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?
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
Hello, Marissa. Thank you so much for posting to the professional panel. This is such a great question! The answer depends on the person you are treating and their personal goals. The biggest factor I take into consideration when it comes to avoidance is: what is the person’s goal in therapy (what do they want to accomplish)? What is being avoided and does the person have a goal to no longer avoid it? I am with Manon; therapy goals are a great opportunity for collaboration and agency in a given care plan. Sometimes client’s don’t know what they want but they want something- so it’s also important to explore therapy options and opportunities with the client. Something to keep in mind: not all avoidance is bad- and sometimes avoidances happen in the lens of operating in survival mode. So, see if the person has avoidances they want to no longer have and go from there. I hope this is helpful, and best wishes in your studies!
Excellent question! I agree with my colleagues on the importance of incorporating the needs of those who stutter into the therapy goals. However, it is quite common for individuals to initially express a desire simply to get rid of their stutter, making that their primary focus. In such cases, I acknowledge their request while steering the conversation toward a broader objective—for instance, by asking: “What would be different, or what would you do differently, if you didn’t stutter?” Through these questions, we explore what they truly aspire to achieve in terms of communication or social participation. This allows me to integrate elements that I believe would be beneficial for them, while keeping the focus aligned with their own personal desires and reality.