Listen to this and all the previous episodes.

We get a lot of questions about Speech and Language Therapy careers. It’s a hugely rewarding area of work where you support and care for people of all ages who have difficulties with speech, language, communication, eating, drinking and swallowing.

York graduate Jess is a Speech and Language Therapist working with adults with learning disabilities. Find out about what she does each day and how she got there.

Jess’s bio:

Jess graduated as a Speech and Language Therapist in 2019 and now works as an NHS Specialist Speech and Language Therapist in an Intensive Support Team for adults with learning disabilities. Jess is also a Speech and Language Therapist for the Down Syndrome Training and Support Service.

Useful links:

• How to become a speech and language therapist
• Speech and language therapist job profile
• Health – Allied Professions job sector page
• Jess’s profile on York Profiles and Mentors

Transcript:

Kate: 

You’re listening to the ‘What Do You Actually Do?’ podcast. Each week we want to bring you an inspiring interview, a useful tip or encouraging message to help you find your place in the professional world. 

Hello and welcome to this episode of ‘What Do You Actually Do?’. My name is Kate Morris, and I’ll be your host today. In today’s episode, we’ll be talking about working in speech and language therapy. Today we’re joined by Jess Foley, who works as a speech and language therapist with both the NHS and a charity supporting people with Down’s syndrome. So, Jess, what do you actually do? 

Jess: 

Yeah so, thank you so much for having me on this podcast to talk about my job. So yeah, I’m a specialist speech and language therapist in an intensive support team for adults with learning disabilities. So, I work in the NHS as part of a multidisciplinary team with nurses, occupational therapists, and psychologists, and psychiatrists. And my team, we work with adults with learning disabilities who are going through a bit of a tough time, and they might have hit a bit of a crisis in their life, really. And my team, we have sort of two aims. The first aim is to prevent avoidable admission to hospital under the Mental Health Act. Because we know that when people with a learning disability go into hospital under the Mental Health Act, they tend to have poorer outcomes, so we work to prevent that as much as possible. And then the other key aim of our team is trying to work with people, so they don’t have to move out of their home, so we try to prevent what we call ‘placement breakdown’. And then, where I kind of slot into all of that is, I’m the only speech and language therapist in the team, so I have responsibility for the communication needs of all the patients on our caseload. And it differs for each patient – it’s very, very different. But kind of overall my role is to promote and facilitate effective functional communication for all our patients. So, for example, if we had a patient who they were seeing an increase in behaviours, and staff weren’t sure if they could support anymore, it’s kind of my job to look at that behaviour and think what is that person trying to communicate to us. Are they trying to communicate that they’re in pain, but they’re not able to say that through their words? Are they trying to communicate that they’re feeling really sad? Maybe their favorite member of staff has left. And then trying to work with the staff in the setting to support them, to be able to support the person to communicate more effectively – in a nutshell. 

Kate: 

That’s really interesting. So, I hadn’t kind of thought about the speech and language therapy in the context of a whole kind of suite of care for somebody. And how, if they can’t communicate, that could have a massive impact on their mental health and their well-being, and their safety, and all of these other things. 

Jess: 

Absolutely. So, another part of my job is to support patients to understand what’s happening. So, if they’re going through a really difficult period in their life and they have difficulties understanding language anyway, if they’re going through a bit of a crisis, that level of understanding and the ability to understand normally decreases. So, part of my role is to go in and try to support them to understand what’s happening. So, the psychiatrist might have prescribed them a new medication to try and help with their mental health. It’s my job to go and try and explain to the patient in a way that they can understand what that medication is, why it’s important that they take it and what might happen if they don’t take it. And that can be creating easy read letters for the patient, or going to visit and taking out symbols or photos or pictures, and trying to support that understanding. 

Kate: 

That’s interesting. So, it’s also about you communicating with the individual as well as helping them to communicate with you. 

Jess: 

Yes, exactly. It’s a two-way street. 

Kate: 

So what like, in terms of actual practical tasks then… So you say you’re trying to prevent people from going into hospital, and kind of these outcomes and stuff. Like, what do you do? Are you teaching people? Is it like, you know, a physiotherapist might help someone exercise muscles in their body to sort of get movement back. Is it the sort of exercises you’re doing with people? Is it increasing their vocabulary? What sort of things do you do? 

Jess: 

So, it’s quite varied. So, part of the role is to assess somebody’s communication needs. So, we have a range of different assessment tools that I would take out with me and use with the patient. So, it’s basically looking at different pictures and asking questions about different pictures to try and get an idea of where their level of communication is at. And then there’s different kind of evidence-based interventions that we might offer somebody to try and promote functional communication with others to try and reduce isolation, so that can look like trying to set up social groups within a supported living environment. And another part, like you say, is using symbols and signs. So, I create quite a lot of resources, so there’s quite a lot of resource making, and then taking those resources out to the person setting, and helping staff to be able to understand how to use those resources and those symbols with the patient. So yeah, quite creative as well, yeah, there’s quite a creative part of the role. 

Kate: 

So, you’ve had an interesting career path, because you did a degree in French and Hispanic studies and did a number of sort of teaching related jobs after graduation, and went on to complete a PGCE in languages. Then you made a career change and undertook a degree in speech and language therapy. So, what was your starting point and where did your interest in speech and language therapy come from? 

Jess: 

Yeah, I took a very sort of wandering path to this profession. So after my French and Spanish degree I was a teaching assistant for a year. And I absolutely loved it, and I thought teaching was the route to go down. But I kind of soon realised that actually teaching wasn’t my passion, and what I enjoyed most about the teaching assistant role was that one-on-one relationship that I was able to build with people to try and improve their life really. And it was just by chance that I had a friend from my first degree, and he texted me one day and he said – “You’ve got to look into speech and language therapy, I think you’d absolutely love it”, because he was studying to be a speech and language therapist at the time. And I was like – “What is speech and language therapy?” – it never crossed my path before, I wasn’t aware of it at all. So I googled it, and I was like – oh yeah, this sounds like it’s up my street. And then I did a bit more reading and I was like – absolutely 100% this is the job for me really. But the kind of experience I got through teaching I think was invaluable in helping me secure a place on the speech and language therapy course, because I had lots of experience of sort of reflective practice, working with different professionals, working with children who might have speech and language therapy needs in the classroom. So, although it was sort of a long route to the career, at the end of it, the teaching aspect I think really helped me to get there in the end. 

Kate: 

Yeah, and when you were speaking earlier about creating resources and adapting your communication, facilitating others’ learning, training other members of staff as well – it does really link well with those skills that you would have been developing as a teacher. 

Jess: 

Yeah, absolutely. And the PGCE that I did at York was a great kind of like bedrock for the skills that I still use today. Like you say, when I’m delivering training to staff, all the skills that I learned during my teaching are so useful and I use them almost on a daily basis now. So yeah, there’s lots of different kind of elements to my job role, but definitely training and teaching staff is one of them.  

Kate: 

So it’s lucky your friend thought of you. 

Jess: 

So lucky. I would never have heard of it really, I would have never known about it. 

Kate: 

I think it’s pretty common. We’ve all heard of being a teacher and some other sort of core professions, and actually sometimes you’ve just got to get started with something to then learn about other areas. And also it sounds like it was a useful experience for you to learn and refine your ideas about what you did and didn’t enjoy, so you knew there was something that you enjoyed about helping people, supporting, teaching, but actually it was that one to one and pastoral staff rather than necessarily the group work and all of those kind of elements of it. So I think sometimes you got to try stuff out to then understand yourself and what options are better. 

Jess: 

Absolutely, yeah! Because I loved being a teaching assistant, but like you say, it was only when I was kind of six months into teaching and I was like – I’m not loving this like I loved my last job, what’s going wrong here. And then I was like – OK, it’s not that I’m, like, super passionate about the subject that I’m teaching, it’s that I’m super passionate about trying to help people, and I wanted more of that element than I did teaching the French and Spanish. So yeah, it was useful because it showed me kind of what I wanted more of, and what I kind of wanted to steer away from in a way. 

Kate: 

So, you could have done either a masters or another undergrad degree in speech and language therapy. What made you choose to do another undergrad? 

Jess: 

So, I actually did get onto a Masters, but that would have involved moving down to London and at the time I didn’t have the funds to do it. And my poor parents, bless them, let me move back in with them. When I said – “I got this great idea, I want to leave teaching and I want to be a speech and language therapist.” They said – “Ok, right, you can move back in.” And Leeds was the nearest university to where my parents were, and luckily they had an undergrad course, so I applied to the undergrad course, just sort of by convenience really. But then when I looked into it more, the undergrad course gave much more time for placement, and kind of exploring different areas of speech and language therapy, and that really appealed to me as well, being able to have lots of different placement experiences. Leeds Met now does run a Masters programme which wasn’t available when I trained. So when I was looking and I was applying for speech and language courses, Leeds Met only ran an undergrad course. But they now do run a Masters, which I think is great that we’ve got a university kind of nearer to York that offers both the Masters level and the undergrad level for people wanting to get into the career. 

Kate: 

And they’re both funded, right? 

Jess: 

I would have to do my research… 

Kate: 

I had a look, and it looked like most of them are funded through – well at the moment – through NHS bursaries and things. So I think that’s another important point – if you’re doing a medical-related degree, sometimes there is funding. But I assume, obviously, your cost of living etcetera, that’s why you moved back in with your parents. 

Jess: 

Yeah, so I got a slight – when I was training a few years ago now – there was a slight cost of living like a bursary available through NHS, but it was very minimal, it wasn’t a lot, which is why I didn’t move to London to do the Masters because it wouldn’t have covered even rent, so it wasn’t a lot, But I’m sure… Because if it was my first undergrad, I would have been able to apply through student finance for the full whack, the full student finance, maintenance loan, all of that. But because it was my second undergrad degree, I didn’t have access to that. 

Kate: 

We’ll be putting links to where people can research this information and get the latest information.  

Jess: 

It’s quite complicated and it changes, doesn’t it? Who’s in government and what’s going on so. 

Kate: 

Yeah, they all like to play around with it. All right, so you’ve you mentioned like loads of skills from teaching that have been useful. What other kind of personal strengths or qualities would you say you need to have to be both happy and successful as a speech and language therapist? Because it sounds like a really multifaceted role.  

Jess: 

Yeah, it is a very, very varied profession. And I think that one of the absolute strengths of the profession is that it is so varied. So, we’ve got speech and language therapists who are working with premature tiny babies on neonatal units, helping them with their eating and swallowing, and then we’ve got therapists who are working kind of throughout the lifespan up to kind of elderly patients helping them with their eating, drinking, swallowing and communication as well. I think the strength and qualities are the same for whatever population you’re working with. I think you have to have empathy, and you have to be able to have kindness and compassion towards your patients. They’re the kind of the real key values and qualities that you need to have. You need to be passionate about communication, that’s really key, and/or helping people with their swallowing. So, it’s kind of a forgotten part of our profession really, cause it’s not in our job title, but lots and lots of speech and language therapists work with patients who have dysphagia, which is difficulties with eating, drinking and swallowing. So yeah, a passion for communication and/or swallowing is key. And I think being able to be resilient is really, really important. To be happy at work, I think you need to have a certain amount of resilience. You know, being realistic, we’re working in the NHS and it’s a climate that’s out of our control. We’re working under enormous pressure with limited resources, and you have to be able to have a certain amount of resilience at work to be able to cope with some difficult situations. And you will be working with patients who are, you know, going through a tough time and there might be some sad situations that come up at work, so that element of resilience is really key. And also knowing when to turn off, so, you know, when you come home and you shut the door, that’s it, work is finished and now you’re focused on home life. That’s also really important.  

Kate: 

That’s interesting – your point around resilience there. So it sounds like it’s resilience actually within the context of your work, so the employment context and the kind of challenges that come with that, and government funding as we were just saying. But also resilience for the actual nature of the work, so the patients that you’re dealing with. And I guess for you, if you are, as you say, seeing sad situations or people struggling, or having difficult time, that could really be very upsetting. So it’s learning how to cope with that, and as you say, be able to shut the door on it when you get home. 

Jess: 

Yeah. And I work for a great organisation. I think most of the NHS trusts, they have an excellent offer in terms of helping the staff’s well-being. I can access loads of different courses and they put on lots of different kind of well-being events for us. So the support is there within the NHS, you just need to know when you need to access it. And yeah, some of the work is tough, but the teamwork within the NHS – or my experience of the teamwork within the NHS – has been absolutely amazing, and the support that you get from your colleagues is second to none and it’s invaluable in supporting you through those difficult situations. But you never face it alone really, there’s always somebody that you can turn to and talk to. There’s always support that you can access, but, you know, you need to have a certain amount of personal resilience to be able to get through it. 

Kate: 

So, thinking about that then, what would you say is the thing that you love most about the work, and then the worst aspect of the role? 

Jess: 

What I love most about the work is when you get a good outcome for a patient, it’s just an incredible feeling. So, if we manage to kind of secure somebody’s home or secure somebody’s placement, so they’re not having to move out, and we’re able to kind of improve that situation and they’re able to kind of move on from this difficult period and engage back into their life again – it’s just unbelievably rewarding, and that kind of keeps you going, it’s just incredible. The most difficult part of my work probably is working within the political landscape that we’re in at the moment. You’re working with a limited number of resources, and often working with colleagues in adult care, and the situation in adult care is extremely difficult at the moment, and you’re trying to work to get the best outcomes possible for your patients, but sometimes when the options just aren’t there for them, that can be extremely frustrating. 

Kate: 

Yeah, it must be. So, thinking about the future then, what do you think the sort of key challenges will be for the speech and language therapy sector over the next few years? Is it just this continuation of lack of government funding and the challenges that brings, or is there anything else that would be useful for students to think about, perhaps research or anticipate, if they want to break into this sector? 

Jess: 

Yeah. So I think like as I touched on earlier, speech and language sector is so varied. So like I said, we’ve got speech and language therapists who are working with premature babies, we’ve got speech and language therapists who are working in school settings with children with developmental language disorder and autism. We’ve got therapists who are doing amazing work in prisons to improve the outcomes for prisoners, we’ve got therapists who are working with homelessness projects to support people who are homeless. And each sector I think is going to have its different challenges over the next few years. In my sector, so learning disabilities, I think the challenge that we’ve been working on but is still going to continue – is trying to reduce health inequalities for people with a learning disability. So a woman with a learning disability dies 18 years earlier than woman without a learning disability, and a man with a learning disability on average dies about 14 years earlier than a man without a learning disability. So there’s still a lot of work that’s needed to be done to try and reduce those inequalities, and speech and language therapy is a key part of that communication, and raising people’s awareness around communication is key to that. In terms of kind of thinking about the pediatric setting, I know that there’s been some research that’s come out this week by the BBC, just kind of on the impact of COVID. So the number of five and six year olds who need speech and language therapy has risen in England by 10% in the past year. So I think we’re only just starting to see kind of the impact that COVID is having on our children, and that’s going to be huge over the next few years for the profession to have to try and cope with that increase in demand. 

Kate: 

So with the different specialisms, is that something that you pick when you’re training? Or is it something that you kind of apply for your first job and then you continue on that path? Or is it quite easy to change lane and like flip between the different specialisms? How does that side of it work? 

Jess: 

Yeah, so the speech and language therapy degree, you qualify to kind of work in any setting. In Leeds Beckett, when I was training, we got an option to kind of put down what setting you wanted to be in your final placement. And that was kind of then trying to sort of steer you to what would you prefer, which placement setting would be good for your final placement so that you can then go and apply for a job in that sector. The first job you get is, you’re at a band 5 level, and that’s normally kind of, even though you’re in a specialism, it’s normally quite generalised. And then you normally work at a band 5 level for a couple of years, and after doing sort of a generalist role, you then apply for a band 6 role, which is the level up. And that’s when you become more of a specialist in a certain area.  

Kate: 

And that’s just based on your interest or what’s available at that time? 

Jess: 

Yeah, absolutely. Based on what you’re interested in, if you had… When I was training, I was dead set that I want to work with children. And then I had a fantastic placement in an adults with learning disability setting, and that completely changed my mind and I was like – right, that’s it, I want to work with adults with learning disabilities now. So it’s just kind of what you’re interested in as the course progresses, really, what sort of catches your eye and you think – yeah, that’s the area for me. 

Kate: 

Could you switch? Could you, like, if you decided – “I actually want to work with children again now”, could you apply for those specialist roles within the sort of pediatrics and that kind of thing? 

Jess: 

It’s not as easy to. Once you’ve applied for the sort of band 6 role, band 7 role, you’re kind of then sort of set on that journey with that sector. But that’s not to say that you can’t… I have known therapists who were working with adults who had a stroke for quite a long time, and they decided that they wanted to change and they wanted to work with children, and they did that. So it’s not common, normally people, once they’ve chosen their area of specialism, they sort of stick within that. But it is definitely possible to change between. 

Kate: 

It sounds like the undergrad or masters are a good place to sort of get those placements and test it out, and find out what you enjoy doing the most. 

Jess: 

Exactly. And on your course you will have a range of placements, so you’ll have placements in lots of different settings. And exactly like you said, that’s the perfect opportunity to test out what you like, what you don’t like. And if there are any students listening, I would say go into every placement with a complete open mind, because you just don’t know. You might absolutely fall in love with it, and that might be the area that you really want to go down. 

Kate: 

So the students who aren’t studying speech and language therapy, who might be doing a different sort of linguistics degree or a different subject like yourself – any tips for them for getting experience? Cause I know with healthcare stuff it can be really difficult to get actual work experience to test it out. Is there anything that they can do to give themselves a taster of what it might be like, develop relevant skills, help them kind of stand out in applications. 

Jess: 

Yeah, so it is quite difficult to get work experience, but I would say call around your local speech and language therapy departments. Sometimes departments will offer half a day experience, a day experience. And so, yeah, call around kind of your local hospitals and see if there’s anything that they can offer you. And then I would look at, as well, at the charity sector. So are there any local charities that are working with people with communication difficulties, maybe supporting people after they’ve had a stroke. And is there any volunteering that you could do with those sorts of charities that would enhance your application. 

Kate: 

But it sounds like being proactive about it rather than just hoping to see an advert for a placement. 

Jess: 

Absolutely. I rang 6 hospitals. I was determined, and I just kept ringing until somebody would offer me half a day. Yeah, but absolutely be proactive, because yeah, they’re not going to advertise it. You need to be able to show that you want to go after it.  

Kate: 

Well, that’s brilliant. So for more info about the areas that we’ve mentioned today, I’m going to add some relevant links to the episode description and a link to the full transcript of today’s show. But, Jess, thank you so much. That’s really interesting and thank you so much for taking the time to do this and speak to us today.  

Jess: 

Ohh, thank you very much for having me. Thank you.