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From: Ken St. Louis
Date: 22 Oct 2010
Time: 14:56:23 -0500
Remote Name: 157.182.15.31
Dear Leigh, I don't know what you mean by "With so much talk about not being so vague by using the term fluency." I'll therefore address the second part of your post. "Is fluency shaping no longer a good intervention technique? Fluency shaping doesn't take the clients feelings and attitudes into consideration. Have we out-grown this form of therapy?" I do not believe that fluency shaping should be abandoned. There is considerable research that confirms my own clinical experience that many stutterers improve dramatically with fluency shaping strategies. Some of them are absolutely happy with their results and do not relapse. But some do (as with most strategies). In my experience, when the client is not sufficiently desensitized to stuttering, he or she is more likely to relapse than when desensitization has been accomplished. This is likely for two reasons: First, the person is likely to use the fluency shaping targets to "try not to stutter" rather than "to try to talk in a new way." This is so insidious that, sometimes, a relapse is the only way that this thinking can be clearly identified and addressed. Second, the person is unprepared for the occasional or frequent failures to "stay on target" (and therefore instances of stuttering). Fluency shaping does not, in itself, deal with what to do in these cases. However, IF desensitization is combined with fluency shaping, both of the reasons I mentioned can be mitigated. Generally, unless the client is already well desensitized and simply wants to be more fluent, I add desensitization strategies to the therapy regimen along with fluency shaping. And, though not related to your question, I do the same when I teach stuttering modification. Hope this helps. Ken