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From: Ken St. Louis
Date: 15 Oct 2012
Time: 08:43:21 -0500
Remote Name: 157.182.15.121
Hi Danielle, Good question. It's a bit hard to answer, but let me try. Before I do that, I must tell you that there are no hard and fast rules here. I believe that we must treat each client and his/her situation as unique and tailor our approaches to what we judge is needed. Here is an example. Suppose your client tells you that she had years of public school therapy and none of it worked at all. After more probing, you find out that although she was fluent in speech therapy, she still stuttered with her friends and on the phone, even right after therapy. In this case, I would suspect that the client had the idea either from herself, her clinician, or both that successful therapy would eliminate the stuttering outside the therapy sessions. After explaining that a goal of no stuttering might (1) be unachievable and (2) would create considerable stress on the person to maintain total fluency, I would introduce the concept of nonavoidance, i.e., acting in exactly the opposite way as avoiding stuttering. Instead of trying not to stuttering, I would suggest that by stuttering some on purpose, one often finds that what was feared is really not so bad. I would then proceed to recommend some desensitization with the client (e.g., voluntary stuttering) if she were willing to try a new paradigm. I hope this answers at least some of your question. Ken