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Expanding the "Ports of Entry" for Speech-Language Pathologists: A Relational and Reflective Model for Clinical Practice

Gilbert M. Foley
Yeshiva University, New York

Contact author: Elaine Geller, Department of Communication Sciences and Disorders, Long Island University/Brooklyn, One University Plaza, Brooklyn, NY 11201. E-mail: egeller{at}liu.edu.

Purpose: To outline an expanded framework for clinical practice in speech-language pathology. This framework broadens the focus on discipline-specific knowledge and infuses mental health constructs within the study of communication sciences and disorders, with the objective of expanding the potential "ports or points of entry" (D. Stern, 1995) for clinical intervention with young children who are language impaired.

Method: Specific mental health constructs are highlighted in this article. These include relationship-based learning, attachment theory, working dyadically (the client is the child and parent), reflective practice, transference-countertransference, and the use of self. Each construct is explored as to the way it has been applied in traditional and contemporary models of clinical practice.

Conclusion: The underlying premise in this framework is that working from a relationally based and reflective perspective augments change and growth in both client and parent(s). The challenge is for speech-language pathologists to embed mental health constructs within their discipline-specific expertise. This leads to paying attention to both observable aspects of clients' behaviors as well as their internal affective states.

Key Words: mental health, relationship-based learning, attachment theory, reflective functioning

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