Planning and Integrating Intervention

Collaborative practice

A team-based approach to healthcare where different professionals work together to provide coordinated, high-quality care through shared decision making, mutual respect, and open communication.

Multidisciplinary team

Professionals from different disciplines work in parallel, each providing separate care.

Interdisciplinary team

Professionals communicate and coordinate care with shared goals and decision-making.

Transdisciplinary team

Roles overlap, with professionals sharing knowledge and skills across disciplines.

Speech Pathologists role in an interprofessional team

Assessment and diagnosis, intervention and management, education and advocacy, and collaboration and consultation.

Competencies of communication in teams

Working with team members to maintain a climate of shared values, ethical conduct, and mutual respect; using knowledge of one’s own role and team members’ expertise; communicating respectfully; applying teamwork principles.

Strategies to avoid role confusion in a team

Clarify scope of practice, discuss overlapping responsibilities, use meetings to align care goals, and respect each professional’s unique expertise.

Barriers to implementing Evidence-Based Practice (EBP)

Time, lack of access to research, skills of clinicians, funding systems, employment setting restrictions, difficulty translating research.

Reasons students/early career clinicians accept information uncritically

Expertise gap, cognitive load, professional hierarchy, lack of confidence, desire for certainty.

Facilitated Communication (FC)

A method where facilitators guide the hand/arm of individuals with communication impairments to type; debunked due to facilitator influence.

Ideomotor effect

Unintentional movements driven by thought or image which are not conscious.

Confirmation bias

The tendency to seek or interpret information that confirms existing beliefs.

Appeal to authority

Claiming something is true because an expert says it is without connecting to evidence.

Appeal to tradition

Arguing that something is correct because it has been done that way for a long time.

Appeal to novelty

Assuming something is better because it is new or innovative.

False causality

Assuming one event caused another simply because it followed the first.

Overgeneralization

Drawing broad conclusions from insufficient evidence or small samples.

Cherry picking

Selectively choosing data that supports a position while ignoring contradictory evidence.

Bandwagon/Conformity

Believing something is correct because many people believe it.

Middle ground

Assuming the truth lies in the compromise or midpoint between two extremes.

Stereotyping biases

Making assumptions based on group membership (e.g., race, sex, gender).

Confirmation bias

Seeking information confirming beliefs, while ignoring alternatives.

Anchoring bias

Over-relying on the first piece of information encountered.

Overconfidence (cognitive bias)

Excessive certainty in one’s own judgements or abilities.

Diagnostic overshadowing

Attributing symptoms to an existing diagnosis, overlooking co-occurring conditions.

Labeling bias

Allowing a diagnostic label to influence perception of expectations.

CRAAP Test

Currency, Relevance, Authority, Accuracy, Purpose

Elements of a Searchable Question

Problem/Patient, Intervention, Comparison (optional), Outcome.

6S Pyramid of Evidence Based Practice

Systems, Summaries, Synopses of syntheses, Syntheses, Synopses of studies, Single studies.

Appraising Evidence for Practice

Strength, Relevance, Importance, Transferability

Also known as internal validity, related to the study design.

Strength

Also known as external validity

Relevance and Importance

Critically Appraised Topic (CAT)

Short summary of the best available evidence on a focused question.

Critically Appraised Paper (CAP)

Critical appraisal of one study.

Trauma-informed practice

A strengths-based framework understanding trauma impact, emphasizing safety and empowerment.

Widespread Impacts from trauma

Increase in Adverse Childhood Experience Score, Risk of sexual violence, risk of intimate partner violence, preliminary death

Key principles of Trauma-Informed Care

Safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment, and cultural considerations.

Counseling

Providing assistance and guidance to resolve psychosocial concerns.

Motivational interviewing

Collaborative, person-centered approach to strengthen motivation for change.

Key principles of motivational interviewing

Express empathy, develop discrepancy, roll with resistance, support self-efficacy.

Counselor control via response

Clinician influences conversation via response type.

Counselor control via response

Content-response, counter-question, affect response, reframing, sharing self, affirmation

SPIKES protocol

Structured approach to deliver distressing information sensitively.

SPIKES breakdown

Setting up interview, assessing client Perception, obtaining Invitation, giving Knowledge, addressing emotions with Empathetic response, Strategy.

When to refer a client for mental health support

Persistent distress, signs of mental health concerns, self-harm disclosure, needs exceeding training.

Ethical reasoning

Resolving ethical dilemmas not directly addressed by standards.

Ethical distress

Knowing what ought to be done but facing barriers.

Ethical dilemma

Two appropriate actions, but pursuing one prevents the other.

Ethical dilemma of justice

Involves distribution of resources or services.

Locus of authority issues

Issue around who is responsible for an action.

Approaches to Ethical Decision-Making

Principles-based, casuistry, ethics of care, narrative.

Principles-based approach

Considers ethical values and principles in decision-making.

Casuistry approach

Focuses on case details and draws on precedent.

Ethics of care approach

Emphasizes care relationships and various perspectives.

Narrative approach

Considers the individual's story and values.

Care Aim: Assessment/Investigation

To determine the nature and impact of the presenting problem, and to support identification

Care Aim: Anticipatory/Prevention

To anticipate and prevent/reduce the chance of any future difficulties

Care Aim: Maintenance/Stabilisation

To slow down or stabilise a deteriorating functional impact or situation

Care Aim: Enabling/Participation

To reduce the impact of the problem and increase functioning, enabling the person to take part more in their daily life

Care Aim: Curative/Resolution

To resolve the problem, or improve the person’s skills and facilitate lasting changes in these to within normal limits

Care Aim: Rehabilitation/Improvement

To reduce the problem, or improve skills, although they are unlikely to reach normal limits

Care Aim: Supportive/Adjustment

To facilitate change in feelings, attitudes, and insight about care and/or the presenting problem

Care Aim: Palliative/Comfort

To increase comfort although the impact of the problem/condition and the impact on daily life remains the same

Reasons to provide group therapy

More clients, naturalistic environment, generalisation, multiple skills, support network, cost-effectiveness.

Considerations for implementing group therapy

Setting and Environment, Dynamics of the Group, Group Structure, Individual Group Members

Telehealth

Providing healthcare remotely via telecommunications technology.

Telehealth service delivery

Synchronously and Asynchronously

Key telehealth methods

Real-time audio/video, remote patient monitoring, store-and-forward.

Face validity

If there is no evidence, does it at least appear to do what it says it's going to do?

What to do if there is limited or low levels of evidence to use telehealth for a given intervention?

Face validity; Client decision-making; and Monitor

Considerations for planning intervention mode or approach

Client related-factors, Efficacy, Acceptability, Practicality, and Ethics