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From: Ellen-Marie Silverman
Date: 20 Oct 2007
Time: 11:29:26 -0500
Remote Name: 64.12.117.66
[[" . . .Do you have any suggestions for SLPs who are hoping to help facilitate change in clients who stutter, either by improving the therapeutic bond, adjusting the client's outlook, or motivating clients to be accepting of change?"]] >>> Dear Meagan, Well, let's consider how we go about accepting someone as a client, and, for the present, let's talk exclusively about adults --- otherwise, I may have to respond by writing a short book or a very long article! (Smile.) I, having trained for several years in transactional analysis, where the concept of therapy contract as we generally know it was introduced and formalized, do not begin to offer treatment unless and until I have negotiated a valid contract with the prospective client. The treatment contract formalizes the goals to be met and the terms of the relationship, i.e., attendance, cancellation, fees, etc. If an adult is unable to begin negotiation with a viable outcome goal or goals, I would help him or her to articulate one. If that still remains difficult or if I lack a certain insincerity --- say, the client seems to be trying to tell me what he/she thinks I want to hear --- then we do not undertake treatment AT THAT TIME. It may be that the individual needs to spend some time independently processing that with me as therapist, he/she needs to a) want to change, b) have a clear idea of what to change, and c) take responsibility for making the change. This can be daunting for some people who have become accustomed to therapists doing almost all the work in therapy. If they, upon reflection, wish to engage with me in that fashion, then we are on our way to estabishing some changes. So, that's basically how I begin helping adults change, i.e., by expecting them to articulate and work for their desired changes as co-equals in the therapy process. Perhaps, this will help you see the process in a slightly more practical way. >>> Best Wishes and Good Luck. Sincerely, Ellen-Marie Silverman