Why One SLP Added Health Coaching to Her Speech Therapy Practice

Tracy Klein spent five years building a mobile private practice in Denver. She was seeing kids at private schools, contracting with early intervention, and doing good work. But something kept nagging at her.

Families weren't following through. Not because they didn't care, but because they were overwhelmed. The standard approach of sending home a list of strategies and spending five minutes with a parent at the end of a session just wasn't cutting it.

So Tracy did something most SLPs wouldn't think to do. She enrolled in a health coaching certification program. And what she learned there changed the way she practices speech therapy entirely.

The Expert Model Is Broken

Tracy's frustration will sound familiar to any therapist who's spent time in the field. You show up, you do the session, you write beautiful reports, you send home homework. The homework doesn't get done. You try again next week.

"I think that model is very outdated and ineffective," Tracy says. "We're supposed to be the driver of doing all of it, and we give a little bit of homework, and we spend five minutes with the parents, and they don't know how to do it, and it doesn't get done."

The problem isn't that families don't want to help their kids. It's that therapists are trained in an expert model where they teach, direct, and prescribe. Coaching is a fundamentally different mindset. Instead of telling parents what to do, you guide them to figure out what's most important and how they can make it happen within the context of their actual lives.

That distinction matters more than it sounds like on the surface.

Strength Spotting Over Strategy Dumping

One of the biggest shifts Tracy made was adopting "strength spotting" from positive psychology. Rather than walking into a session focused on what needs to be fixed, she looks for what parents are already doing well and names it out loud.

She shares a story about a dad in early intervention. He told her at the start of the session that he thought his child would be fine. Instead of pushing back with clinical concerns, Tracy decided to reinforce him. She spent the session pointing out everything he was doing right with his child.

"After the session, the dad sent me a text and said, 'That was really helpful. I'm on such a high that I'm doing a lot well with my child.'"

Tracy recommends Character Strengths Matter by Shannon Polly and Catherine Britton for anyone interested in this approach. It covers 26 different character strengths and how to spot them in action. The core idea is simple: when you build a parent's confidence first, they're far more likely to engage with the work you're asking them to do.

Coaching Families Through Stress, Not Around It

Here's where the health coaching training really pays off. Tracy describes working with an early intervention family where the mom was under serious stress. If Tracy had gone straight into speech therapy strategies, none of it would have landed.

"If I don't address some of that to support her, to be able to show up in a way to support her child, I feel like all the strategies I'm going to share regarding her child are not really reachable for her."

So she starts with the parent. What's causing the stress? What can you do about it? What areas do you want to work on? Then they transition to talking about the child's communication. It's a layered approach that treats the family as a system, not just the child as a case.

This is a real gap in SLP training. Tracy puts it bluntly: "We're taught that we're supposed to coach, but now that I've really learned how to coach, I don't feel like those coaching skills are taught very well in our profession."

Telehealth Made Parent Coaching Better

Tracy was already doing teletherapy before COVID pushed everyone online. But the pandemic accelerated something she'd already been noticing: telehealth actually improved parent involvement.

With in-person sessions at schools, parents were often absent. With telehealth, Tracy requires a parent or nanny to attend every session. They watch, they participate, they talk about what happened afterward. It's baked into the model instead of being an afterthought.

"I have a parent or a nanny attend all the sessions so that they're also part of it and that they are doing some of it, and then we talk about it. It's more of an integrated approach."

For her early intervention caseload, telehealth and coaching are a natural fit. Early intervention is already a parent coaching model. Adding real coaching skills on top of that framework made it dramatically more effective.

Building Two Businesses Without a Brick and Mortar

Tracy deliberately never opened a physical office. She built her speech practice by networking with private schools, taking referrals through word of mouth, and contracting with early intervention. Parents pay privately or through HSA funds. The schools are happy to have a resource they don't have to put on staff.

Her health coaching business, Inspired Health and Wellness, is still new. She's taking data, planning continuing education courses for SLPs, and thinking about offering parent groups focused on stress management and showing up as the kind of parent they want to be.

The two businesses are merging naturally. Coaching skills make her a better speech therapist. Speech therapy gives her a built-in audience for coaching. And neither one requires a lease.

For therapists feeling burned out by the traditional model, Tracy's path is worth studying. The disconnect she identified, between knowing the strategies and actually getting families to implement them, is one that better coaching skills can bridge. And it doesn't require a career change. It requires a mindset shift about what your role actually is.

Running a practice without a brick and mortar office means your systems have to be solid. ClinicNote is a HIPAA-compliant EMR built for private practices and university clinics, handling documentation, scheduling, and billing in one place so you can focus on the families you serve. See how ClinicNote works.

Transcript

Kadie: You are listening to Clinic Chats. Clinic Chats is a multidisciplinary therapy podcast that was created for students, professionals, clinic directors, and supervisors. Clinic Chats is bridging the gap between graduate programs and professionals, sharing personal journeys of the smallest of private practice startups, large and expanding practices, as well as university clinic triumphs and tribulations. We hope you'll find our podcast informative and helpful in your career endeavors. Clinic Chats is sponsored by ClinicNote, an electronic medical record company for private practice and university clinics. ClinicNote was designed to make scheduling, documentation, report writing, and billing effective, efficient, and HIPAA compliant.

Kadie: Today I have Tracy Klein, who is joining me to be featured on the podcast. Tracy is in Denver, Colorado, and her business is called Ready, Set, Talk. It's a speech and language business. However, she's going to also talk to us about her most recent endeavors in a health coaching business called Inspired Health and Wellness. So before we get started, hi, Tracy.

Tracy: Hi, thank you for having me on your podcast.

Kadie: Typically, we get started with a story on how you first began into private practice in general.

Tracy: I have been working in speech and language private practice for about five years. I had before that been doing primarily outpatient clinic associated with a few different children's hospitals, one here in Denver and then also in Cleveland at the Cleveland Clinic Children's Hospital. And I made the switch at about the time my oldest daughter was entering kindergarten and just kind of wanted the flexibility and the freedom and creativity to do something different. It was sort of a family lifestyle choice and just personal desire to have that autonomy.

Kadie: And was there a lot of stress at that time and how do I start a business and keep finances afloat or are you fortunate enough to maybe get started slowly and not have that stress factor?

Tracy: I mean, I feel like there was a little bit of that. I didn't need to have a full caseload off the bat, but what I did do at the time was I contracted with our local early intervention department and received referrals through early intervention while I was also building up some private practice. So I felt like that gave me a steady stream of options and I still actually have not done an office, like a brick and mortar office, which is a way I contemplate about, but I go to a few different private schools and have networked that way and have developed relationships with the schools. And then I also do telehealth as well, which I've been doing primarily during this COVID time.

Kadie: So even before COVID, you were doing some teletherapy and then just going to schools, no homes?

Tracy: Well, the early intervention is home-based, so I was doing some home.

Kadie: You were doing it. Okay. Through early intervention, but private practice, I was going to a few different private schools.

Tracy: Yeah.

Kadie: I see. Gotcha. And so you were doing that for how many years and then you started considering a new business as well?

Tracy: Yes. I've been doing the private practice for about five years and I would say probably the last two years, just in my own personal life, I'm also a triathlete and I was just kind of coming up on age 40 and thinking more about health and just really interested in different health podcasts and listening and decided to pursue a certificate program in health coaching. And it's been over the past year and as I have been doing that program, I've also seen so many opportunities within what we do as speech and language therapists to support families more broadly.

Tracy: Probably one of the things that I was feeling a little bit frustrated about in speech and language was sometimes the lack of family support or progress in families because the common lingo that we're just so busy, we don't have time or not really knowing what to do. And as I've been going down this health coaching road and learning more really coaching strategies, which can be implemented for any kind of behavior change, I'm seeing such better progress with families and really engaging them in a new way, which has been really exciting.

Kadie: Wow. Yes. That is awesome. And so typically, as far as contracting with a school, will a school be paying you?

Tracy: So no, because they're private schools. What I do, and I think this year will look a little different, but I network and it happened very organically. I did initially also contract with some insurance panels and so I received some referrals that way and just word of mouth. Some of the early intervention kids who aged out wanted to continue services and then I saw them at their school. But a lot of time it was the principals or the teachers giving the families my contact information and then the families are private paying or using their HSA funding, things like that to pay.

Tracy: But a lot of times the private schools, that's part of where I think as a private practice therapist, we can support them because they don't have the resources to be providing those services.

Kadie: And so typically, do families reach out to you and then the school allows you to come or is it the school reaching out to you?

Tracy: It can be both. In some cases, a principal at one of the schools or a director at a preschool will say, we gave your information to a family and you'll be hearing from them or I'll just hear from them. But often I know that someone is going to be reaching out and I would say the key is really maintaining good relationships with the administrators of those different schools and they've been so appreciative to have a resource that's not on staff, that they don't have to pay necessarily, but able to still direct their families to be able to get the help that we need.

Kadie: Yes, absolutely. And so if you recall, when you first started your speech and language business, how did advertising yourself first start out? I know you had your early intervention clients and that's fairly straightforward, but any additional clients, how did you market yourself?

Tracy: I have a Facebook page. I have received some referrals through Facebook, again, through the insurance panels. I've received quite a few referrals. I'm no longer on the insurance panels. I think it depends on where you live and what area. I happen to live in a pretty suburban area, fairly densely populated. So I feel like there's quite a bit of need where I am. I have found in my experience that word of mouth and networking really has been the primary way that I've received most of my referrals. I have not done a lot of advertising, but I do think the Facebook page can get some traffic. I think posting meaningful information on there that drives people and drives their interest can be helpful as well.

Kadie: Right. Yeah, absolutely. Well, it sounds like it's really worked out nicely with a little stress, but I know that that's not necessarily the case. As far as your speech and language business, looking back, can you speak to any hardships along the way, things that really kind of threw you for a loop, you had to do extra research on or reach out for help about?

Tracy: Yeah. I mean, I think when you're in private business of any kind, in particular our field, which is so wide and so varied, it can feel a lot of times like you're a jack of all trades. I think continuing to do continuing education and learning and being on different Facebook groups and connecting with other professionals, listening to podcasts like this, and just staying connected to people has been really important.

Tracy: I think that making sure, and this is one of the ways that the health coaching comes in, but really focusing on self-care and having boundaries. For me, I have two little kids, so one of the things that's most challenging is finding that balance between work and having the energy to show up in all areas of my life that I want to.

Tracy: One of the things too, with not having a brick and mortar office is sometimes, like I said, I live in a pretty dense, populated area. I'm not driving a whole lot, but I could imagine in other areas that that might feel challenging to be going to a couple different places. So like this past year where I've been seeing kids at this particular private school for a few years, I had probably seven kids at the one school. So it was nice. I could just go the whole day and just see kids there.

Kadie: Wow. Yeah. That's great.

Tracy: For me, I haven't wanted a brick and mortar office because it felt like it would all be after school kids. And that's what I've been trying to avoid.

Kadie: Right. Yeah. It's so hard.

Tracy: Yeah. So just balancing that. My husband has a very busy job and his job is not flexible. So it often feels like I'm always trying actually not to take on too much and just find that balance place. And I think self-care is so important and just not working all the time because when you work for yourself, it's easy to return texts on vacation or read emails late at night and create that structure around when you're going to work and when you're not.

Kadie: Yes, you are absolutely right. And so moving forward with your newer business, it sounds like you're really passionate in the health field. And what do you think is your ideal scenario as far as clientele? Do you hope to stick with speech therapy clients and intermix that health aspect? Or are you looking to make a pretty large switch?

Tracy: Well, before the whole COVID thing, I would have probably answered that question a little bit differently.

Kadie: Really?

Tracy: Well, because I don't plan on going back to lots of in-person places this year, just with the situation. So I plan on sticking with the telehealth, at least for now. I have read some of the CDC guidance about when you're working one-on-one with a student and you're up close, that it's a different situation than being able to stay six feet apart. So I feel like that will influence things a little bit this year.

Tracy: But in general, I would like to continue my speech and language business. I would love to integrate some of the coaching strategies to be a more effective parent coach and teacher coach. And I also would love to be able to offer some groups for parents on stress management and showing up as the kind of parent they want to be, so that they can support their kids and their families.

Tracy: And just seeing with the health coaching piece, I may branch out a little bit just for some variety, but I definitely plan on continuing my speech and language work. And for now, with telehealth, I feel like with early intervention, the health coaching is really powerful because it's a parent coaching model. So using the coaching strategies for behavior change to help really guide families.

Tracy: And I think as speech and language therapists, we're taught that we're supposed to coach. But now that I really learned how to coach, I don't feel like those coaching skills are taught very well in our profession. And one of my goals is to create some continuing education around that and using the knowledge that I've learned.

Kadie: I think that's a really great point. I mean, I recall so vividly learning about parent education, but it's not like we were ever given, maybe some programs do, but not necessarily all are giving direct instruction on just how to coach, which is understandable.

Tracy: Right. We are taught along with so many other expert model kind of professions that we're the expert and we're teaching them what to do. And coaching is really a different mindset, which is you're guiding them and you're helping them to figure out what's most important and how they can make that happen within the context of their lives.

Tracy: And so toggling back and forth between helping actually teach the strategies to support communication and helping families to implement that in their lives, I think is where there's a lot of disconnect and a lot of burnout among therapists. I think so often we're supposed to be the driver of doing all of it and we give a little bit of homework and we spend five minutes with the parents and they don't know how to do it and they don't know what to do and it doesn't get done. And I think that model is very outdated and ineffective.

Kadie: I think you're right. And I think you're onto something because your mind is thinking, how can I best teach the parents? But also ever since COVID and so many therapists jumping into teletherapy unplanned, how many therapists have you seen on all of our Facebook groups saying, I don't know how to do this? They're not used to constant communication with parents and telling the parents what to do in their own home. So that's a whole other business aspect of marketing to other SLPs, I suppose.

Tracy: Yeah. So I actually see the health coaching both as, yeah, I mean, the coaching skills, like I said, are really coaching skills that can be applied to a variety of different situations. It can be applied to parent coaching. It can be applied to teaching therapists how to coach. And it can be applied, I'll give an example. I have a client right now in early intervention. The family is really struggling. She has a lot of stress. And if I don't address some of that to support her, to be able to show up in a way to support her child, I feel like all the strategies that I'm going to share with her regarding her child are not really reachable for her.

Tracy: So when I start with supporting her, and it's really guiding her around, let's talk about some of the stress that's going on and what can you do to really help her to identify some areas that she wants to work on. And then we transition to talking about her role with her child. And I do a lot of strength spotting, which comes from positive psychology, which is really pointing out all the things that she's doing really well so that she feels confident.

Tracy: Because I think a lot of times when we go in and it's the expert, we really actually take away family's confidence in what they're doing. And what we need to do is to strengthen what they're doing and to point out all the positives and then help them achieve where they need to go. We do know a lot, but we have to do it within the context of their support system.

Kadie: Yeah, that's great points. Well, how do you think that you'll expand on your coaching business? I'm sure COVID has really gotten in the way, but do you foresee yourself needing to advertise that in a whole different way or do you think it'll just be organic with the families that you already have and kind of begin there?

Tracy: I've been starting to take some data. As I said, I would like to create some continuing education for SLPs. And then I also do plan on marketing it separately or maybe offering groups for parents as well. So that it's something that's, I think sometimes if we layer too many things, it can feel overwhelming. So I would like to maybe offer some groups for parents and for therapists.

Tracy: And I'm also a little bit concerned about what's happening with school this year and how much my kids will be in school. So I'm spreading a little slowly.

Kadie: That's a whole other aspect of your own life plus other parents. Even if schools open back up, who's going to send their kids to school? You don't know. They might need some help with that decision as well.

Tracy: Right. Right. And then if kids aren't going, yeah, what kids are going to be needed?

Kadie: Yeah. I'm just trying to really stay flexible and open.

Tracy: And I love actually that I have both areas that I can kind of do some work in both areas. I would like to expand the coaching some this year just as it's new so I can really get a foothold in that. But my ultimate goal is to merge them.

Kadie: Yeah. Absolutely. Yeah. Well, you have a really interesting business model and a new take on expanding outside of just straight up speech and language therapy.

Tracy: Thanks. And I've thought about opening a brick and mortar clinic at some point now. It really feels like not the model. It's interesting to see what happens with telehealth after this is over, if people stick with it or go back. I think there's pros and cons to both.

Tracy: I have found with telehealth in some cases it's more effective and in other cases it's more challenging. I think that in some cases I get better eye contact with kids. I get they're really interested in the different activities on the computer. But of course you can't put your hands on their face and do prompt therapy.

Kadie: Yeah. Exactly. And you bring up a good point and I've always thought about this. It's like our kids that are on the spectrum, they might do wonderful with teletherapy, which is awesome. We want to bring out their strengths. But then it's like, okay, at what point can we get our hands on them and be in person and see areas that they're still maybe need improving upon, where they might be making eye contact with the computer, but would they really be doing that in person? It's so hard to know.

Tracy: Right. Right. And like you said, it's like, well, for six months or a year, I think teletherapy is definitely going to be the preferred option for clients, but what will be the long run? I don't know. I really don't know. I'm not sure. We'll have to see. It's an ever evolving situation.

Kadie: It is. Would you say that your practice currently specializes in any certain age groups, or do you have a preference, or are you pretty wide open as far as pediatric goes?

Tracy: I mean, I guess mostly pediatrics, but I don't have anybody that's older than nine or 10. My favorite age category is really the nonverbal kids who are under two and helping, I guess it's that my love for that parent coaching model of really helping the families to work on the communication within the hand-in model, the relationship, and to get them to the point of communication.

Kadie: Absolutely. Well, is there anything that you'd like to share specifically about your business or your business journey that you think would be beneficial to our listeners?

Tracy: I just feel like I know there's a lot of people who are on the fence about it, and I think as therapists, one of the things that I found early on that used to frustrate me was I just felt like we so often didn't value ourselves enough or really think that we have a lot that we offer, but I feel like we make such a difference in people's lives. Being okay with taking up space, and what I mean by that is I don't know about any of the listeners, but I used to sometimes get a little bit nervous to talk about things outside what I consider outside my scope, but I think when you look at everything being connected through communication, it's a really wide scope.

Tracy: And so having that confidence to think about how we support families has been a growing area for me, and it's also been an area that I feel more satisfaction from being able to do that, because I think when we are too narrow, we really lose sight of how we're helping people or really helping them more fully.

Tracy: And so I've learned a lot about sensory and integrated that into my work with children and families, and just kind of looking at the child as a whole child and what all the areas that influence communication are has helped me to feel more satisfaction and more ease with what I'm doing.

Kadie: I love that point. For our listeners who have maybe been here since the beginning, they've heard me talk about my own burnout probably just from the pressures of doing therapy yourself, the pressure you put on yourself to make progress. Well, sometimes these hefty diagnoses lead to slow-moving progress, so like you said, maybe your perspective as far as being that lending hand to the families as well brings that fulfillment for you.

Tracy: Yeah. I had a dad yesterday in a session. He told me at the beginning he really thinks his child is going to be fine. He's not worried, and I decided not to give a whole lot of advice. I said I was like, great. I wanted to reinforce him as a single dad, and I did a ton of strength spotting and really reinforcing while I was doing a parent coaching session and having him interact with his child. I wasn't giving advice. I was pointing out all the things that he was doing really, really well.

Tracy: There's a great book all about character strengths, and I recommend it to anybody. Really being able to identify human character strengths and to spot them in action and to let people know is so powerful, and it's so encouraging. After the session, the dad sent me a text, and he said, you know, that was really, really helpful. I'm on such a high that I'm doing a lot well with my child.

Tracy: I think sometimes we lose sight of that. We don't just need to come in and tell them what to fix, and it can be really empowering not to have to be the expert all the time. I was feeling some of that burnout that you talk about too, and now a lot of times when it gets to the homework, I will instead of telling them what to do, I'll say, what do you want to do? What do you think you can do this week? What can you commit to? Okay, how do you want to do that? I guide them through figuring it out.

Kadie: That really does sound so powerful and helpful, and I'm going to jot the name of this book down.

Tracy: It's called Character Strengths Matter by Shannon Polly, P-O-L-L-Y and Catherine Britton, B-R-I-T-T-O-N. It's a really quick, easy read, and it's all about all the 26 different character strengths that are out there.

Kadie: Thank you so much. That's a big part of what, I mean, I used to do therapy where I was the expert. I had to come in knowing everything we were going to do. I mean, I was flexible with the kids if they wanted to do different things, but sometimes not seeing progress, sending home beautiful reports of what they could work on, wasn't getting worked on, and it just felt like this isn't working.

Tracy: Yeah, turning your wheels, right?

Kadie: Yeah, so I've changed that, and one of the things I actually love about telehealth that I've discovered with a few of my school-age kids even is that I have a parent or a nanny attend all the sessions so that they're also part of it and that they are doing some of it, and then we talk about it, and it's more of an integrated approach.

Tracy: Do you feel like that this is kind of something that sets you apart as far as if someone were to choose you versus, you're in Denver, I'm sure there's quite a few competitors. Do you think that that is your main selling point?

Kadie: I feel like it's becoming that way because it's sort of an evolving process, but I would say, yeah, at this point, I think so.

Tracy: That's awesome. Really, really great to have something to pinpoint that makes you stand out.

Kadie: Yeah, and I would like to because I feel I need to do some research about the coaching models that are out there, but when I went looking for coach training in our field, I was really not enlightened by much of it. I felt like it was very directive still and mostly modeling, not a lot of discovery for families of what they're wanting to do.

Tracy: Gotcha. Yeah, so maybe something that in general is lacking out there.

Kadie: I feel like it is. I think integrating it from different fields would be a great blending with what we're doing because I hear that from so many, when I'm on some of these Facebook groups with speech therapists, so many people are burnt out. They feel like they're exhausted. They feel like they're not making progress.

Kadie: I think what drives so many of us in this field is wanting to help and then when you don't feel that connection that the family is putting in, if we're doing most of the work and the families are not doing their part, we have to reevaluate why that's happening and what the disconnect is and they're not engaged in the process, then there's something wrong.

Tracy: Yes, 100%. I really appreciated you coming on and sharing your story. Is there anything else before we hop off?

Kadie: I appreciate the opportunity to get to talk with you today and if any therapists out there are interested in any mentoring on coaching or coaching themselves, I would love to be able to be that support for other therapists out there as well.

Tracy: That sounds wonderful. Yeah, if you want to mention how to get ahold of you via email or something, that would be awesome.

Kadie: readysettalk, R-E-A-D-Y-S-E-T-T-A-L-K at Outlook.com.

Tracy: Perfect. All right. Well, thank you so much again and enjoy the rest of your week.

Kadie: Thank you. You as well.

Tracy: Thank you for joining me and listening to Clinic Chats, the speech therapist's private practice podcast. If you have a moment, please leave a five-star review for Clinic Chats to help other SLPs find our podcast. If you'd like to share your own personal journey through private practice, please email me katie at clinicnote.com. That's K-A-I-D-E at clinicnote.com.