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From: Ellen-Marie Silverman
Date: 10 Oct 2008
Time: 11:18:44 -0500
Remote Name: 64.12.117.14
[[ . . . what can you suggest to therapists to help their clients who stutter with the many frustrations and burdens they are dealing with? How can we help them find their path of happiness so they can look beyond their stuttered moments in order to enjoy the life they are living?]] Dear Ms. Page, You are asking reasonable questions about the speech-language pathologist's role when working with adults who come to therapy to address their problems with stuttering. I'd like to start by responding to the implication you suggest that it is our (I assume you are a speech-language pathologist in-training.)responsibility to erase the frustrations and lift the burdens from clients. Unless a speech-language pathologist has become qualified as a counselor or psychotherapist, ASHA does not sanction addressing clients' burdens and frustrations, and, if the therapist should choose to do so, she or he would face severe consequences. Moreover, as much as they would like to do so, speech-language pathologists can not remove clients' problems; client do that. And, if you think about it, you will realize this is a more helpful circumstance to the client. This is not to suggest that therapists should ignore the cognitive and emotional aspects of clients' stuttering problems. On the contrary, to do so would be folly and, ultimately, lead to an unsatisfactory therapeutic outcome. So, balance is required here, as it seems to be in all matters. The balance I am suggesting is to address clients' mind-sets and behaviors specifically associated with the stuttering problem, such as limiting self-concepts and behaviors, including resisting stuttering. (You may find a re-read or two of "Happily Ever After" will provide you with some more specific direction in these matters with these thoughts to direct you.) >>> Then, too, you will want to be selective in accepting clients with stuttering problems for treatment. Before you and the client formally agree to work together on a program of treatment, you will want to be quite clear regarding their motivation for enrolling and help them be clear also. Almost all clients, and, at the moment, I can not think of an exception, seek therapy to become happy or happier. But what they think may help them achieve that might surprise you. Some may decide to enter therapy to get a spouse or relative off their back by "doing something about their speech." They think relieving themselves of the spouse's or relative's nagging will make them happy. Some may decide to enter therapy because they want to improve their chances to achieve or maintain gainful employment in a tight job market. Others may decide to enroll in treatment once again because they are angry and unhappy that, after years of therapy, they still have a stuttering problem and want to share their pain by signing on with a therapist only to unleash their anger to, they hope, punish the therapist for the failures of the previous ones. And so it goes. It is key that you qucikly establish clients' motivation. And, by the way, as I've learned, your own as well. >>> Lastly (not because this is all that can be said but because this is all the time I have to answer your question), I'd like to remind you that, from a certain perspective, not society, not culture, not our parents nor anyone else places burdens on us. They each may provide obstacles to be sure. Whether or not we consider them burdens makes them so or not. Considering obstacles as challenges or tests of our character helps us fashion a self-concept that is resilient and strong, patient and enduring. Considering obstacles as burdens can lead us to feel defeated, victimized, weak, and hopeless. The choice of how we view ourselves and the world around is always our own and certainly makes the difference as to whether or not we will live a life with happiness everlasting. Regards, Ellen-Marie Silverman