The Monday Modalities post for today is an excerpt from another ISAD 2015 paper.  Loryn McGill, MS CCC-SLP and Nora O’Connor, LCSW wrote Self Advocacy; How to Help without Hindering.  This is an example of how a Speech Language Pathologist and a Licensed Clinical Social Worker collaborate together to provide comprehensive treatment to people who stutter.  This section addresses how self esteem impacts a PWS ability to advocate for themselves.

Find the full article at the following link  https://isad.live/isad-2015/papers-presented-by-2015/research-therapy-and-support/self-advocacy-how-to-help-without-hindering/

Self Esteem:

One of the ways to increase self-confidence is to allow the client to take chances. This starts in the controlled environment of the therapy or counseling room and gradually moves to situations that the client has determined to be of higher risk. Clients will typically take risks as they establish trust with the SLP or LCSW and feel that they are being helped and not hindered. Guiding a client to be prepared for setbacks allows “failures” to be learning experiences.

SLPs can prepare clients by doing speaking situation activities in the office (i.e. telephone calls).  Watching an SLP do tasks first can increase a client’s willingness to try. A client can choose how they want the therapist to voluntarily stutter and what they should say. This can be done through role-play in and out of the therapy room, then with trusted individuals, and then the actual trial situation. Prior to the actual task, the client can make predictions as to how the situation may go, and then discuss prediction vs. reality after the situation. Specific fluency strategies are discussed as well as how to react if asked to repeat a certain word or phrase. Whether to advertise, or mention stuttering, would be determined prior to engagement. A school or work presentation on stuttering would be an option to increase self-esteem through educating peers.

An LCSW will model positive affirmations in front of a mirror and then have the PWS do the same. A Daily Mood Log is taught to identify negative feelings, automatic thoughts and cognitive distortions (Burns, 1999 pg. 75). Grounding exercises and mindfulness techniques are led by an LCSW during the session, and then will be set up for PWS to do on their own. Client’s reality testing is measured by a “Prediction vs. Reality” worksheet to explore assumptions held before situation, and then discusses what actually happened afterwards. Lastly, Dr. Breitenfedlt explains in the Successful Stuttering Management Workbook, “Advertising is the most important technique that a stutterer can learn.” (Breitenfeldt & Lorenz, 1999, p.26). Advertising or being open about stuttering will most likely increase self-esteem and plays a role in self advocacy.

Enjoy!

Nora O’Connor

Monday, October 12, 2015