In this podcourse episode, we are joined by Elise Mitchell, an SLP and school contracting consultant, about moving from burnout to renewed purpose through school contracting. Elise shares her background working with a staffing agency at the executive level, consulting provider-run businesses on school contracting, hosting the Beyond the Big Agencies podcast, and founding the Therapist Support Network to support SLPs, OTs, PTs, and assistants in building sustainable school-based work through direct contracting with an emphasis on ethical growth, pricing, compliant contracts, and autonomy. We discuss why burnout persists among school-based SLPs, emphasizing that caseload size alone does not explain workload and that research and clinician reports point to reduced autonomy, limited control over setting/caseload/workload, and feelings of ineffectiveness and being overextended. Elise describes how contracting can feel different by creating a business-to-business relationship where clinicians can set contractual boundaries around caseload, schedule, availability, group size (including virtual group limits), and billable tasks (including paperwork), while still adhering to legal and compliance requirements. Contracting can also allow clinicians to choose schools that align with their values (e.g., rural districts), establish clearer scope-of-work boundaries, and exit contracts more easily via notice terms; they note some states favor short-term contracts such as maternity/FMLA coverage.We explore how contracting can help clinicians reconnect with meaningful work by reducing non-therapy duties, focusing on student impact, restoring professional autonomy, and enabling rate-setting beyond teacher pay scales. We also define autonomy in practical terms—control over schedule/time, rate, student population, and the type of work performed (e.g., supervision/evaluations only vs. direct treatment only). And also discuss trends such as easier recruiting for virtual roles, challenges sustaining virtual work long-term, and barriers like facilitator requirements.
