'It Is Not Possible to Go Back to Normal, but It Is Possible to Start Again': Experiences of Speech-Language...

Earthquakes severely disrupt health and rehabilitation services. However, little is known about the professional and personal experiences of speech-language pathologists (SLPs) in such disaster contexts.

This study aimed to examine the professional and personal experiences of SLPs working in the provinces affected by the 6 February 2023, earthquakes in Türkiye. It explored challenges faced by SLPs, continuity of client services and psychosocial impacts.

A phenomenological design was adopted. Semi-structured online interviews were conducted with 16 SLPs actively working in the disaster region. Data were analysed using reflexive thematic analysis with MAXQDA 2020. Interviews were recorded, transcribed with the AI-based Turboscribe program and verified by the researchers.

Four main themes emerged as follows: (1) working conditions of SLPs after the earthquake (living conditions, professional performance, physical environment and support mechanisms), (2) status of clients after the earthquake (interruptions in therapy processes, new and increased speech and language difficulties), (3) psychological effects of the earthquake on SLPs and clients (anxiety, burnout, and grief among therapists, clients and families) and (4) post-disaster interventions and preparedness (short-term needs in the field, and long-term strategies such as digitalization, teletherapy and trauma-focused professional training). Findings indicated multi-dimensional challenges for SLPs, major disruptions in therapy access and psychological impacts directly reflected in therapy processes.

This study highlights the critical role of SLPs in disaster conditions and emphasizes the need for policy development in this field. To ensure the continuity and effectiveness of speech and language therapy services, it is necessary in the short term to increase the number of specialists in the field and to strengthen psychosocial support mechanisms. In the long term, it is recommended to establish digital material and record systems, expand the use of teletherapy practices, develop programs to prepare families for disasters and integrate trauma-focused professional training into both undergraduate and in-service education processes of SLPs.

What is already known on this subject Natural disasters such as earthquakes cause severe disruptions to health and rehabilitation services, often limiting both access to care and professional performance. Previous studies have examined the experiences of nurses, midwives, teachers and pharmacists in disaster contexts, showing that these professionals face significant challenges in maintaining service continuity under such conditions. However, there has been no systematic exploration of how speech-language pathologists (SLPs) are affected, despite the fact that individuals with communication disorders are among the most vulnerable groups during disasters. The lack of research on SLPs highlights an important gap, as interruptions in communication-based interventions can have profound and lasting consequences for clients and families. What this paper adds to existing knowledge This study qualitatively examines the experiences of SLPs during the 2023 Türkiye earthquakes. The findings reveal multidimensional challenges, including disrupted therapy processes, increased communication difficulties among clients and significant psychological strain on both SLPs and families. They also highlight the urgent need for SLPs in tent and container settlements, their potential role in search and rescue teams or in training such teams and the importance of long-term preparedness through trauma-focused training. What are the potential or actual clinical implications of this work? The study emphasizes that SLPs should be included in disaster management teams to ensure the continuity of communication and swallowing services during crises. Clinical practice can be strengthened by integrating disaster preparedness into undergraduate curricula and ongoing professional development.