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Next Step TherapyWednesday, December 4th, 2019

Today I wrote a check to cover my monthly student loan payment. It’s always a cringe worthy moment. Each number rolling off the end of my ball point pen takes a little piece of my soul with it. As a new therapist, the memories of those classroom lectures that cost so much seem to get further and further away, and the memories of old expectations become more and more comical.

I was going to wear a white lab coat and heels… the classy ones with the pointy toes. I would have a perfect picture on my perfect name tag. People would call me a “speech language pathologist”, and my patients were always going to be cooperative and thankful for my amazing therapy services.

Meanwhile on planet Earth, I’m sitting criss-cross applesauce in the middle of someone else’s living room wearing my old sneakers and a sweatshirt sticky with, what I hope is apple juice while I sing “Wheels on the Bus” and fight a two year old for my pen and clip board.

Thinking back to all the classes I sat through, all the notes I wrote, and the exams I crammed for I can’t help but think of all the stuff they “forgot” to mention about being a therapist. There was a lot they didn’t include in those power points.

Scheduling for example, they never told you that scheduling your weekly caseload was going to feel a lot like a hostage situation. They forgot to mention that, for traveling therapists, driving would become an Olympic sport of sorts. No one ever said that three weeks into flu season, your immune system would scream for mercy. You didn’t know that in the real world, your title as speech language pathologist would be quickly replaced by terms like “speech lady, speech teacher, speech person” or my personal favorite, “lady who brings the books”. Oh, and willingness to participate…? Try telling that to the two year old who missed his nap time.

Some of the things they never mentioned were the hardest lessons to learn as a new therapist. The highlighted passages in those $300 textbooks you were forced to buy never told you that part of your job was listening to a teary-eyed single mom vent about financial issues or family drama. What do you say when a preschooler tells you that they get abused or go to bed hungry? How do you tell a parent that the feeding tube in their child’s belly won’t be coming out any time soon? Why wasn’t there a power point for that?

As my first year as a therapist continues to roll by, I realize more and more that this job means positioning yourself right smack in the middle of someone else’s craziness. It means walking right into a stranger’s home, and right out of your own comfort zone in the hopes that you will make something better. It means being comfortable in the most uncomfortable situations and being ok with your own vulnerability.

So I don’t really know if that power point exists. I don’t think that information can be found in a textbook or a bullet point because maybe it’s not something that can be taught. Maybe it has to be experienced…felt. For some lessons the “hard way” is the only way.

Humanity is something that can’t be defined or put into a box topped with a perfect bow. Sometimes it can be messy and scary and sometimes it hurts, but that’s alright, because nowhere in that freshman year day-dream did I understand just how fulfilling it would be to hobble home with sore muscles and smelling like things I’d rather not smell like, as I recalled all my successes for the day. I didn’t know that I would care so much when a child said a brand new word, or when the same mom who ranted for half of last week’s session about her electric bill, calls to say that her son called her “mama” for the first time.

Every day certainly presents its own challenges and there isn’t a playbook for any of it. I guess the only thing you can do… is the best you can do. Then wake up… put on your old sneakers, and do it again.

Ashley Ahrens

Speech Therapist


We accept most major medical insurance plans including:

  • Highmark
  • UPMC
  • Tricare
  • Health America
  • Medical Assistance Plans: Amerihealth Caritas, UPMC for You, and Coventry Cares
  • Medicare