A Therapist’s Change of Pace: Considerations When Changing Employment Settings

by | Nov 7, 2019 | Uncategorized | 1 comment

Changing therapy environments can be a thrilling time for a therapist: new exposure to a wide scope of practice, new schedules, new management, and a position that will, hopefully, better meet your needs. With that said, deciding to switch can be daunting, overwhelming and a difficult decision. Here are some tips while considering the switch to ensure that you are making the right choice!


Some therapy environments offer good compensation on paper and it becomes easy to let that sole number be the deciding factor. However, many considerations make that number higher or lower when you factor them in. Travel, vehicle wear and tear, per session vs per hour compensation, benefits, bonuses and productivity are all external variables that can change that number on paper.

Let's look at an example (skip this if you get the picture): let's say you're an SLP that is considering switching from home health to a contract, full-time school-based position that's going to pay $45/hr. You take $45 X 180 (average days of school) X 8 (full-time hours) and you get=$64,800 gross. Now, add in the ASHA CCC's reimbursement, decrease ____ for gas, add in any PTO and so on and so on--despite $45 likely being less than your home health hourly number, the two may end up being closer together than you realize when you add in or subtract external variables.

(Disclaimer: the author of this blog is an SLP that fits the stereotypical mold of being bad at math and cannot be held liable for any mistakes in the formula above 😀. )


It's time we all admit the hard truth that graduate school was a minute ago for the majority of us. Even when considering a position, it's a good idea to begin taking some continuing education revolving around the new population or environment you're working with. Not only will this allow you to throw out the latest evidence-based practice terms during interviews (as someone who has interviewed MANY therapists, this is a good thing) BUT it will give you exposure to the population(s) you're about to work with before making the swap.


Do not be afraid to ask the company to provide some referrals. I will say that those referring therapists may be biased (or have a recruiter perk they get) but, even if they do, it is valuable to talk to "boots on the ground" of the organization you're considering joining.

Also, I always recommend therapists turn to Indeed, Glassdoor or other anonymous locations to read reviews. Be cautious as often with anonymous reviews you see the extremes--the disgruntled employee or the elated employee--so don't take these tools as a completely perfect picture of the day-to-day in the organization but they still provide insight.


Social compensation involves aspects of the potential new position outside of monetary value: your feeling of self-worth, your stress level, your happiness, your time and so on. Social compensation can make leaving an environment you're in or staying in an environment, despite something monetarily better, completely worth it. Social compensation should be one of the top considerations when making a change. My list when considering a change is: 1.) Will this pay the bills? and 2.) Will this give me more time with my family? Social compensation is #2 for me when deciding on change.


When considering leaving your current setting, put down 1-3 objectives with what you hope to accomplish from leaving. When making the consideration for a change, any motivating factor that doesn't fall into one of these objectives needs thrown out as it's a distraction.

The reason I say this is that something luring like wage can get us to swap settings BUT if it isn't answering "the why" of you wanting something more flexible, you'll likely be back to wanting to change again soon.


Therapists need support. We have too wide of scope of practice to not have support. The difficult thing about certain environments, particularly 1099 positions, is that support can be limited. If you are changing settings--and with that change comes a change in populations--take support, or lack thereof, into consideration as you make the switch.

If it is a 1099 position or comes with limited support, reach out on social media or (shameless plug) the Therapist Support Network to line up mentorship for your first month or so. Going in without support can make that initial experience a negative one and a bad first experience with a job is hard to get over.

Summary: I applaud any therapist as they embrace change, pursue new avenues of being a therapist and continue on their amazing professional journey. Take these things into consideration and, as always, let me know if I can help! -Elise