Questions for Professionals
Hello Professionals! What do you think is one of the most important things an SLP can do to be supportive of a client who stutters? And what is something that an SLP may do with the intention of helping, but instead makes the client feel worse and/or not progress?
Hello-
Thank you so much for your questions!
I think one of the most important things we can do as clinicians – with any client that we work with – is to take the time to build rapport and establish a strong client-clinician relationship. At the end of the day, research suggests that this is one of the most powerful factors involved in the progress a client makes in therapy (way above the specific treatment approach used). This relationship really is the foundation on which the rest of therapy is built.
When building this relationship, you really get to learn a lot about your client – his/her values, his/her goals for therapy, his/her dreams, fears, etc. This information then becomes essential as you move throughout the therapeutic process – as you want to ensure that what is being focused on in therapy has a direct impact on the individual’s life outside of therapy.
I think it is important to remember that as clinicians – we are guides. Our clients really are the experts on their stuttering – and we need to involve them in the therapy process as much as possible. This means that they help set their goals, they give feedback on what’s working/what’s not, we follow their lead, etc. In many ways, especially as a new clinician, this can be scary and overwhelming because it requires us to set all of our planning/thoughts/ideas, etc. aside and follow our client’s lead. However, with the mindset that therapy is a client’s time and space, we can practice the skill of letting go.
I also want to point out that as clinicians – we ALL make mistakes. No one is perfect and we are learning right along with our clients. When this happens, we can own it, admit our mistake, ask our client for his/her feedback, etc. I think, too, that this is where the relationship really comes into play. When our clients really know that we are on their side – they probably aren’t going to be nearly as critical of us as we are of ourselves. Also, modeling is so important throughout the therapy – and this modeling can include being vulnerable, admitting mistakes, problem solving, not being perfect, etc.
At the end of the day, ask your client what is important to them and really, really listen to what they have to say. Then, take that information, and use it to guide the therapeutic process. With this mindset, and a genuine interest in helping your clients (which you innately have), you’ll do great things!
I hope this makes sense – feel free to ask any follow-up questions as needed.
Good luck!
~Jaime
Thank you so much for your question. To add here, one of the many things SLPs can do to be supportive is to really take the time to understanding the client as a person, and to get to know their client’s unique experience with stuttering. This involves not just what they do when they stutter, but also what they think and feel as it relates to their experience with stuttering.
Please feel free to ask any follow-up questions. I’m happy to clarify anything further, too.
The most important thing in my opinion is to look and listen.. not just to the stuttering, but to the smallest things and tiniest of thoughts and feelings that the PWS conveys both overtly and covertly. Just doing this will prevent most mistakes we might unknowingly make, like setting goals for the PWS (you don’t set goals, they do.. you just help them get to those goals), or imparting too much information in one go, much more than they can process..
So look and listen, and ultimately aim – and teach the PWS to aim- not for a stutter free life, but for better communication, and a better quality of life.
All the best!
Pallavi
Thank you for your important question!
I very much support the feedback already shared above.
Life is a matter of choices. A prerequisite for change is that the persons who stutter perceive the therapy as appropriate, effective and meaningful. I think that we as SLTs, generally speaking, should be even more individual- and context sensitive, and not so much influenced by predetermined principles. It is important to know in which contexts the person is operating. To ask the following question ‘What is important for you now?’ more frequently, would be one tool to improve the working alliance between the SLT and a person who stutters. We knnow for sure, that goals and wishes are changing throughout life, and this is the case also for persons who stutters. That’s why I think such lifechanging questions should be asked more frequently.
I often integrate elements from ACT (Acceptance and Commitment Therapy) in stuttering therapy. One meaninful aspect here is really to get to know what is important for each person. How would you live your life fully and meaningful? Another issues is to ask the person whether a particular action, behavior or thought is taking us towards or away from living the life we really want… (ref. ACT) Instead of evaluating the persons behaviour, feelings and/or thoughts as either negative or positive. I find it more helpful to let the persons themselves to consider these issues. When the therapy it built upon joint decision making, it is strengthen the alliance in a very positive way.
With the very best wishes, from
Hilda