We’ve all had clients on our caseload that we’d like to move. It all comes down to feeling inadequate to provide the best services to that individual. Unfortunately, when we are assigned someone it can be difficult and a little uncomfortable to express the desire to transfer them to a different clinician. The type of responses we may get could be something like “Well, you are the professional; you should be able to service this student” or “You were assigned this student, so you must make it work in your schedule.” The people who respond to you in this way are likely not service providers; otherwise, they’d have a better understanding of where you’re coming from. It should be solely about how to provide the best services to the individual and if you feel you are not the most appropriate person to do so- it is in everyone’s best interest to say something to improve the situation. 

My biggest tips if you are in this situation are to:

• TAKE DATA: If the individual is making insufficient progress, that is evidence that the current therapy needs modification. Be sure to collect behavioral, attendance and client engagement notes to support your claims. 
• SAVE ALL EMAILS: You can reference the emails you have written when you’ve reached out for support or to get assistance. This is evidence you can bring to the table that you have been seeking guidance and it has not been effective. 
• PROPOSE A PLAN: If both the data and written documentation support your claim that an individual should be moved off of your caseload, you may have to reach out to other therapists to see if they are able to take the client, find out if the in-person speech therapist (if there is one) has an opportunity to see this student, or even ask to trade with another therapist as to not increase workload for someone else. If you have a plan already set, then your employer may be more likely to take the leap. 

If you are an independent contractor working for a teletherapy company you have every right to speak up and say you are not comfortable seeing an individual. You may get aggressive feedback, but they ultimately need you more than you need them. If you get a 1099 then do not allow someone to bully or pressure you into a situation you’re uncomfortable with. The perks of being your own boss is that you do not need to do anything you don’t actually want to do- remind yourself of that as often as possible. That’s likely the reason you decided to work for yourself in the first place!