Counseling in Fluency
Hi! My name is Brooklyn. As a new SLP, how would you suggest incorporating counseling into fluency therapy to address the emotional and psychological impacts of stuttering, and what resources or tools have you found most helpful for supporting clients in this area?
This is a great question. Did you have a counseling class in your graduate program ?
You can use several counseling approaches within your scope of practice , including motivational interviewing, CBT-informed strategies, and acceptance-based work. I’d encourage you to take a course in Mindfulness, that would help you in all areas of your practice. If you notice your client experiencing symptoms of depression or anxiety that exceed your skill level – refer to a mental health therapist.
There’s a recent article posted in ASHA Wire that would be good for you to peruse. https://pubs.asha.org/doi/10.1044/2026_PERSP-26-00029
Hi Brooklyn!
I strongly agree with Nora’s comments. Mindfulness practice may help reduce avoidance behaviours and improve emotional regulation (see, for example, Boyle, 2011). I was pleased to have the opportunity to develop my knowledge and skills in Acceptance and Commitment Therapy (ACT). ACT is a flexible approach that can be combined with stuttering management (ref. for example Beilby et al and Sønsterud et al). Developing flexible attention and psychological flexibility are important aspects of this work. To learn more about ACT, you might look at the work of for example Hayes or Harris.
In keeping with ACT principles, mindfulness can be understood as an embodied practice (see Sønsterud et al., 2025). For me, body awareness is closely connected to how we use our voice. It can also be applied with speech work, if the person is asking for such support. If you would like to learn more, you are welcome to read the following article, which you can download for free: https://pubs.asha.org/doi/10.1044/2024_AJSLP-24-00074 (Multidimensional Individualized Stuttering Therapy Outcomes At 24 Months Post Clinic: An Embodiment and Awareness Perspective)
I hope some of these references will help you if you would like to continue exploring this topic.