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Counselling

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Counselling and the speech pathologist's role
Referral to professional counsellors
References

Counselling and the speech pathologist's role

Counselling of the client and family members has been stated as part of the speech pathologists role (Pollens, 2004; Parkinson & Rae, 1996; American Speech-Language-Hearing Association, 1990), and is an essential component of care for palliative clients and their families (Palliative Care Australia, 2003).

According to Parkinson and Rae (1996), counselling in speech pathology may involve the following:

Exploration of feelings, thoughts and behaviors so that the client can come to terms with their problems.
Assisting the client to exercise autonomy so that he/she can take responsibility for making a change in their lives.
Listening actively and empathetically to clients and families.
Teaching skills and informational counselling (e.g. regarding appropriate intervention).

All of these counselling skills may be applied in the palliative care setting, however some may be more applicable when taking into consideration quality of life issues and the minimised focus on curative intervention in palliative care.

Referral to professional counsellors

Referral and liaison with professional counsellors, social workers and pastors/chaplains is an important counselling consideration when counselling a client and/or family* (Nardi, Ornelas, Wright & Crispell, 2001; Thompson, Rose, Wainwright, Mattar & Scanlon, 2001). It may be appropriate in palliative cases for speech pathologists to refer clients and their families to a grief counselling service. Grief counselling services have been found to be effective with bereaved individuals following loss of a loved one due to terminal illness (Sheldon, 1998; Worden 1991). Professional counselling and self-help services (beyond the role of the speech pathologist) can also reduce the risk of psychiatric and psychosomatic disorders (Worden, 1991).

References

American Speech-Language-Hearing Association (ASHA) (1990). Guidelines for the delivery of speech-language pathology and audiology services in home care. ASHA, 33, 29-34.

Palliative Care Australia (PCA) (2003). Palliative case service provision in Australia: A planning guide. Retrieved June 10, 2005, from http://www.pallcare.org.au/Portals/9/docs/publications/Planning%20guide2003.pdf

Parkinson, K., & Rae, J. (1996). The understanding and use of counselling by speech language therapists at different levels of experience. European Journal of Disorders of Communication, 31(2), 140-152.

Pollens, R. (2004). Role of the speech-language pathologist in palliative hospice care. Journal of palliative medicine, 7(5), 694-702.

Nardi, D., Ornelas, F., Wright, M., & Crispell, R. (2001). Clergy and social workers' attitudes towards death and palliative care in an acute care setting. International Journal of Palliative Care, 7(1), 30-36.

Sheldon, F. (1998). ABC of palliative care: Bereavement. British Medical Journal, 316(7129), 456-458.

Thompson, M., Rose, C. Wainwright, W., Mattar, L., & Scanlan, M. (2001). Activites of councellors in a hospice/palliative care environment. Journal of Palliative Care, 17(4), 229-236.

Worden, J. (1991). Grief counseling and grief therapy: A handbook for the mental health practitioner. London: Springer.

Please note: Asterisk (*) indicates that information is based on the survey responses of 13 experienced speech pathologists working in palliative care in Victoria.

Disclaimer: The purpose of this website is to provide speech pathologists with a summary of the available evidence-base and current practice when dealing with patients in palliative care. The guidelines provided may be used as a guide for providing palliative care; however, cases will undoubtedly arise for which our findings may not be readily applied. The information contained in the website is not intended to prescribe specific procedures to use with palliative patients referred to speech pathology, but rather aims to assist speech pathologists by outlining the available evidence base and current practice methods used in the area. Information regarding current practice in palliative care was obtained from surveying thirteen speech pathologists with experience working in palliative care. It must be noted that not all speech pathologists surveyed contributed equally to all sections of this website.

© Copyright 2005.
Website developed by forth year speech pathology students Jane-Frances Gooden, Courtney Jones, Alyssa Mann, Marita McDowall and Jo Shugg. Supervised by Louise Brown.
School of Human Communication Sciences, La Trobe University, Melbourne, Australia.