About the author: Karissa Colbrunn, M.S., CF-SLP is a school-based speech-language pathologist in Pocatello, Idaho. She is passionate about merging the values of the stuttering community with the field of speech-language pathology. She considers herself a lifelong learner whose research interests, while based around stuttering, are continuously growing and developing alongside her own personal journey. |
Northwest Center for Fluency Disorder’s Intensive Interprofessional Stuttering Clinic
Summer 2016
I gained my first in-depth insight into stuttering during the Northwest Center for Fluency Disorders’ Intensive Interprofessional Stuttering Clinic, run by Dr. Dan Hudock (SLP professor) and Dr. Chat Yates (Counseling professor) at Idaho State University (for more about that experience please see our ISAD presentation from last year: here). We used an acceptance-based framework and worked from a person-first model to look at stuttering in a holistic sense. How does stuttering influence different situations? We looked at stuttering as a part of who they are and all worked together as a team to figure out our values and pushing ourselves to lean into discomfort in pursuit of our dreams. I woke up every day feeling excited and more passionate about what we were doing to help Susannah discover more about her stutter and herself, and I learned so much about myself in the process. I was encouraged to not take the easy way out. Perhaps one of the most important take-aways reflecting on this experience was how stuttering added an extra layer to feelings I had inside but never talked about, like not belonging, feeling different. I had always seen feelings as good and bad and tried to control as many good as I can and push away the bad. I threw out my Masters’ portfolio paper that I spent a semester writing, and started over exploring ways that SLPs can positively influence quality of life with the people we work with who stutter. I attended monthly NSA local chapter meetings and the more I did, the more I wanted to do and learn.
Speech In Real Life (IRL)
Early Summer 2017
I decided through the encouragement of my professor that I needed to continue my work with stuttering for my final externship. He knew of an awesome SLP from NSA named Katie Gore and I knew as soon as I looked at her website that I had to do everything I could to work with her. At her practice, Speech IRL, she makes speech therapy more like life therapy, and has the overarching goal that her work will positively influence “her people’s” lives outside therapy… And it totally does. Despite this feeling of needing to do this work, moving to Chicago seemed entirely unrealistic. How could I go somewhere that I knew no one, had never been before, for an eight-week placement? Through the support of my therapist, boyfriend, family, and friends, I knew this was a part of my journey, and off I went two days after my Masters’ graduation.
The biggest contrast between the IISC and working with Katie was the motivation of the people I worked with. At the IISC, everyone was interested in acceptance and we had a fancy manual to operate from that gave great rationales and outlines of why we were doing what we were doing. With Katie, there is no manual and every session depends on what the person brings in. In a crash-and-burn moment, I worked with someone who said they spend all their time hiding their stuttering, but once he stuttered, felt so much more comfortable and less restricted by his stuttering. When I asked if he had thought about advertising and telling people he stutters, he immediately shut me down with a quick “No! I would never do that” and I really struggled in that moment to figure out where to go from there. Katie was extremely supportive throughout my whole experience and helped me troubleshoot these situations, where I didn’t know how to get to a place where I could talk about things and try activities I wanted to do.
Speech IRL specializes in working with adults who stutter, but we also see other adult clients who fall through the cracks in traditional therapy, working on really interesting cases like executive function coaching, advanced articulation and language therapy, and one of my favorite areas, social skills. The social world is so complex, and I really saw a link between the work we were doing with stuttering. Meeting new people can be scary, but if someone hasn’t faced their stuttering, these can be absolutely terrifying and debilitating. This fear can keep someone from doing things they value.
NSA Conference
Summer 2017
I was really nervous about going into my first NSA conference in Dallas, Texas. Many of the members of the stuttering community have received awful therapy from SLPs and understandably harbor some resentment toward our profession. I was afraid they would place these negative experiences onto me as a person and question my reasons for being there. One of the first people I met was on my shuttle from the airport and found out that at 50 years old, the first time he had ever left his hometown was for the NSA conference in Atlanta the previous year. He was in a place where he didn’t want stuttering to control his life anymore and it was obvious that NSA empowered him on the road to living his best life.
At the first timer workshop, I met a young guy at his first conference who was really struggling to say his name. After telling him I was an SLP, he lit up and said “I’ve never met an SLP who stutters!” and the feeling I came in with that I, a fluent SLP, shouldn’t be there, because it’s not my place, was intensified and magnified. At my first open mic, I heard a story about a 27 year old who had dreams when she was younger of being in a world where everyone else stutters. I met lawyers, doctors, professors, and SLPs who stutter and gained even more insight as to what our job should be as a professional. Not to push fluency and societies stigmas onto people, but to support the stuttering community and break down these barriers. I attended an amazing research symposium, super applicable clinical workshops, and what stands out most to me was a workshop on fluent allies and what people who stutter want from their support system.
We directly addressed the resistance between SLPs and the stuttering community, and something I took away from it that was that it’s important to open up dialogue about resistance, share our rationales, and it’s okay to push boundaries but not overstep them. Dr. Boyle’s research about stigma shows that good ways to address society’s false expectations and judgments toward stuttering are to protest and educate, but that the best way is to contact and tell personal stories about stuttering. I can’t do that and I see this as a role I can’t fill in the community.
A way I really see my interests and knowledge playing in is through educating not only my friends and people I already know, but other SLPs who haven’t had the experience and training I’ve had on things I’ve learned at this conference. Treating stuttering can be really challenging and is outside the box compared to most things we do in our field, but the time and energy it takes to provide excellent, acceptance-based treatment repays itself tenfold by the results you get compared to a fluency-based treatment.
I feel like my role as a professional is to support and encourage the people I work with and advocate and educate others about stuttering to (hopefully) reduce the amount of jerks they meet on a regular basis. I find that the more people I meet who stutter, the more research I do, the less I feel like I know about stuttering. We are making progress as a field into the neurological differences and functioning that cause stuttered events, but everyone’s experience with their stuttering sheds new light on what it’s like to stutter. There is a general lack of knowledge about stuttering and what bothers me the most is when good people, especially SLPS, don’t know how to interact with someone who stutters so I spend a lot of time talking to people about what stuttering is and how to interact with someone who stutters. Honestly, society hasn’t caught up to the awesome things my friends are doing and it makes me really mad and frustrated with how hard they have to work just to get past the stigma of stuttering.
This conference helped me uncover my true self and be open with my vulnerabilities that I hide every single day and I learned that by sharing these things that I hold so closely to myself with others, I don’t have to be alone in dealing with things that I hide. People are willing to listen and understand if I let them in. I’m devastated to leave Adult Disneyland as I describe the conference, but I’m excited to go into my profession with a refreshed, expanded insight as to what my role is in the stuttering community and collaborate on projects that can improve the world for people who stutter.
I love this! Thank you so much for sharing! You had an incredible summer and walked away with so much knowledge and insight. I think that we all have challenges and obstacles to face, and everybody has something they would rather hide. I love what you said about, “People are willing to listen and understand if I let them in.” It is conditional! We get to choose. If we choose to let people in and give them a chance to, they will try to listen and understand. Vulnerability is power! Best of luck to you in all your endeavors!
Thanks so much Lindsay! You totally picked out my main point in writing this 🙂 Good luck to you too!
I’m a graduate student and our Fluency Disorders professor stutters. I think it really enriches the class to have instruction and insight from a person who stutters. It adds a whole new level to the learning (in my opinion).
Do you ever have any difficulty connecting with clients because they feel you can’t understand their problem as a non-stutterer? When/if this happens, how do you overcome it?
I LOVED reading your paper, it is really inspiring to me since I’m about to embark on a similar journey of professional discovery!
Hi Brenna,
I totally agree that having a professor who stutters is so beneficial to our learning and offers such a necessary perspective going into the field. We are so lucky!
Great question. This is definitely something that comes up for me, mostly in situations involving groups of people who stutter. My advice is to try and connect in an authentic way, without invalidating their experiences. In stuttering therapy sessions, I’ve found it beneficial to talk about my experiences with pseudostuttering, and also situations where I’ve felt some of the emotions that come with stuttering. When we open up and are real with our clients, they’re likely to respond in a similar manner.
Good luck with your program!
Karissa
Karissa,
That is great advice! I’ve never thought about that before, but I have definitely had frustrating moments of disfluency. Thank you so much for taking the time to share :)!
I love this post! As a future SLP, it is encouraging to hear that professionals within our field still might feel nervous about how they are received with a client who stutters. I will take your advice about opening up a conversation about resistance to our profession with future clients, and in turn educate my own peers.
My question is, what tools do you utilize as a practicing SLP, to engage with clients who stutter with your and their peers?
Thanks for the post!!
Hi Katie,
Great to hear! Stuttering is so complex and going into therapy with an open mind is so crucial.
I like finding media resources to talk about, like Youtube interviews (especially with teens that I’ve worked with in the schools). With really motivated clients, I like to assign Stuttertalk podcasts relevant to whatever we’re covering as homework and we talk about those at length.
The Stuttering Foundation (http://www.stutteringhelp.org) and NSA (http://www.westutter.org) have great articles, handouts, and resources. I HIGHLY recommend The Practical Guide to School-Age Stuttering Therapy by Nina Reeves and Dr. Scott Yaruss if you’re working with school-age children (http://www.stutteringtherapyresources.com/store/product/school-age-stuttering-therapy-a-practical-guide). Papers and videos from ISAD are great too! I really try to tailor my therapy to whatever the individual is working on rather than bringing my own agenda and find that they are more motivated during and outside of sessions.
Also I believe the BEST thing you can do as an SLP working with stuttering is to give your clients information about self-help and groups like NSA and Stutter Social.
Best of luck!
Karissa
Great post! I am a graduate student at the University of Minnesota, Duluth in an advanced Fluency Disorders class. My question for you is, how have you help advocate and educate others who stutter? Do you have any resources that you like in particular or have discovered when attending different conferences?
Thanks! I just replied to Katie above with some things I use in therapy so check that out. As for advocating and educating people about stuttering, I talk to my friends and family about stuttering. One of the reasons I wrote this paper was to share why I care so much about this part of our field. I’m really passionate about SLP education in regard to stuttering, so I try to be a resource for my coworkers in the school district, students from my cohort, and SLP students who don’t have as much experience as I do. I gave a presentation over the weekend about taking a holistic approach to stuttering therapy and would like to do more outreach in the future 🙂
Check out https://isad.live/isad-2017/papers-presented-by/creative-expression/how-to-be-a-fluent-ally-to-people-who-stutter-an-illustrated-guide/ if you haven’t already!
Hi Karissa!
I really enjoyed reading your post and seeing the ways you’ve been inspired, taught, and grown in the field already. I am a second year SLP graduate student, and reading your post is inspiring to me as I embark on the soon approaching career life, showing me how beneficial it is to keep learning once you’re out of school. As you said, the more you research the less you feel like you know. That being said, what are a few key things that you think are most beneficial to know when it comes to working with that first client you have that stutters, while using an acceptance-based program?
Thank you so much for sharing!
Marshall
Karissa,
I enjoyed reading your article and hearing your unique insights into stuttering.I am currently a graduate student studying speech-language pathology and was just curious as to if you had any tips on what social skills in therapy should look like for adults. Also, I never even considered targeting the social aspect of stuttering during therapy but that makes so much sense. Since you have had experience working with both people who stutter and adults working on social skills, do you have any advice on how to go about doing this?
Thanks so much,
Abby Wheeler
Hi Karissa,
What an awesome journey you’ve had thus far! So interesting to hear about what you’ve experienced/overcome. I am a SLP graduate student, currently in a Fluency class, but getting ready for my last semester on internship in January. You said at Speech IRL you focused on working with adults who stuttered…What are some of your best tips/tricks when working with adults who stutter? I feel as though much of what we are talking about in my Fluency class is focused towards children.
Thanks,
Megan
Hi Karissa,
I really enjoyed this post! As I am a current Speech Language Pathology graduate student, I feel like I am able to relate to some of the feelings you described when doing your externship fieldwork. You mentioned that results of acceptance-based treatment are usually significantly greater than the traditional fluency-based treatment. My question is, is it beneficial to combine these two treatment options? Or is it better to stick with the acceptance based method?
Thank you so much for your time, and the wonderful post!
Best wishes,
Lea
Hey Karissa!
Wow what an awesome summer you had!
I am currently a SLP graduate student at Appalachian State University. My second semester placement was in a school system. Out of the 65 children served, I worked with one child that stuttered. Throughout that semester I felt very lost and had no clue what I was doing. My supervisor had little experience with stuttering and recommended different strategies, such as “smooth speech”, slowing the rate, and easy onset. I felt the session was directed to getting rid of the stutter. I really enjoyed reading your article and how therapy should be focused on acceptance. Individuals who stutter are just like you and I and deserve to be treated no less. I am thankful for people like you to have the drive and passion to help people who stutter. Your passion in this area radiates through your writing.
Question for you:
What is one activity that you use during therapy that the client likes?
Hi Karissa!
I am a graduate student currently in a fluency disorders course. We have discussed that the best therapy approaches involve self acceptance and self confidence. You mentioned earlier in your post that you were working with a client and advised him to tell people he stuttered, which in turn he shut down pretty quick. How did you/do you go about changing a clients view on their stutter?
Karissa,
I thought this post was really interesting and helpful. I am currently in graduate school to be a speech-language pathologist in fluency class. How would you tell a new SLP to interact with children who stutter on their caseload? I am currently in a clinic placement at an elementary school and have a few kids who stutter.
Thank you!
Alex
Hello Karissa,
I really enjoyed reading your post. I am a graduate student studying speech-language pathology and am currently in a fluency class. I agree with your comment that our job should not be “to push fluency and societies stigmas onto people, but to support the stuttering community and break down these barriers”. In class we have touched on the importance of supporting PWS and not trying to push them towards “normal disfluency”. I also love that you are an advocate to your clients and friends who stutter – we should all be! In a previous class, we discussed the use of pseudostuttering both by the client and the clinician. Do you have any positive or negative experiences using pseudostuttering with a PWS?
Thank you for sharing your insight!
Karyn
Karissa,
Thank you so much for your valuable insight and candor about your experiences. I loved that you shared your fear behind going to the NSA conference. In my past experiences with the Deaf community, I have often felt the same way. I felt fearful in telling people that I was studying to be an SLP, but was surprised that they were open and nonjudgmental towards me. While PWS are a completely different population, I feel like I could relate to you and your experience with fear. I also loved the following statement: “…but everyone’s experience with their stuttering sheds new light on what it’s like to stutter.” I loved that statement because it reiterates and stresses the importance of using individualized therapy with anyone we encounter because we don’t really know what that individual has experienced.
Thank you again for your candor and sharing your experience!
Makenzie
Great stories, Karissa! The stuttering community is lucky to have you!
Hello, Karissa!
I’m a second-year online SLP grad student at Idaho State University, and I had the pleasure to be able to sit in on the presentation you did with Dr. Hudock at the IMASH conference a couple of weeks ago. I really appreciated the extra information about the counseling component during that presentation.
The Speech IRL clinic’s approach sounds perfect, and I’ll bet you saw a lot more success in generalization of treatment goals into client’s everyday lives during your placement there. What a wonderful opportunity for you.
I believe you perfectly summed up the resistance many SLPs feel towards treating fluency. I believe a certain component does come from the fact that many SLPs are fluent speakers, and will thus always feel like outsiders to a degree and that we can’t fully understand where a client who stutters is coming from. The fear of not knowing how to interact and the fear of doing or saying the wrong thing also plays a part, I believe. I completely agree that the only way to overcome it is to dive headfirst into it, have open and honest discussions about it.
Thank you for your efforts to educate your fellow professionals and the wider community. I know your efforts will have wide-reaching effects. Just from what little I’ve learned from you and Dr. Hudock, I’ve already put into practice writing goals that are acceptance-based more than fluency-based, and I believe that shift in treatment approaches will truly make all the difference in the world.
Hi Karissa,
I am a first year graduate student in speech pathology and I’m currently taking a fluency course. I found your paper to be helpful, as I know I’m going to be in your position in a few short years! One of the biggest takeaways I found was when you talked about your experience at the NSA conference this past summer. I have an interest in working with people who stutter, and I feel your suggestions of having an open dialogue about the resistance between people who stutter and SLPs will be helpful when building rapport with my clients.
Thank you for sharing your experiences with us, they will be helpful in my future!
Jenny
Your experience sounds amazing! I am glad you were able to pursue what you truly love. I think your comment about how you have to take your experiences and not only teach the general public about stuttering but SLPs as well is so true. I am currently doing a placement and my supervisor was so excited to hear I am currently enrolled in a fluency course and constantly asks what we are learning about. Sharing your experience with others is key because not many of us get such a great chance! Thank you.
I enjoyed reading about your journey! I am a graduate student and I am most interested working with children. I have often come into contact with adults who stutter (unfortunately I do not have experience yet in therapy) but not children. Do you work with children and if so what “life” approaches in stuttering therapy do you take with them versus adults? I would love to hear any input you may have!
Thank you!
It sounds like you have had some pretty informational summers! As a first year speech language pathology graduate student, I have found that sometimes the best way that I find I learn is by crashing and burning. The experiences and networking you had the opportunity to do sound fascinating! I am so glad that you found a passion and have continued to work for it.
Hi Karissa,
I really enjoyed reading this article and learning through your experiences. I am currently a grad student at ISU and just finished a wonderful Summer on the Pocatello campus.
Your writings really helped me understand who I want to be as a clinician. I really appreciated that you mentioned several times throughout this article that you learned more about who you were through opening up and being vulnerable. I think true success is learning about who we are and who we want to become. And the only way to really know we are, is to become vulnerable. Thus, as a clinician, I really want to enable my clients to learn more about themselves. And I know as I guide them on their journey, that I will learn about myself as well.
I also appreciated the story you shared about how you asked a client if he had ever considered just telling people he had a stutter. He quickly replied with a resounding “no” and you mentioned that you were a little thrown off. First of all, I’m grateful I’m not the only one who gets thrown off during therapy sessions ;). But I’m grateful you mentioned this because so often we memorize our lecture notes from graduate school and a list of therapy techniques and ideas and think we have therapy sessions in the bag. But realistically, memorizing therapy techniques doesn’t cut it. In order to be successful in therapy sessions we HAVE to adapt to needs. What works on one person won’t always work on the next person. And that’s so frightening to me. Especially because I feel that I’m inept at troubleshooting. But your article reminded me of how important this skill (learning how to adapt) is in our career, and it’s something I want to improve in.
I also love what you said regarding learning about stuttering. You said that the more you learn, the less you learn. Because everyone has a different experience with stuttering and a different perspective on it. And we have the pleasure, as SLPs, to be life-long learners and learn from all those we meet. And I’m so excited to go forth and learn.
Thank you for this beautiful article.
I loved reading this! What a great experience you have had and I think you are going to help so many people in the future, not just PWS but also SLPs. I met you briefly this summer in Pocatello and we talked about the intensive stuttering clinic. Your passion around stuttering was contagious and it really piqued my interest in the clinic as well. Thank you!
Karissa, I loved reading about all of your experiences involving fluency. I can really tell that you have such a passion for working with this population. I have somewhat limited experience with this population, but I have learned of the importance of building rapport with clients and not pushing fluency, but acceptance. It seems like you had a great experience working with individuals who stutter and bridging the gap with their communities. I think many of the insights you shared can not only be applied to the PWS but also other clients who have communication difficulties. Thank you for sharing your insights!
Karissa,
I loved reading about your experience at the NSA conference. I think I would also share the same fear initially, as it would be terrible to have offended anyone in that situation. That being said, immersing yourself in that conference gave you a completely new perspective on the stuttering community which I’m sure opened your eyes to a whole new side of working with PWS. As a student, I am inspired to do this throughout my career as well.
Best,
Taylor
Hi Karissa,
I loved reading about your experiences as an SLP and the discrepancies you’ve decided to dedicate time to in the areas of stuttering. One thing I found very powerful in your sharing of your experience was when you stated “but everyone’s experience with their stuttering sheds new light on what it’s like to stutter.” Given this statement, can you share further about what others have shared with you about their experiences dealing with stuttering and how you observe a void in research or attention of that specific area? Id also like to know if you feel there are other ways that NSA can promote themselves that can reach further to others such as SLPs and those who stutter as a resource for them? You also made mention of how your friends work hard when facing the stigmas of stuttering? As an aspiring SLP, id love for you to elaborate on this so that I can utilize some of the aspects of fighting stigmas revolving stuttering in my practice throughout my career.
Thank so much for sharing this!
Hi Karissa,
I am currently a graduate student in SLP and reading your post was really inspiring. I think it takes guts to throw away a semester’s worth of work to pursue your passion even if that means going somewhere completely new. Your post also revealed a side of stuttering I was unaware of. I didn’t know there was a stigma towards those that stutter and how it can cause you to withdraw from the rest of the world. Do you know the percentage or ballpark of those who stutter and not seek services? I’m curious to know how many of those who stutter hide it.
Thanks for sharing!!
Thanks for taking part in youth camps. I hope your paper will inspire other SLPs to join as well, as it’s a great learning experiences to see young PWS being themselves and interact. I have been a leader for children and youth camps for many years and we always invite SLPs to join us. Those who did really got an eye opener and were inspired to work with PWS. Thanks for sharing your experiences.
Keep talking!
Anita S. Blom, Sweden