She Didn't Want to Walk First, She Wanted to Belong
This story challenges traditional therapy priorities by centring a client’s deepest goals: connection, faith, and love. A call to move beyond impairment-driven therapy and toward practices that honour what makes life meaningful for the people we serve.
Mawaddah Brown
1/19/20261 min read
She wheeled into my office almost five years after her accident.
“I need speech therapy… how much would it cost?”
I hesitated for a moment. “Anna at the front desk can assist with the rates, but let’s see how I can help you today.”
Our initial consultation included an interview component, diagnostic assessment, and homework. Kayla had a severe speech difficulty that affected her ability to articulate words clearly—particularly when formulating sentences during conversational speech. Her social interactions were not always appropriate, or as we would label it, her “pragmatic skills were affected,” which is not uncommon in adults following a head injury.
This presented as inappropriate social proximity, a lack of conversational filter, and poor topic maintenance. In her case, it also included calling and sending voice notes to one of our administrators every other hour—mostly rehearsing her speech therapy homework.
From a traditional impairment-based model, Kayla had many areas that “needed fixing.” But before choosing where to start, we chose to pause.
Instead of beginning with drills or exercises, we started with a vision board.
Her homework was simple but powerful: to think about what she wanted from life. Because she was unable to write, she used cut-out pictures and words to represent her goals. When she returned the following week, she presented her vision board with pride. This is what she shared, in order of importance:
To have a friend
To speak at church
To get married
To have ice cream at the pier
To (maybe) walk one day
Walking—often seen as a primary rehabilitation goal—came last.
Connection came first.
It was in that moment that her why became clear. Kayla didn’t come to therapy to perfect sounds or sentences. She came because she wanted a friend. She wanted to participate in her church community. She wanted love, belonging, and a future that felt whole.
Her speech difficulties were the greatest barrier to those dreams.
This is why understanding a client’s values matters more than any checklist of impairments. When therapy is guided by participation, purpose, and what makes life meaningful, progress becomes more than clinical improvement—it becomes personal!
And that is where real therapy begins.