That first call made by a patient, believe it or not ,is the difference between a patient who say’s “I’ll try” when I ask if they will practice on their own, and a patient who plots out the daily schedule, and asks: “when’s the next appointment?” When a patient says to me: "I'm not that bothered by my voice, my husband or wife is," that is a huge red flag for me. For the same reason no one ever usually successfully loses weight because someone else wants them to, few patients are going to make or retain improvements in speech and voice if they are not self-motivated.
No one but YOU, the patient, can do the work of therapy. The best intentioned spouse can drive you to appointments, provide feedback when you master a goal, but, they simply cannot play the instrument, in this case, your voice.
Once we meet for that initial appointment and for every visit thereafter, it is my responsibility, as your therapist, to continue to consider your input. Is the treatment working? Do you, your spouse, and I, all have the same or different expectations? Do you enjoy the home practice, or does it seem tedious and boring? If you, as the patient, say to me: “I want my speech and voice to sound better”, how will we measure that improvement? How will you retain that improvement? These are all things that need to be discussed on the first visit and throughout treatment.
If the treatment being offered does not seem to be producing the result you expect or desire, we need to review goals. We may need to re-evaluate the approach, and try some different methods. Even treatment approaches that are written about in medical journals as benefitting Parkinson’s speech will not resonate with every patient. If I was told, for example, that the only way I could obtain aerobic exercise was by running, I would be miserable. Why? Because I hate running. But, put me on a bike, and I will climb hills and ride the longest distance. Evidence gathered from research about the benefit of a particular approach and your personal values, motivation and goals must all be taken into account in producing a successful result.
I frequently video-tape patients on their first visit, and employ some methods that result in them, achieving a louder and better voice quite instantly. Together, the patient and I review that video-tape and analyze what they like and don’t like and establish a target goal for the future. With the video tape of their better voice now on their computer’s desktop, they can refer to it daily. Just as we might tape a photo on the fridge of how we looked 10 pounds thinner to motivate us during a diet, the video of that better voice can serve as ongoing motivation to achieve therapy goals.
Think it.....believe it...and make it happen!