A Multidiscipline Practitioner Pilot Study Into the Potential Professionalization of Singing Voice Rehabilitation Specialists in the United Kingdom.

Abstract

Objective: Despite anecdotal evidence highlighting the benefits of singing teacher involvement in voice rehabilitation for effective and sustainable biopsychosocial treatment of vocal injury, singing teachers working as singing voice rehabilitation specialists (SVRS) in the United Kingdom (UK) have often been criticized for working beyond their scope of practice. With limited empirical research into the role, concern and confusion has fueled challenges to its legitimacy. The lack of regulation raises questions around safeguarding, skills, and demarcation of roles within the multidiscipline team. Previous research into patient experiences in the voice clinic has suggested hierarchy and power imbalances between patients and clinicians are impeding development of rehabilitation practices and outcomes. The aim of this pilot study is to explore whether similar socioeconomic and epistemological structures are perceived as contributing to critique of SVRS involvement in rehabilitation and whether formal professionalization of the role may provide a solution to the debate.

Methods: To systematically explore the views and experiences of professionals working in the multidisciplinary voice clinic team in the UK, a deductive, qualitative methodology was adopted. Recognizing the majority female workforce in this context, MFST was applied to semistructured interviews with nine female-identifying participants: three Otolaryngologists, three SLTs, and three SVRS. Data were analyzed according to the themes and concepts of materialist feminism, using in vivo and embodied facial coding to capture verbal and non-verbal communication.

Results: Participants viewed the SVRS role as a positive addition to clinical practice. They indicate that in their experiences, some of the concepts found in materialist femininist analysis of organizations and women's role in the workplace hold true, and may be reasonably said to contribute to skepticism surrounding the SVRS role. They suggest there are challenges and benefits to professionaling the role. These relate to relationships, management and oversight; navigating and respecting professional identity; individual scope of practice, skills, and qualifications; establishing and managing shared ethical and economic values.

Conclusion: Overall, professionalization for SVRS was viewed positively, to enhance integration into existing workplace structures. Professional training, certification, and regulation was felt to be important for creating a shared language between clinicians and nonclinicians. It was noted, however, that there are challenges within the current medical paradigm, which would be less advantageous to pursue. The requirements of professionalization should be carefully negotiated alongside the current freedoms and creative practices employed by SVRSs.