A New Perspective
Hello! I am currently a graduate student and would like to know, as a person who stutters, what do you wish SLPs would do differently or knew more about when working with individuals that stutter? I think we learn about stuttering from a very textbook stance, and would appreciate an additional perspective on stuttering and what we can do to better help our clients.
Thank you so much for this really excellent and important question!
In my lifetime I have experienced sessions and programs with many speech-language pathologists (as well as professionals in other fields – such as psychology – offering clinical services to people who stutter).
In my experience there have been some very common misconceptions, which I have heard repeatedly expressed, by clinicians regarding stuttering. Significantly I have never heard these expressed by any clinician who stutters, only by fluent clinicians.
One misconception is the idea that people who stutter could do better if only they “tried harder”, if only they were more “motivated”, if only they took their therapy “seriously”. I have heard allegations like that so many times.
Even worse, some clinicians – too many – go a step further if a client who had seemed to be making progress experiences a relapse. (Relapses are VERY common in people who stutter following periods of therapy that had resulted in good progress. This is based on my own experiences, and the experiences of many others who stutter who I have known.)
What is often heard from clinicians is: “You didn’t try hard enough”, or “You aren’t following my directions”, or “You’re not doing what I told you to do”, or similar statements.
It’s important for clinicians to understand the nature of stuttering – that it is entirely common and natural for people who stutter to relapse, and that relapses are NOT the fault of people who stutter. That is VERY important for clinicians to understand – and to know how to effectively advise clients who relapse, so they can regain their positive attitudes towards their speech, regain the methods which succeeded for them in the past, and to get back on the right track.
It’s also important not to blame the client if the client does not appear to succeed with a particular therapeutic approach. From knowing the experiences of myself and many others who stutter, different methods work well with different people who stutter. So if one approach doesn’t seem to “work” with an individual, perhaps another approach can be tried – or alternatively, the client can be referred to another clinician, who might be able to work more effectively with that particular client, using a different method.
It’s important for clinicians to really understand the thinking of people who stutter, to become very familiar with how people who stutter cope with challenges in their everyday lives. Therefore I recommend that clinicians and student clinicians attend gatherings of people who stutter whenever possible, and get to know people who stutter on a personal level.
I don’t want to leave the wrong impression here. I have experienced some truly excellent fluent clinicians who helped me a great deal. In thinking over the seven clinicians who helped me the most during my lifetime, five were fluent speakers. So it IS really possible for fluent clinicians to truly understand people who stutter, and to provide great help to people who stutter.
I commend you for wanting to enter the field, for your special interest in stuttering, and for your motivation in helping people who stutter. Best of luck to you!
– Paul Goldstein
Hi – great question. I would love for SLPs to fully understand that it’s crucial for the client to have a goal, and that goal becomes the primary of the therapeutic alliance.
I remember when I first tried therapy, as an adult, I thought showing up to a SLP was the only move that I needed to make, that the SLP with their education and background, would know what to do. Boy, was I wrong!
The student clinicians I worked with attempted to have me learn fluency shaping techniques, which I couldn’t get the hang of, and found myself resisting. The clinicians didn’t really have anything else in their toolbox, as they were clearly only learning fluency shaping.
I figured out early on that employing FS techniques made me feel covert again, which I was for 30 years. I needed to stutter, and be told it was OK. I was not broken and didn’t need to be fixed.
Clinicians seemed not to know what to do with me. So I left therapy after a short stint and largely considered that as “bad therapy.”
I think SLPs should take at least one counseling class as part of their SLP education, to be better equipped to help clients who want help in achieving the goal of acceptance which is just as important, if not more so, than learning how to alter how one speaks in order to be perceived as fluent.
Pam
First you need to understand many ways that people who have self assessed themselves as stuttering can present. Unfortunately there is basically only one word to describe all the different ways this thing manifests and to just call everything “stuttering” is rediculous. I personally do not believe that the treatment of stuttering is best handled by a speech pathologist. Sure, if you are talking about a child seeking treatment before the age of 6 years old then yes a speech pathologist is the persone to go to (if adequately trained in an early intervention treatment modality) but when you are talking about adolescents and adults, particularly those with a severe and chronic stutter, often accompanied by some level of psychological issues surrounding the stutter like social phobia, then at the very least the
oops …. at the very least the clincian should be a highly trained stuttering treatment specilaist. That may be a speech pathologist but that clincian needs to not only be aware of how stuttering needs to be handled from a physical speech perspective but also a psychological mental perspective and often that clinician has a psychologist background. So with all respect I believe that a generalist speech pathologist with no experience in treating chronic adult stuttering is best to refer the individual to someone better tained to successful treat the individial as a failed attempt at treatment can stop a stutterer from seeking any further treatment in their life. Finally, if you really wish to help a person who stutters with some simple advice, that would be to encourage them to seek out a good self help group like a national body in your country.
I think the toughest, but wonderfully challenging part of your job is that we’re all different. A broken bone is a broken bone. It might be broken in different ways, but it’s still a broken bone, no matter the person attached to it. ? So, to be able
When I speak to therapists I tell them to not just hear my stutter, but to see and hear the whole me. Find out my background, find out where I stand today, find out what my needs are, and work from there. We’re all individuals with different stutters, different cultures, different experiences, so we all need a different approach. Tough for you, I know, but also an exiting challenge to find what makes us bloom! ? Give us a smörgåsbord of things to try. What helped me to get a better flow, mentally, physically and speech wise is a mix of regular speech training (pausing, articulation and alternating voice volume has been the most helpful for me), relaxation, mindfulness and NLP, music, massage, public speaking, fear reduction and finding my stamily and my voice. As you can see these things are very different, so if you’re not into all of these, find people who can, so that I can work on all of these things at the same time, just as John Harisson talks about in his Stuttering Hexagon.
Also to be humble (sometimes a therapist and a client are simply not a match, noone to blame) and to be creative (why not bring friends to the therapy room, so that they too learn about stuttering and can join their friends doing exercises, support and have fun together while doing tough challenges).
The face you’re here and asking these questions show you’re the right person for the job. ?
If you want more answers, do check out my papers and replies in previous conferences.
Stay safe and keep them talking
Anita