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Hello, my classmates and I have a question regarding adolescent and adult fluency treatment. We are aware that clients move through stuttering modification therapy at different rates (some slower than others) but what is your advice for helping clients jump back on board once hitting a plateau? Of course, clients must be willing to participate in this type of therapy but how can we pull clients out of a rut? (especially when there are still negative emotions attached to stuttering?)
Thanks for your post. My first thought would be this: if there are still negative emotions attached to stuttering, then that is where I would be focusing my attention. In that case, the issue wouldn’t be the stuttering behavior, or even the management of the stuttering behavior, but rather the negative emotions and thoughts that are making the stuttering behavior problematic and the management difficult. Often, we see that clinicians feel pressure to be “doing something” about the observable speech even when that is not the primary issue. By addressing the underlying affective and cognitive reactions more directly, we can, in many cases, help people overcome the challenges that are leading to the plateau.
Of course, all of this is predicated on whether or not the person is still experiencing negative consequences in their lives as a result of stuttering. If they are, then, sure, there is reason to continue to press ahead on behavioral changes. If the adverse impact of stuttering has diminished, then it may simply be that the person has reached a level of comfort where further behavioral work is not really necessary.
More to be said on the topic, of course, but you’ve asked a very nice question. I’m sure that my colleagues will have much to add!
Thanks for your great question. I am cautious about commenting when I know so little about the details of your therapy approach. However, this jumps out at me: You are doing fluency treatment and stuttering modification therapy when there are still negative emotions attached to stuttering.
Often negative thoughts, feelings, and attitudes about stuttering, and about oneself as a communicator, must be addressed before a person can make much progress with changing the mechanics of speech. These negative internal experiences can be (much) more problematic for some people than the interruptions in fluency themselves. Until the cognitive and affective aspects of stuttering are adequately addressed, some clients will remain in the rut you describe. Cognitive Behavior Therapy (CBT) and Acceptance and Commitment Therapy (ACT) are just two examples of therapeutic approaches that may be helpful. They certainly helped me.
We could discuss this important topic all day. For now, just one more thing. For some people, such as myself, there may always be negative emotions attached to stuttering. (Few people seem to love their stuttering 24/7.) The key is not to “fix” unwanted thoughts and emotions but to gain perspective and psychological flexibility that can make the problems of stuttering much more workable.
I hope my comments prove helpful to your problem-solving process. Best,
Rob Dellinger