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From: Walt Manning
Date: 20 Oct 2010
Time: 17:06:02 -0500
Remote Name: 141.225.97.59
Mike - you have it right and I think any experienced clinician would agree with you. There are instances where clinicians - often for legal reasons - are not allowed to leave the school grounds or the clinic and do walking-talking therapy or have a conversation while driving a car but, as you say, that is where practicing behavioral techniques is really meaningful. Rolling a kayak in the safety of a pool or a lake - even when you do it 100 times in succession - doesn't count for much. Doing it in whitewater where there is real time pressure and even some danger and certainly real penalty for failure is the only place it really counts. So, to the extent one can, conducting therapy on the streets, in stores, malls, and restaurants is where as much therapy as possible should be take place. Of course, even without the clinician present (which I found often made it easier for me due to the understanding and support provided)the speaker also has to be determined to decrease patterns of avoidance, increase risk-taking, and consistently practice in daily speaking situations on their own in order to become proficient.