“Do you think they’re improving?”

In my 12-year career as a speech pathologist, I’ve heard this question from parents/carers countless
times. Given how resource-consuming speech therapy is, I don’t blame them for wanting to see
tangible results, and yet in the past, I felt my ability to measure and convey outcomes was lacking.
Over the years, I’ve tried different ways to measure therapy outcomes. I’ve created and sought out
probes, informal assessments, and surveys. I’ve even turned to the parent after they’ve asked me
that question and said, “What do you think?”

A therapy plan, if you’re not sure what it is, is a document written by the therapist at the start of a
therapy block that explains:

  • What goals you’re working on
  • How you’re going to work on it and;
  • How you’re going to measure progress

    You can download a template of our Word Stars Therapy Plan here. Click here to listen to Dr
    Rosemary Hodges explain how we use it.

    Writing a therapy plan provides me with the opportunity to:
    • Be clear about the goals for the child and how I will measure them: It is no surprise to me
      that those who state their goals are the most likely to achieve them. By linking my goals to
      outcome measures at the very start, I can make sure I use sensitive outcome measures, and
      administer these at the start, during, and end of the therapy block.
    • Make sure the parent/carer and I are on the same page: If I write a goal that doesn’t
      resonate with the parent/carer, they are able to point it out and tell me that goal either isn’t
      important to them or ask for clarification. Often parents/carers may have different
      expectations as to what therapy/progress looks like and writing down these details allows us
      to talk through and collaborate on our plan early on in our therapeutic relationship, ensuring
      family-centred practice.
    • Make decisions about what to focus on in therapy: Often children coming to therapy have
      more than one goal to work on. Selecting priorities is important for good outcomes. The
      therapy plan helps me identify and stick to my goals.
    • Problem-solve challenges during a therapy block faster, and in collaboration with the
      parent/carer      : Not all of my therapy plans have worked out exactly as planned, and it is
      probably because I failed to consider something (e.g. the child’s behaviour, a pre-requisite
      skill). Having the therapy plan allows me a starting point to discuss these challenges with the
      parent (and sometimes the child – depending on how old they are) and involve them in
      problem-solving. They know their child best after all!
      When we don’t sit down at the start of a therapy block and write down our plan, we are likely to
      miss the opportunity to define our goals and measure them using appropriate tools prior to
      implementing an intervention. This makes it so much trickier, to know “are they really
      improving?”


We could also forget to collaborate and explain our plan to parents/carers/clients, a crucial part of
being a family-centred therapist. A written therapy plan helps both therapists and families to feel a
sense of direction and clarity in the therapeutic journey they take together.
And, if something isn’t working, the therapy plan, with sign-posted moments for collecting data, can
help us make necessary clinical decisions such as changing strategies, intensity, goals, or even
ceasing therapy. With reference to our therapy plan document, we can share our clinical thinking,
and have these trickier conversations with families.
If you’d like to start using therapy plans in your practice, you can:

  • Download our free template and watch Dr Rosemary Hodges’ video on how to write a
    therapy plan.
  • Start small. Pick one client and suggest to the parent/carer that you’d like to write a therapy
    plan for them. As therapy plans are bespoke and can take a long time to write (especially if
    you’re new to this), depending on where you work, you may need to explain to the
    parent/carer that there may be a fee associated with this. You can show them our therapy
    plan template to explain what your therapy plan might look like.
  • Talk about how you can use therapy plans more regularly with your manager or direct
    supervisor.


Written by Celine Lowe Pascual, Managing Director