Factors when considering therapy goals
Hello, my name is Marissa, and I am currently a student pursuing a career in speech. I was wondering what factors you consider when choosing therapy goals for a person who stutters, especially if their main concern is fear or avoidance of speaking?
Hello Marissa
Perhaps the most important goal of therapy is to educate the person about stuttering. Teach them how to differentiate between stuttering (which occurs due to our neurobiology) and the struggle to avoid stuttering (that we do as a reaction to stigma, anxiety, shame, and fear). So, in the ABCs of the stuttering, the B is for Behaviors, and those behaviors are stuttering on the one hand and struggle on the other hand. Do not try to fix the stuttering – it is simply who we are. Helps the PWS identify their struggle behaviors. Use mindfulness approaches – non-judgmental observation of what is going on, what is happening to me and what I am doing in reaction to it.
The goal is always to live the life that we want for ourselves, without letting stuttering or the fear of stuttering stop us. Teaching fluency techniques just keeps the person who stutters trapped in fear of stuttering. Instead, find out what the person really wants to do and why they feel that stuttering is stopping them.
The antidote to fear or avoidance of speaking is speaking and stuttering openly. If you teach fluency techniques you only reinforce the fear. Of course, you need to guide the client. Define goals, small steps that seem achievable. Analyze each step, then move to the next step.
Wishing you success
Hanan
Hi Marissa,
I do not choose therapy goals. We do it together. Everyone has a different goal. So, we start by exploring the goals and the (im)possibilities. If their main concern is fear or avoidance we will start to explore the fears and look for the avoidance behavior. How do they avoid, when, why, etc. Knowledge about that already increases the power within them. So, every therapy looks different, because everyone IS different and has different goals. It is not up to me to decide, because I am not the one living with this person’s speech on a daily basis.
Manon