How do speech and language therapists go about doing their work, and why do they do it that way?

Although my PhD is in the field of implementation, I have a somewhat uneasy relationship with the word.

According to, its etymology can be traced back to Late Latin, meaning ‘a filling up’ in the sense of completion, satisfaction or fulfilment. I like this because, for me, ‘implementation’ is about people doing something because it matters to them and because they are curious to see if it makes a difference. I am uncomfortable with an alternative definition that focuses on compliance, carrying out orders and doing what you have to do in order to get what you want.

Speech and language therapists have many demands on their time and energy, and you don’t have to be among them very long to know that their main motivation is helping their clients. Implementation scientists want to support therapists to integrate research findings into this process, also with the aim of doing the best for clients. But, as sociologist Ray Pawson argues so eloquently (e.g. 2013), implementation is not a passive, one-way process. Rather, it is a cumulative, dynamic chain that depends on the active reasoning and reactions of all involved at different stages in different contexts. It is therefore important that implementation scientists ask how therapists already go about doing their work, why they do it that way, and what the consequences may be.

Within speech and language therapy research, implementation papers that I like include Walden and Bryan (2011), Muttiah et al. (2011), James (2011) and Crais et al. (2006). This is firstly because their research designs recognise the social, interactive and reciprocal aspects of implementation, but secondly because I think they give real clues about how we can improve efforts to support practice change. I am looking forward to exploring this theory further.

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