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From: Darrell Dodge
Date: 07 Oct 2004
Time: 13:59:21 -0500
Remote Name: 198.81.26.40
Thanks for your post Tim. I think there are really two broad issues associated with the difficulty of maintaining results from fluency programs. One is that there isn't enough counterconditioning happening. The other is that the intensive programs simply don't last long enough to extinguish the situational conditioning that is ALWAYS associated with stuttering. That's not just because of the lack of de-conditioning reps. The belief structures and avoidance conditioning that support stuttering also need to be metabolized and transformed into more helpful and realistic cognitive behaviors (notice I didn't say "beliefs.") I've also had clients from intensive stuttering modification programs who've experienced relapse because the changes haven't been supported for one reason or other. And it's difficult to change a behavior like stuttering when there isn't a clearly defined and deeply experienced alternative. Hence, as you say, the importance of an integrated approach. Thanks again. - Darrell