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Have you ever walked into a session only to realize your client doesn’t want to be there? Host Sarah Baar, MA, CCC-SLP, sits down with colleague Treasyri Williams Wood, SLPD, CCC-SLP/L, CDP, to discuss why we should lean into—rather than pull away from—client resistance in speech therapy. They dive into the “clinical artistry” of developing discrepancy and rolling with discord, specifically for those living with Parkinson’s, aphasia, and dementia. This episode offers you actionable counseling-informed strategies to ensure your patients feel heard, valued, and motivated to fight for their own voices.

Learning Outcomes

• Analyze the evidence on the use of motivational interviewing (MI) as a behavior change framework for individuals with neurodegenerative conditions
• Apply evidence-based, practical strategies to actionably address ambivalence and engagement barriers by adapting core MI techniques for cognitive-communication challenges
• Solve patient case scenarios involving varying levels of therapy readiness to collaboratively establish meaningful goals and sustain engagement

Timestamps

• (00:00:00) Welcome
• (00:00:05) Introduction and the reality of client resistance
• (00:00:36) Welcome to Speech Scope and guest introduction
• (00:02:20) Dr. Williams Wood's background and professional roles
• (00:05:02) Why we must discuss motivation in neurogenic care
• (00:11:00) Case study: Mr. James and the power of self-reflection
• (00:17:50) Defining motivational interviewing (MI) and key principles
• (00:23:35) Developing discrepancy and rolling with resistance
• (00:28:40) Supporting self-efficacy and building clinical wins
• (00:31:26) Audience Q&A: refusals, research, and dementia care
• (00:42:59) The DARN roadmap: eliciting change talk
• (00:47:00) Applying DARN to clinical goals and identity
• (00:53:38) OARS: communication tools for the therapeutic session
• (00:59:20) Actionable takeaways and double-sided reflections
• (01:04:00) Addressing grief and apathy in the clinical setting
• (01:09:49) Final wisdom and closing remarks

Speech Scope is brought to you by Medbridge. If you’d like to earn continuing education credit for listening to this episode and access bonus takeaway handouts, log in to your Medbridge account and navigate to the course where you’ll find accreditation details. If applicable, complete the post-course assessment and survey to be eligible for credit. The takeaway handout on Medbridge gives you the key points mentioned in this episode, along with additional resources you can implement into your practice right away.

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