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From: Walt Manning
Date: 11 Oct 2011
Time: 16:28:54 -0500
Remote Name: 141.225.97.202
Great discussion topic. I know there are some clinicians like Kristin Chemla and others on this "list of professors"(but not enough) how go beyond focusing on the frequency of stuttering. Like Charlie Healey commented, I don't spend much time on the frequency of stuttering but more on the form and effort associated with the stuttering. The overt behavior associated with stuttering is, of course, the most obvious aspect of the problem and the feature(s) the person is often most interested in changing. At least when they first come to therapy. But improving their ability to comunicate is also critical, especially for continued success and many begin to realize that once they begin to achieve greater fluency. Jane Fry and her colleagues have incorporated this into their treatment at the Michael Palin Center in London. The last I heard a manuscript was in press Fry, J., Millard, S., & Botterill, W. (in press). The effectiveness of intensive, group therapy for teenagers who stutter. Journal of Fluency Disorders.) However, an even more basic goal of therapy, and one that underlies a basic aspect of change is the development of an agentic lifestyle (and is closely related the the earlier comments on this thread on quality of life. I think it is best desribed as the ability of a person to “achieve a voice in a literal as well as a metaphorical sense” and where they can act and speak for themselves (see Monk, G., Winslade, J., Crocket, K, & Epston, D. (1997). Narrative therapy in practice. San Francisco, CA: Jossey-Bass Publishers. This is why the line in the King's Speech "Because I have a voice." went through my chest like a spear - and I suspect that it did for many others who have a history of stuttering. So, as others have commented, I think the best clinicians take a broad, multifactorial approach and not only attend to the goals and abilities of the speaker but also focus on aspects of change such as communication ability and recognizing and developing agentic behavior in a variety of forms.