Emotional Stress with Disfluencies
Hello! My name is Anna, and I am an undergraduate student studying Speech Language Pathology. In the future, I hope to focus my time working with people who stutter. I have a few questions for you all as professionals. First, what is the most effective method you have found to deal with the emotional aspects that come along with a disfluency such as sadness, frustration, and anxiety? Also, how do you treat a client who may not yet have come to terms with their stutter?
Thank you for sharing!
Hello, Anna. Thank you so much for asking these questions of the professional panel. Congratulations on your undergraduate studies! You are entering a very special world- one that is more than a career but a life journey that is so hard to truly put into words what the experience is like until you are a part of it. So, I am glad that you are a part of it! I am truly honored to answer your questions.
Question 1: First, what is the most effective method you have found to deal with the emotional aspects that come along with a disfluency such as sadness, frustration, and anxiety?
-This is a great question! First, I must say that stuttering is a very individualized experience for the person that is experiencing it. No two people who stutter are the same. They have both different backgrounds, families and life journeys just like all of us do. So, therapeutically, methods for treating the emotional aspects of stuttering look a bit differently depending on what the person in front of you needs or wants from therapy. Counseling is within the scope of practice of a speech-language pathologist, but here in America, the American Speech-Hearing Association, or ASHA, is very specific on where that scope of practice cuts off. We are able to counsel in the therapy room with individuals we serve when it comes to “swallowing disorders” and “communication disorders” with anything falling beyond that being out of our scope of practice. You would then, in those situations, need to make sure the individual got referred to an outside professional- so either contact the person’s referring physician, or contact a child’s parent, etc. With that, there are activities that you can do in the therapy room to help a person who stutters with communication confidence in certain speaking contexts, IF the person is ready for it. Prior to even establishing that these areas will be targeted in the therapy room, you will want to first see what the individual who stutters wishes to work on in therapy. I have my graduate students draw a picture of a ship and label it- the ship is the SLP- the SLP provides the template for therapy, and the steering wheel of the ship is the person who stutters of the child/guardian. One part of the therapeutic alliance (the “ship”) cannot work without the other. The goal writing process is also collaborative- but the person who stutters and/or child/guardian steers that ship- and tells us (the clinicians) their wishes for therapy. Just like if we are in physical therapy, we tell the physical therapist what are goals are, right? Same concept. It just makes sense therapeutically. So, if your individual wants to work on improving communication confidence in certain speaking contexts, then there are some different activities that can be done in the therapy room to target that- when the person agrees that he or she is ready to do them. That’s part of the key here- when the person is READY. We don’t want to force our individuals to do anything at all- we always want to ask “are you ready/comfortable to do this. Role-playing of communication situations like job interviews can be beneficial (there are great workplace initiatives brought on by groups like the National Stuttering Association where individuals who stutter can even participate in mock job interviews by real companies/employment recruiters), practicing self-disclosure (this has been researched to improve communication confidence in speakers), and even voluntary stuttering are all ways that can improve confidence in communication for people who stutter. You want to find what works best for your individual. Also, getting your person plugged in with resources is huge. Organizations like the National Stuttering Association if this person is ready to join a support group (some people who stutter have never ever met another person who stutters), the Stuttering Association of the Young (SAY), Friends, publications from the Stuttering Foundations of America, summer camps for kids who stutter, digital hangouts for adults who stutter like Stutter Social- these are all excellent resources to get your person plugged in if they are ready, able and wanting to meet other people and find some resources- there is so much out there. So, I hope that this helps to answer your first question.
Question 2: Also, how do you treat a client who may not yet have come to terms with their stutter?
-This is a pretty loaded/heavy question but this happens often. “Coming to terms” is quite the process- and oftentimes an ongoing one. I would venture to use the word “acceptance” here, and for me, “acceptance” isn’t a constant. Some days I accept something while the next day, it may be tough and I just don’t. You may see that…. some day the individual who stutters that you are seeing in your therapy room may be very accepting of stuttering, and the next day perhaps someone made a comment to them, and they are not accepting of it. Learn as this person’s clinician to embrace their journey, and to listen. Listening is the most affective thing that you can do- as perhaps this person has never been fully listened to before. Also, know when to seek a referral. Counseling is so important- and I feel that this piece is missing so often and so needed for our people who stutter, and other individuals that we serve as well. Educate your referring physicians on the importance of counseling with individuals who we serve with communication needs, and see if you can get an increase in those psych/counseling referrals if the individuals you serve are in agreement. There is something to that, and it seems to be more than we realize. I hope that this helped you, and take care! Be a world changer, and if someone ever gives you “no” for an answer just keep going and don’t sweat it- you are no different than before you asked.