The River and The Rock: Acceptance and Commitment Therapy

The River and The Rock: Acceptance and Commitment Therapy

Ever feel like you’re fighting your patient just to get through a session? Explore Acceptance and Commitment Therapy (ACT) as a framework for speech therapy—not psychotherapy, but a way to rethink how we approach resistance, engagement, and progress. Using the metaphor of “the river and the rock,” Eva and Emily unpack how ACT shifts us away from power struggles and toward flexibility, values-based care, and meeting patients where they are. They break down the research on ACT in post-stroke depression and emerging work in aphasia, showing how emotional adjustment and communication recovery are deeply connected. Plus, we translate ACT concepts into real clinical scenarios—from dysphagia refusals to cognitive pushback to aphasia shutdowns—and walk through how to respond without arguing, forcing, or “fixing.” Because sometimes the most effective therapy isn’t pushing harder—it’s learning how to flow. Citations Niu, Y., Sheng, S., Chen, Y., Ding, J., Li, H., Shi, S., Wu, J., & Ye, D. (2022). The efficacy of group acceptance and commitment therapy for preventing post-stroke depression: A randomized controlled trial. Journal of Stroke and Cerebrovascular Diseases, 31(2), 106225. https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106225 Evans, W. S. (Principal Investigator). (2021–2025). Adapting acceptance and commitment therapy for stroke survivors with aphasia (ClinicalTrials.gov Identifier: NCT04984239). University of Pittsburgh. https://clinicaltrials.gov/study/NCT04984239 [https://clinicaltrials.gov/study/NCT04984239] Evans, W. S. (n.d.).Acceptance and commitment therapy (ACT) framework [Continuing education course]. https://www.speechpathology.com/slp-ceus/course/acceptance-and-commitment-therapy-introduction-10771 Get in Touch: hello@speechtalkpod.com Or Visit Us At: ⁠www.SpeechTalkPod.com⁠  Instagram: @speechtalkpod Support: buymeacoffee.com/speechtalkpod Part of the Human Content [http://human-content.com] Podcast Network Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]

Choking Risk

Choking is one of those moments where everything goes from normal to crisis in seconds—but how well are we actually measuring that risk? In this episode of Speech Talk, Emily and Eva break down the integrative review “Dying for a Meal” to explore what really contributes to choking across populations. From who is most at risk to the foods most commonly involved, the research reveals that choking isn’t always as straightforward as we think—and dysphagia isn’t always the main factor. We dive into five key prevention strategies, including mealtime modifications, oral health, medication management, interdisciplinary care, and system-level training. But beyond the strategies, we tackle the bigger question: how do we balance safety with autonomy? Because when it comes to choking risk, it’s not just about what’s on the plate—it’s everything around it Citations Hemsley, B., Steel, J., Sheppard, J. J., Malandraki, G. A., Bryant, L., & Balandin, S. (2019). Dying for a Meal: An Integrative Review of Characteristics of Choking Incidents and Recommendations to Prevent Fatal and Nonfatal Choking Across Populations. American journal of speech-language pathology, 28(3), 1283–1297. https://doi.org/10.1044/2018_AJSLP-18-0150 -This article link contains the choking risk scale for use in your practice! Get in Touch: hello@speechtalkpod.com Or Visit Us At: ⁠www.SpeechTalkPod.com⁠  Instagram: @speechtalkpod Part of the Human Content [http://human-content.com] Podcast Network Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]

Reseach but Make it Accessible

Research is supposed to guide our practice—but what happens when we can’t actually access it? In this episode of Speech Talk, Eva and Emily get into the reality of paywalled research and what it means for evidence-based practice in speech-language pathology. Breaking down the article “The Effect of Open Access on Scholarly and Societal Metrics of Impact in the ASHA Journals,” they explore how access (or lack of it) shapes who reads, shares, and applies research. From citation counts to social media reach, the data is clear: the more accessible the research, the greater its impact. But with thousands of articles still behind paywalls, clinicians are often left out of the conversation. This episode gets real about the barriers SLPs face—and why making research more accessible isn’t just convenient, it’s essential for better patient care. Citations Long, H. L., Drown, L., & El Amin, M. (2023). The effect of open access on scholarly and societal metrics of impact in the ASHA journals. Journal of Speech, Language, and Hearing Research, 66(5), 1784–1796. https://doi.org/10.1044/2022_JSLHR-22-00315 [https://doi.org/10.1044/2022_JSLHR-22-00315] ASHA website for free resource links! https://www.asha.org/siteassets/uploadedfiles/asha/research/ebp/finding-free-access-research.pdf Get in Touch: hello@speechtalkpod.com Or Visit Us At: ⁠www.SpeechTalkPod.com⁠  Instagram: @speechtalkpod Part of the⁠ Human Content⁠ [http://human-content.com] Podcast Network Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]

Does “Wet Voice” Actually Mean Dysphagia?

Does a “wet” voice really mean your patient is aspirating? In this episode, Eva and Emily unpack research that challenges one of the most common clinical signs used in dysphagia assessment, wet vocal quality. Turns out, what we’ve been trained to hear might not be as reliable as we think. The need for instrumentals hasn't gone away, but the biggest national providers of mobile FEEs has...So what happens when we know we can’t solely rely on bedside exams and access to gold standard tools is limited? Let's talk about it. Citations: Centers for Medicare & Medicaid Services. (n.d.). Skilled nursing facility consolidated billing. U.S. Department of Health and Human Services. https://www.cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing [https://www.cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing] American Speech-Language-Hearing Association. (2023). The case for FEES in skilled nursing facilities. https://leader.pubs.asha.org/do/10.1044/leader.OTP.28072023.fees-snf-slp.36/full/ [https://leader.pubs.asha.org/do/10.1044/leader.OTP.28072023.fees-snf-slp.36/full/] Weldon, K., Kelchner, L., Silbert, N., & Rule, D. W. (2023). Listening for dysphagia: Voice quality sequelae of material in the airway. Journal of Speech, Language, and Hearing Research. https://doi.org/10.1044/2022_JSLHR-22-0012 [https://doi.org/10.1044/2022_JSLHR-22-0012] Get in Touch: hello@speechtalkpod.com Or Visit Us At: ⁠www.SpeechTalkPod.com⁠  Instagram: @speechtalkpod Part of the Human Content [http://human-content.com] Podcast Network Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]

Thickened Liquids...It’s Complicated

Thickened liquids are one of the most common recommendations in dysphagia management—but are they always the safest option? In this episode of Speech Talk, Emily and Eva review The Adverse Effects and Events of Thickened Liquid Use in Adults: A Systematic Review and dig into the real evidence behind thickened liquids. We talk aspiration risk, dehydration, pneumonia, quality of life, and why dysphagia management is rarely as simple as “just thicken it.” From the proxy problem in aspiration research to free water protocols and real-world SNF decision-making, this conversation explores why thickened liquids can help some patients, harm others, and almost always require careful clinical judgment. Because when it comes to dysphagia management… thickened liquids are complicated. Citations Abrams, S. W., Gandhi, P., & Namasivayam-MacDonald, A. M. (2023). The adverse effects and events of thickened liquid use in adults: A systematic review. American Journal of Speech-Language Pathology. https://doi.org/10.1044/2023_AJSLP-22-00380 Get in Touch: hello@speechtalkpod.com Or Visit Us At: ⁠www.SpeechTalkPod.com⁠  Instagram: @speechtalkpod Part of the Human Content [http://human-content.com] Podcast Network Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]