Trust & Rapport: The Building Blocks of Speech Therapy

Trust & Rapport: The Building Blocks of Speech Therapy by Paul Simeone

Trust & Rapport: The Building Blocks of Speech Therapy by Paul Simeone

The foundation to any successful therapeutic relationship between clinician and child (and their family) is established trust. Speech and language therapy is like building a house: much of the focus is on the frame (receptive and expressive language) and the finishes (speech sounds), but none of this is achievable without a solid foundation (a good relationship).

For children to progress in therapy, they need to trust the therapist. Oftentimes, we think of the importance of building rapport at the onset; however, the relationship is not static and requires ongoing attention and care.

A common misconception is that building rapport means that we are not “working.” This couldn’t be further from the truth. While building a relationship with the child, we are also observing and assessing as well as modeling language and play.

Recently, there have been a number of instances in my sessions when I was reminded of the importance of building rapport—a trusting and enjoyable relationship with a child. It takes a continuous effort to balance this focus while attempting to achieve progress as quickly as possible. However, a good relationship pays off when it’s time to work hard on a particularly difficult target.

How Do We Build Rapport?

  • Follow the child’s lead: Spend the first few sessions following the child’s lead. Read her mood and comfort level and allow her to get comfortable with you and the process.
  • Establish yourself as a fun person: If he wants to play in a specific way, go along even if it doesn’t fit with your plans. Eventually, once this relationship is established, you will be able to shift the activities to be as productive as possible.
  • Everyone’s favorite price is free: With some children, you may set up sessions so that they “earn” preferred toys for work. However, in the beginning, everything should be “free.” You want them to associate you with reinforcing items.
  • Bring in the experts: Use Mom and Dad to help strengthen the relationship. Make sure that parents join in the play. The child will see that you are trusted, and you will see all the fun that Mom and Dad bring to the table.

Children communicate when the communication is enjoyable and worthwhile. As a speech pathologist, the ultimate goals is help a child improve communication as quickly and thoroughly as possible.

Success in my practice is attributed to following the child’s lead and then providing the right amount of support to help her gain new skills. Building a solid and trusting relationship is crucial, and the time spent on the relationship will pay dividends down the road.


Paul Simeone, MA, CCC-SLP, ATP