Managing your Speech and Language Therapy Caseload

Whether you have been a Speech and Language Therapist for years and years or are a newly qualified therapist, managing your caseload and work life balance is a challenge. It can seem especially daunting for those just starting out in the profession going from managing a small number of cases to suddenly very large numbers. So, here are our best top tips to manage your caseload and having a good work life balance.

Be open and honest with your supervisor/ line manager

If they know how you are feeling, they can help you. If you keep how you are feeling in the dark, they can’t. You are not the first person to feel this way and you are not the last. You do not know the support mechanisms they have in place until you ask. There are often things that can be done to help you.

Finish work on time

If you keep going and work long days into the evening and again at weekends, the only thing that is inevitable is burn out. You are not supporting the people you work with well if you are burning out. A better quality of therapy is better than a larger quantity. You need to give yourself time to breath. A no work lunch is another way to give yourself the time and space to stop, think and reflect. Having this time and space to reflect makes you a better Speech and Language Therapist and isn’t that what we are all working towards?

Utilise emails

A message over email is often quicker than face to face. Yes, there is a place for face to face and its great to build rapport but not every conversation needs to face to face and an email is a time-saving method.


This is one of the best ways to manage our caseload. But how can we do this? Every workplace has different methods, so it is important that you are familiar with the policy and procedure of where you are working. But here are some of the best ways I have found. Some trusts use packages of care to decide who is seen and for how often to support their prioritisation process others use therapy outcome measures (TOMs) to help them decide who is the most in need of support. These are tools that we can utilise to decide how we spend our time. If we have neither of these, colour coding can be an effective method. We can identify whether child’s need in terms of impairment, participation and activity is severe, moderate or mild and then colour code them to help us decide who to see first, usually supporting those with a more profound need first.

Plan your day- be realistic

Spend time deciding what you want to achieve in the day. You can use a timetable to decide this allocating tasks to different times of day. Start with a list of all the tasks. Split this list into must do today and then things that it would be good to do today. Allocate each of these things to a time and be realistic. It is better to plan for things to take longer than they do rather than rushing around and not achieving what you planned. It feels so much more positive doing one more thing than you planned than to not achieve everything planned even if you have achieved more by planning too much.


We spend lots of our time at university, making resources for sessions but this is not realistic. Every child does not need a different set of resources. You can use one resource in multiple ways. A picture from the language for thinking book can be used to ask a prompt for a child to create sentences using conjunctions, talking about the past tense as well as inferencing. A teddy can be used for naming, for concepts, for information carrying words and for understanding verbs. Too many resources are hard to manage but a small few that can be used flexibly are a smarter way of doing therapy. Its about not working faster but smarter.

Look things up

Do not be afraid to say that you need to ask or just look things up. We are all on a learning journey and that means we can’t always know the answer. Rather than suggesting or promising something that you are not sure about, say you will find out and let them know. This is a much better way of working rather than attempting therapy that you are not sure is the right thing, when instead you could look it up and get a better outcome.

Different ways of working

Not every child can be seen for therapy. We have to accept this as therapists and look at different ways of supporting children. Giving a programme of work to a teaching assistant or training the whole of the nursery staff in basic strategies to support communication development, can be just if not more effective. We need to recognise our own limitations, we cannot work daily with children so helping and supporting others to do it for us, can be a time saving and more effective method. Through training others, we may prevent others having speech and language difficulties as strategies are being incorporated into the everyday environment.


Most speech and language therapists work as part of a team and we can support each other with managing our caseload. Does your trust have a speech and language therapy assistant? Just because you have just started your role, does not mean you cannot ask for people to support you to do things like make resources. If you are not delegating, why not check that someone does not have the resource that you need. There is no point making a resource when you can use someone else’s.

Support one another

Whether you have been allocated a buddy in your new job or you have friends that graduated from university at the same time as you, you can support one another giving advice and helping one another to manage their caseload. Talking to people experiencing the same thing as you is invaluable.


Hopefully, these tips can help you to manage your caseload. The biggest thing I would recommend is being open and honest if you are feeling overwhelmed. It can really turn the situation around!


Check out Our Resources and 10 tips for being an organised SLT for more advice.