Speech Therapy, Mental Health & Trauma – 10 FAQs

There are so many different areas we, as SLPs can work in. Our scope of practice is so incredibly wide and naturally that makes it impossible for us to learn everything before graduating. To add to that, Speech Pathology is a relatively new profession and is rapidly evolving.

If you’ve found your way to this page, welcome! Mental health and trauma is one of the newer additions to speech therapy and a major passion of mine. I imagine some of you reading this post are less familiar with what mental health and trauma means in speech therapy and what it might look.

If you’re hoping to gain a clearer understanding of this you’ve come to the right place! Below you’ll find the top 10 questions I get asked quite often as a mental health trauma-informed speech pathologist & person with lived experience of c-ptsd.

I hope you find this useful 🙂

Can Speech Pathologists Work in Mental Health & Trauma?

Short answer – yes!

Considering the incredibly high rates of communication needs in mental health settings, SLPs should be a core part of the mental health workforce.

Additionally, speech, language and communication differences increase the risk of abuse and mental health. Trauma also increases the risk of developmental delays and communication difficulties. 

What Does a Speech Therapist Do for Mental Health?

Speech Therapists don’t directly work with or address mental health or psychological trauma. This means we don’t diagnose, treat or advise on mental health & trauma.

However, speech therapists play important roles in mental health services and teams.

How do SLPs Work in Mental Health Without Becoming Counsellors & Social Workers?

My goals are always speech therapy specific. This means I’m always working toward outcomes that meet speech, language or communication needs. What changes is my APPROACH. I take a whole person perspective that is trauma-informed and uses bottom up brain-based approaches. I never attempt to treat or advise on mental health or trauma but work closely with mental health clinicians.

Examples of how my approach changes: I am mindful of my non-verbal communication such as facial expressions and volume (hypervigilance as trauma impacts parasympathetic nervous system), keeping my own nervous system regulated, prioritizing safety and connection, and considering window of tolerance when planning therapy tasks.

Is Upskilling Required to Work in Mental Health & Trauma?

Yes and no. At the end of the day, we’re not trying to address or treat mental health and trauma. We’re speech therapists and our goals are speech therapy specific. However, it is very beneficial to have an understanding of mental health and trauma to inform your approach and increase the success of therapy.  

I recommend seeking interdisciplinary supervision from a mental health clinician and working closely with the mental health clinician on the team. This can mean identifying joint goals, clarifying roles and discussing your approach and plans with them.

I Don’t Specialise in Mental Health & Trauma – Should I Still Learn About It?

Mental health and trauma are a part of life. Even when we aren’t personally impacted it’s likely we know of someone who has. Covid is an example of a collective trauma that has impacted all of us and as many of us have observed, has impacted speech, language and communication development as well.

An absence of mental health diagnosis or trauma history does not rule out the presence of mental health and trauma. It just means it has not been formally identified or reported.

So the short answer is, yes. Even if you don’t intend on working with mental health or trauma it’s still very beneficial to learn about. Mental health is foundational to all other aspects of life and there is a growing body of research that shows speech, language and communication differences increase the risk of mental health difficulties.

Do I Have to Adjust My Approach When I Know My Client Has a History of Mental Health or Trauma?

No. Just because your client has a history of mental health or trauma doesn’t mean you have to do things differently. A diagnosis or history doesn’t automatically mean more challenges in therapy.

However when people are dysregulated or don’t feel safe their thinking and learning brain goes offline. Understanding the impact of trauma, survival responses and bottom up brain-based approaches can really help ensure speech therapy is meaningful and beneficial.

How Do I Avoid Triggering My Clients?

Unfortunately you can’t. Even the most highly trained clinicians can trigger their clients. We’re not perfect and that’s okay. 

BUT if you prioritise safety and connection plus being present and attuned to your clients needs, my experience (lived & clinical) is you can increase their window of tolerance. This can enable our clients to tolerate more stressful situations.

What Are the Key Things I Should Know to Work in Mental Health & Trauma?

I recommend getting a better understanding of the trauma-Informed practice principals. There are a few different guidelines and principals floating around the internet, all of which are excellent.

These are the ones I personally try and follow (however remember to practice self-compassion – it’s not going to be possible to implement all the below all of the time, in particular when starting out, and that’s okay!!):

  • Understanding what trauma is and the impact it has
  • Priotising felt safety and authentic connection
  • Respecting and nurturing choice, control and autonomy (body and mind)
  • Be guided by diversity affirming practices
  • Understanding your impact on the power dynamic and taking steps to address the power imbalances
  • Following strengths-based and person-centred practices
  • Forming genuine collaborations with the client, support systems and team

I absolutely LOVE being a mental health and trauma speech pathologist. It’s so rewarding and I honestly enjoy the work! However I am only able to enjoy continued success and satisfaction because of one crucial factor, and that is self-care. I highly recommend you establish a consistent self-care routine and emotional support network that remains in place whether you’re having a good day or a bad day. It is so incredibly important to put yourself first, so the work doesn’t overwhelm you and drain the joy out of what you do.

Can Mental Health & Trauma Impact Speech, Language & Communication Skills?

Yes. It can actually work both ways. Mental health and trauma can influence our speech, language and communication development and skill access. Speech, language and communication differences or needs can impact mental health and increase risk of trauma.

How Does Speech Therapy Help Anxiety?

The word anxiety is used in many contexts nowadays so let’s look at anxiety from the perspective of mental health – an anxiety disorder.

Speech therapy itself can’t help with anxiety disorders as it isn’t a mental health treatment. However anxiety disorders originate from nervous system dysregulation and the fight/flight/freeze response. This response is triggered by high levels of stress that signal to the brain impending danger – it is a survival response.

So how does speech therapy relate to this? I won’t go into too much depth on this here. However, there’s a lot of research that shows speech, language and communication differences can increase risk of anxiety disorders and depression. Even without reading the research I think it should be pretty clear why. Anything seen as different by the majority of society is likely to be discriminated against.

Difficulty communicating needs can feel highly stressful, if not life threatening. Communication is a basic right and human need. We communicate to connect. If we can’t communicate that must surely be anxiety provoking right?

So when asked how speech therapy helps anxiety, the answer is it helps when the source of anxiety relates to speech, language and communication (or swallowing). It helps by providing solutions that can come in the form of strategies, accomodations, understanding, empowerment and much much more.