The Invisible Workload of School-Based Speech-Language Pathologists Who Identify as Overwhelmed: A Grounded Theory Study.

Purpose: This qualitative study investigated the lived experience of school-based speech-language pathologists (SLPs) who self-identify as overwhelmed. The goal was to devise a formal explanation of the reasons for such overwhelm. Method: Seven elementary and five secondary school SLPs in two separate focus groups discussed the following questions: (a) How are you advocating for your needs as an SLP? (b) Do you know how to advocate for yourself? (c) How confident are you in advocating for your needs? (d) Do you feel safe to advocate for your needs? Data were analyzed according to the tenets of grounded theory, resulting in a formal theoretical model. Results: Participants indicated an invisible workload for school-based SLPs consisting of three major factors. One, involved parties (teachers, administrators, parents, etc.) do not understand SLPs' roles and responsibilities; as a result, SLPs have to advocate for themselves relentlessly. Two, organizational structure all but ensures that their advocacy is unsuccessful. Three, SLP culture, consisting of perfectionism and a tendency to lack boundaries, exacerbates the situation. A mitigating factor was also identified. SLPs who set boundaries firmly and advocate collectively fare better than SLPs who do not. However, even they are often ineffectual in the face of structural barriers. Conclusions: Results indicated a direction for future research. A survey instrument that captures the dimensions of SLP overwhelm identified in this study should be deployed to assess the prevalence and severity of these issues. Also, it is argued that top-down action by systems-level players is paramount to addressing school-based SLP overwhelm. [ABSTRACT FROM AUTHOR]