I have been thinking about this a lot lately. Maybe because it is the beginning of the year and insurance is demanding treatment plans. As a Speech and Language Pathologist and an Autism Specialist, insurance is telling me that therapy is all about what is researched, deemed appropriate by their “experts” and measurable within a specific time period. As someone who has worked with hundreds of families impacted by autism, I am certain that the primary needs of people with autism have nothing to do with what is easily measured, researched, and achievable in a specific time period. This has me wondering about the purpose of therapy and why anyone does it. When I ask clients, what is the purpose of therapy, I get a variety of answers. Some people believe that it is to gather strategies that help their child. Others say it is about somehow helping their child. Some even say it is to fix their child or making him/her better. As a Speech and Language Pathologist, I absolutely agree with the strategy and helping thoughts. I know that I can give people strategies to become more effective communicators. I know that helping with communication helps everyone. But how do I “fix” a child with more severe disability such as Autism or Cerebral Palsy? And how do I do this in a way that insurance deems reimbursable? When we realistically look at the needs of people with more severe disability, it is impossible to pinpoint and measure one achievable goal at a time. The needs of people with disabilities are not tied to only their mouths or ears or hands. Any disability is embedded in a real, living and deserving person. Within their body and mind. Brains and bodies are connected. If one is struggling, it is impacting the other. Every person with disability is embedded in a family. Every member is affected to a degree. The entire system is made of living, deserving people who are suffering and deserving of help. Can that help be fit into a list of black and white achievable goals that are worthy of insurance coverage?
Everyone wishes for magic pills to fix everything. Everyone knows that it is a fantasy. In my opinion, therapy is about working hard to remediate suffering and damage resulting from a disability. As a therapist for people with Autism, Cerebral Palsy and other significant disabilities, that means I need to address the whole system. Body, brain, family context. Hundreds of additional training hours and multiple certifications along with common sense support this thinking. Remediation or change (real true change in the body and brain system) requires a bigger picture of the human who is suffering. It requires individual consideration of that person in the context of their body and life. Therapy is a whole person process. And it requires hard work. Hours and hours of dedicated work to achieve change for those who have severe issues. And it is heartbreaking to see those hours spent trying to fit in the paperwork and endless phonecalls to insurance companies. Because I believe the purpose of therapy is to bring positive change and relieve suffering. I wish the funding for this change and relief was more readily available so the real work of therapy could happen for all those who need and deserve it.