The It Factor: Strategies for Developing the Therapeutic Alliance
Presented by Edie R. Hapner and Jackie Gartner-Schmidt
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Edie R. Hapner, is the Professor of Otolaryngology - Head and Neck Surgery, Co-Director of the UAB Voice Center, and Director of Speech and Hearing at the University of Alabama at Birmingham. She is Author receiving royalties from Plural Publications. She is the co-developer of Phonation Resistance Training Exercises, PhoRTE Voice Therapy LLC. She receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.
Non-Financial: Jackie Gartner-Schmidt has no competing non-financial interests or relationships with regard to the content presented in this course
Edie R. Hapner was Co-Chair, 2022 ASHA National Convention. She has no competing non-financial interests or relationships with regard to the content presented in this course
Although many speech-language pathologists (SLPs) take a seminar in voice disorders, training in the application of effective intervention strategies for use in treatment of the voice-disordered patient is all too frequently a small component of their educational training. An even smaller component of voice training is in what is being called the “metatherapy” of voice therapy. Many have referred to this category as “clinical expertise” and the SLP’s “silent know-how.” Yet, others have long referred to it as the “it factor” that master clinicians cultivate after years of experience. This clinical expertise refers to the clinician’s cumulated experience, education, and clinical skills (ASHA, 2004). This course will help the voice clinician understand the factors that take therapy from the application of voice therapy tasks to connecting those tasks to patient trust and relevancy and engaging the patient in therapy for improved outcomes and adherence. This course can and should be viewed often as the clinician moves through the MedBridge voice curriculum to refresh the perspective that the what in voice therapy is important, but the how may be the magic ingredient to success.
Meet your instructors
Edie R. Hapner
Edie R. Hapner is professor of otolaryngology-head and neck surgery, codirector of the UAB Voice Center, and director of speech and hearing at the University of Alabama at Birmingham. Among her honors, Dr. Hapner was named the George W. Barber Jr., Foundation Endowed Professor in 2021, ASHA Fellow in 2019, Associate Fellow…
Jackie Gartner-Schmidt
Jackie Gartner-Schmidt, PhD, CCC-SLP, ASHA Fellow, is co-director of the University of Pittsburgh Voice Center, professor of otolaryngology, and director of Speech-Language Pathology-Voice Division at the University of Pittsburgh Medical Center. Dr. Gartner-Schmidt’s 25-year clinical and research focus specializes on care of…
Chapters & learning objectives
1. Same Results, Different Therapy
After almost 30 years, our profession still has not identified the active ingredient of voice therapy. Although research has shown that a myriad of different voice therapy techniques/therapies work as reflected positively in such outcomes measures as quality-of-life questionnaires, acoustics and aerodynamics, etc., the theoretical foundations of why these different voice therapy techniques/therapies work has been less observed. To complicate matters further, many of these differing voice therapies are conceptually different. Said differently, the active ingredient in most voice therapy techniques/programs remains elusive. Yet, therapy works! Perhaps a component of what makes therapy work is how it is taught. Although declarative and procedural aspects of voice therapy will be discussed (the what), the main theme of this course is on the metatherapeutic approaches chosen by two master clinicians and will be succinctly described (the how).
2. Getting to Their Relevancy
One of the fastest ways to communicate concepts to people is via analogies. Analogy is the similarity of different concepts on which a comparison can be based. Achieving fast and direct relevancy of voice therapy to your patient’s activities of daily living via analogies will be discussed in this chapter. The instructors will share their tried-and-true collection of best analogies/metaphors that have withstood the test of time and instruct viewers in how to develop their own to truly communicate abstract voice therapy techniques. Clinicians need to reach the person behind the voice and make voice therapy accessible through their common knowledge.
3. Earning Their Trust
An important part of voice therapy is the process the clinician uses to guide the patient’s self-discovery of the feel and sound of a more efficient voice production. Many of the techniques are foreign to our patients and have been reported as being silly and embarrassing. Elucidating how we establish trust with our patients so that they trust the process will be discussed.
4. Developing Your Morph
It has long been known that the relationship between the clinician and the patient is important in all types of therapy, including voice therapy. Van Leer and Connor, in their 2010 article on the patient’s perception of voice therapy, found that the match matters, meaning the patient–clinician relationship is important to the outcome of voice therapy. But does this mean that we can only work with people who have similar or complementary personalities? The instructors propose that indeed the match matters but that clinicians morph their style, their instructions, and their language of voice therapy to meet patients’ needs. In other words, the clinician morphs to meet the needs of the patient, often also called “meeting them where they are” in voice therapy. The instructors will discuss the match and the morph and provide guidelines for clinicians for developing individualized, relevant, trusted, and successful voice therapy, no matter the diagnosis or the treatment protocol.
5. Finding Your Voice
This chapter will discuss the idea of whether the "it factor" is innate, developed, and/or taught. Perspectives from novice and experienced clinicians will be highlighted.