Navigating the “Passaggio” Between Voice Therapy and a Singing Lesson: Ethical Considerations for the Speech-Language Pathologist

Abstract

Purpose The purpose of this article is to discuss factors that guide ethical decision making in determining what constitutes medically necessary voice therapy that involves or targets singing, which is distinct from a singing lesson. Method Different treatment tasks and scenarios are identified, and their rationales are compared with deference to precedent literature and relevant portions of the American Speech-Language-Hearing Association Code of Ethics. These materials are referenced in an effort to define the boundaries between voice therapy involving singing technique and a singing lesson. Results Suggestions regarding goal writing and documentation to highlight apparent boundaries are made. Conclusions In the care of injured voices, both precedent and ethical principles support speech-language pathology treatment that targets singing. However, it is incumbent upon the treating speech-language pathologist to determine when they are venturing into tasks that no longer serve a therapeutic purpose and to refer the patient for voice lessons as appropriate.