel competent or confident in using assistants, of course, one actually legitimate way to navigate this is to not use them at all. And again, to be fair, that is a very valid option. But today, I want to talk a little bit more about why I actually think using rehab assistants in your planning can be a very valuable part of creating a bigger impact for yourself and for your clients. And why I think this is actually coming for you in your work, whether you like it or not in your career, and then how to navigate the first steps of using assistants in your practice if this is something you want to try.

Now, before I share my perspective on this, again, I know so many of you already know this, you might actually already know this. But it’s important to say that this podcast is a passion project of mine, because I want all clinicians to have the ability to use this kind of tool set and tips as a way to magnify their impact, even if they never work either alongside us or with us at Abilities.

I consider myself so lucky to be able to do this and to share this as part of my workweek. It is such a fun part of my workweek. So you can help make this more meaningful by helping to spread the message. More input and engagement helps more clients and more clinicians. So let’s work together to make that happen.

So you can help me to do that in a couple of ways. First, if you can follow, rate, and review this podcast wherever you’re listening to it, that helps to feed that algorithm so that when a clinician is searching for something like this, this kind of podcast will come up for them. And secondly, if you can share this podcast, or better yet a favorite episode with a colleague, that’s even better.

If you’ve heard this before, and you meant to do it before, and you maybe haven’t done it yet, it’s okay. I say this every time, but it really is okay. But let this be the sign today. Let this be the sign that today is the day that you can actually do something concrete to help other clinicians, maybe even clinicians you don’t even know.

If this is your first episode, welcome. Thank you so much for listening. And hopefully as you listen, you can decide who of your clinical besties you would love to hear more of this kind of information and help them at work as well. Thank you so much in advance for your action here. And with that, let’s get back to the episode.

So let me start by explaining why I think we should use assistants as part of our practice, especially as SLPs, OTs, and PTs. Using assistants really allows you to leverage your knowledge in a way that isn’t actually that direct swap of time for money. So using assistants really allows you to increase your impact, again, both for yourself and for the amount of clients that you can impact in a way without overloading yourself.

So what that does is that allows you to potentially increase your compensation. It allows you to increase your ability to effectively take time away from work. And that’s a really big piece. I just want to pause there for a moment because I think as therapists, we often believe that all things being equal, so say if you were in a private practice, for example, that if the price was the same for a therapist and a rehab assistant, I think we often erroneously think that clients or patients would choose a therapist over an assistant every time.

I know that I offer that because I used to think that, but I’m here to tell you that it’s actually the relationship and the help that they feel like they’re receiving, not the title or the letters that we have or we don’t have behind our name. So knowing that that’s where an assistant can be a crucial relationship that allows you to more effortlessly take time away from work.

So it means that when you plan a vacation, more of your clients won’t even notice that you’re gone because they’re being seen by an assistant. And if you have clients that aren’t necessarily a great personality fit for you, be it personality or an energy level, it allows you to be able to create that bigger impact by fitting them in with an assistant who has more of that personality or energy level that they’re actually looking for.

Next, you actually can, by using assistants, you could decide that, for example, you want to change your availability. And when you do that, using rehab assistants can allow you to have your clients to be able to be seen at a time that they want to be seen, but not have you be there at the time that the clients want to be seen all the time.

And I share that because when I started Abilities 17 years ago, my children were a lot – Now they’re all in their twenties, but they were a lot younger. And so what I noticed is as my children got older, I was able to switch my availability without negatively impacting my clientele. It’s really an amazing way to be able to, again, increase the impact that you have for your clients and for yourself without negatively impacting the way that you want to work yourself as the therapist.

And finally, using assistants can really help you to be able to better fit the financial realities of your clients. And I want to offer that that’s even true if we are working in public practice or more of a government funded model, as well as private practice. Sometimes in public practice, again, I worked in public practice for years so I remember this myself, that I thought this erroneously that if it’s free for them, then it doesn’t matter if it’s ourselves or an assistant.

But I just want to offer somebody is always paying. If you are drawing a salary as a therapist, be it the government or a funding source or the patient or client themselves, somebody is paying for your services. So if you can increase your availability, and therefore it decreases the amount that each person is actually paying their portion of your salary, it really can help fit the financial realities of your clients.

Now, again, I say this because we know in the public space there are increasing financial pressures. And really, there are increasing financial pressures in the private space as well. And clinicians want to be paid fairly. I know that, and so you should for the education and the knowledge that you have. And whether you are in public practice or private practice, again, that’s coming from a place.

In public practice, your pay is coming from our taxes, especially if you live in Canada. So no matter what kind of practice environment we are in, I don’t think anytime soon we are going to have any kind of relief of financial pressures to reduce the cost of our services while maintaining a high quality service for our client or patient.

And again, those of you who are living and working in BC, this is a major upheaval and a major part of what is happening for funding for services for children with neurodiversities right now. So without going too far along that tangent, I think it’s an important example that we can bring to apply to a larger piece.

In that piece, the government has said that they actually want to use assistants. And so if we as clinicians don’t get good about using assistants, and especially what we like and don’t like as a group from a service provider perspective, the government is going to decide how we use assistants, and they’re going to decide for us and make those decisions in a vacuum.

So I really do believe that we as professionals need to get very good at using assistants quickly so that we can provide the government and other people a more educated and informed perspective on the use case for using assistants from a place of authority. So not using assistants does not allow you to inform from a place of authority. Using assistants is going to allow you to inform from a place of authority.

So that’s where I think there is a need, especially in British Columbia right now, and especially if you are working with children with neurodiversities, a place for you to decide and to experiment with using assistants so that you can help to inform the government how we do want to use it. We want to drive the ship here. We don’t want to have the ship course driven for us from a place that’s outside of us as professionals.

This change is coming, and again, we can help shape it for the best use of your clients and patients as well as for ourselves as clinicians, as service providers. Or alternatively, we can be shaped by what happens. And I want to say clearly here today, I want to shape that. And I assume you want that as well, because you’re listening to this kind of podcast. So hopefully I have convinced you to a certain extent. If not for yourself and not for your clients, but for the greater need of our profession let’s think about where we want to start.

And I want to offer there are a few ways for you to start to dabble in this. And this is where I started myself on how I wanted to extend the impact to those that I worked with. I knew, as you’ve heard before, I’ve had a long lived experience of using and loving working with rehab assistants in deliberate and specific ways. And I wanted to extend that to the clinicians that were working at Abilities. That’s my sphere of influence right now more than anything else, so that’s where I wanted to start.

So what we need to do first, I would like to offer, is to expand your competency and your confidence in working with assistants as a way to extend your clinical reach. So I like to think of using assistants as a tool. And I don’t mean in the way that they are people to be used, but in the sense of using assistants as a powerful clinical tool that I can leverage to increase the impact for both myself and the clients. So that’s how I like to think about it. That’s the mindset that I would offer that you want to start when you’re on this journey.

So just like any other clinical tool that you are using and that you have used, it will take some kind of knowledge. It will take some practice. And it’ll probably take some kind of mentoring and or coaching to help you to build that skill set. It’s not something that you’re just going to be necessarily born with, you’re going to have to get more knowledge and practice in this area to get good at it.

So I’m proud to say that we’ve just had our first therapist at Abilities achieve a level of competence and confidence through an internal certification. And I just want to offer it’s been an amazing learning opportunity for both them and for myself. One of the things that I believe we have all learned as I’ve reflected myself, and as I’ve talked to some of the therapists that have gone through this training, is the value and power in ongoing group coaching and mentoring in the challenges that will invariably come up as you use this kind of clinical skill set.

As we’ve met regularly as an interdisciplinary therapy team to discuss the challenges in the context of a multidisciplinary group, we’ve been able to be vulnerable to share our experiences and then to individually decide what the next best step is for us, again, as individuals in our own learning journey. I’ve loved it so, so much.

Now, I just want to offer that you don’t need to work at Abilities to do this. Although, here’s my shameless plug. If you are a PT, OT, or SLP, and this does interest you, of course, I’d love to talk to you more about this. Of course I would. But either way, here are some concrete ideas that you can decide outside of Abilities to create so that you can also get confident and competent in using these skills. Because again, I believe no matter where you are, and especially in British Columbia, they are coming.

So first, what I would say is find a place to learn about your own individual rules and regulations about using assistants. That’s where your own health college and their guidelines are going to be a very good place to start. Second, you want to find a safe place to start practicing using assistants. And then third, and I do believe most importantly, and again, it’s from my own experience and then as I am actively leading to mentor and coach other therapists to be able to get this skill, what I have heard from them as well is the most important thing is to find a way to get ongoing coaching and mentoring so that you can continuously uplevel your skill in this area.

So three simple things. Maybe not totally simple in application, but simple in terms of these are the things that you need to do. I have no doubt that you’ll be able to figure this out, so give it a try and let me know how it goes. Of course, it might be tricky, but I am here to help you. Yes, I’m busy. I say this every week, but it is true. Yes, of course, I’m busy, but I am never too busy to connect with you. Please feel free to email me at heather@abilitiesrehabilitation.com. Let me know how it goes and I’ll be happy to help you out with your next step.

With that, I hope you have an amazing week and I’ll talk to you soon.

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Thanks for joining me this week on the Clinicians Creating Impact podcast. Want to learn more about the work I’m doing with Abilities Rehabilitation? Head on over to abilitiesrehabilitation.com. See you next week.