Harmful Tactics in Speech Therapy
Hello everyone! I am an aspiring SLP student currently studying fluency disorders. I was made aware that many PWS/PWC have negative associations with speech therapy, due to the continued use of outdated and harmful practices. I was curious if anyone would be willing to share a personal experience with these harmful practices, and how they affected your speech/communication going forward after therapy. What do you wish you could go back and say to yourself in these moments?
I look forward to your responses!
Hi, and thank you for this unusual, but important question!
I have to change the question somewhat, in order to fit my viewpoint and my own experiences.
During my life, I estimate I have seen about 35 different therapists for my severe stuttering (yes, you read that correctly, about 35 different therapists!). In these therapies, I encountered a wide variety of approaches.
There were only 7 therapists that I found significantly helpful to me. All the rest weren’t of any help whatsoever. Some were fluency shaping programs; others emphasized the psychological side of stuttering (including reduction of avoidances). In my most successful programs, I enjoyed temporary periods of consistent fluency, lasting for weeks or months. But always there was a relapse sooner or later.
I wouldn’t regard any particular therapy program that I had as being “harmful”. Many were not helpful in the least, but they didn’t cause harm – the worst programs were a waste of time and money, but they didn’t cause me harm; my speech didn’t worsen in those programs, but just didn’t improve.
In knowing hundreds of other people who stutter, from attendance at many national/international stuttering conferences and conventions, my belief is that almost every therapy program helps some people a great deal, others to a limited extent, and others not at all. Yes, some also find that a therapy program not suitable for them can make their speech temporarily worse; but typically, once they stop using such a program, their speech returns to its pre-therapy level. So I believe it would be rare for a therapy program to permanently worsen a client’s speech, or cause permanent psychological damage.
My therapies at various clinics all occurred between the ages of 4 and 40. Beginning in my late 40’s, I shifted my philosophy entirely, and gave up my long quest to transform myself into a fluent speaker. I started to accept myself with calmness and confidence as a person who happens to stutter, a person with a speech difference. And I found that this brought greater pleasure to my life, and took a huge pressure off my shoulders.
But to get back to your question: If I were to rephrase the question to fit my own experiences, it would ask about the worst therapy program I ever went through – one that not only didn’t help, but also in retrospect was an absolutely complete waste of time and money.
At a university where I was a grad student of music, I tried an expensive program run by the Psychology Department. It was early 1977; I was 22 years old, and it was during a period when my stuttering was much more severe than it is now. I was having very long blocks on almost every single word. (The payments for this program were deceptively called “voluntary donations”, which effectively ruled out any kind of health insurance coverage. Luckily I had a well-to-do grandfather who covered the costs.) In tbis program, I learned a simple fluent pattern of speech, based on breathing and phrasing.
The clinicians were of the even more simplistic opinion that once someone learned their fluency pattern inside the clinic, it could then be applied in all other situations. And if it wasn’t so applied, the reason must be that the client CHOSE to stutter rather than using the pattern, due to some deep-seated benefit the person was receiving from stuttering.
The therapy sounded to me like nonsense from the outset. But the clinic claimed a 98% cure rate, and I was really desperate for speech help. With a 98% chance of a complete cure, and my great difficulties of speech at the time, I jumped at the opportunity to try it out.
I had immense trouble applying their speech pattern in the outside world, and I certainly knew I was NOT choosing to stutter, nor was I receiving any benefit from stuttering. The clinic spent hours with me trying to figure out what was the alleged deep- seated reason for my “wanting” to stutter in so many situations. Why was I so (allegedly) tied to my stuttering? Why was I so adverse to using their technique? What benefit was I receiving that made me wish to stutter so severely, and refuse to use their technique? We explored these questions in depth, even though – deep inside – I completely rejected their concepts. In reality, I WANTED to be fluent – I wanted to use their fluency technique. But I just could not do it, no matter how hard I tried.
A few months later, they called me in for a follow-up. I asked point blank if I was among the 2% who had “failed” their program. Yes, they told me. I was (allegedly) among the 2% who had “failed”. (In retrospect, I do not believe their 98% claim.)
To the best of my knowledge, this clinic no longer exists. The psychology professor who had devised and run the program has passed away. I have read or heard no more about the program in the years since. Looking back at this experience, I am glad this clinic no longer exists.
Did the clinic help some people? Yes – I have met others who went through the program; and though they are not cured, tney report that the program was helpful to them. To me, it wasn’t helpful at all – not in the least. And that damn program was incredibly expensive!
Anyways, that’s my most negative story from my many therapy experiences.
Luckily, it did not cause harm. My speech after the program was exactly as it was before the program. It was a waste of time, money, and effort.
I wish you the best of luck in your coming career!
– Paul
Well I am still wearing my battle scars from the Fluency Shaping in the 1980s … That program was focussed entirely on eliminating stuttering by learning an entirely new (and artificial) way of speaking and it got drummed into you that stuttering was BAD or a FAILURE. Additionally there was no follow-up post program, nor any experience of practicing your targets outside the therapy session so it set up a lot of people for relapse (including myself).
Okay – rant ended. I am incredibly heartened by seeing how the field is changing with regards to many different types of therapies out there, individualized attention (what works for one person may not for another), and the attention being paid to the inevitable emotional knots of growing up while stuttering very severely. May SLPs continue to recognize this.
Fluency shaping therapy was particularly harmful to me.
In my perception, I changed one way of speaking with which I was uncomfortable with another way which made me even more self-conscious and uncomfortable.
The effort to produce “shaped” speech was exhausting, and often I could not focus on both my message and the effortful production of shaped speech.
And when I stuttered, the sense of failure and shame were much worse than before that “therapy”.
The stuttering-repressing fluency-shaping therapy is outdated and harmful. There are much better, modern approaches that are stuttering-affirmative, such as the CARE model and Avoidance Reduction Therapy. When those therapies are supported by mindfulness training, they are even more effective.
Hanan