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From: Charlie Healey
Date: 23 Oct 2008
Time: 10:38:03 -0500
Remote Name: 129.93.99.57
The CALMS model implies that one would attempt to work on all of the factors at once during any activity but sometimes one factor will receive more focus than the others. For example, if I were working on decreasing negative emotions toward stuttering with a client, I would focus on a discussion of feelings and attitudes toward stuttering. So, that factor would be the first thing to address and might be the main focus of the treatment. However, at the same time, I would add into that discussion what thoughts they have that are linked to the emotion or what they are thinking while they are in a difficult speaking situation. Most of the thoughts are negative and they are not aware of what they are doing (Cognitive) to impede improved flow of the speech process (Motor) and how that relates to what they are saying (Linguistic) and who they are talking to or the situation they are in (Social). So, even though you focus on one factor, you really are working on the others indirectly. The biggest problem I see is when clinicians only focus on motor skill work and don't think through how the other CALMS factors are coming into play or how much they are being manipulated. Another example is if all the therapy is with the clinician, then the social factor is held pretty constant until you ask the client to use the skills at home or in the classroom. Then role playing changes the social factor. Hopes this clarifies how any activity or focus of therapy becomes more integrated with other factors more than one realizes with a little planning.