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Multidisciplinary treatment team

From: Ed Feuer
Date: 16 Oct 2006
Time: 12:31:30 -0500
Remote Name: 207.161.42.121

Comments

To Prof. Tetnowski: Allow me to clarify what I mean by a multidisciplinary treatment team or to be more precise, a coordinated multidisciplinary treatment team. I do not mean referral AWAY. I do not mean an essentially meaningless “eclectic” approach claimed by sole SLP practitioners. I invite you to take down a volume from your bookshelf and turn to page 201 where the writer says: “We feel that stuttering needs a global therapy, a total push, if it is to yield to clinical intervention and that it must be attacked from every quarter and with every available weapon.” I take very seriously those words written by Charles Van Riper in The Treatment of Stuttering. I wish every SLP with stuttering clients would do the same. You know, however, that in practice, the vast majority of such SLPs are not on the same page, in the same county or even in the same galaxy. Van Riper’s stuttering modification therapy, which still makes best sense of anything out there, is simply too great a task for SLPs, alone. Lacking the knowledge and time, they have picked and chosen cafeteria style and the results should surprise no one. The reality is that stuttering therapy effective over the long term demands genuine and thorough systematic desensitization, healing and strengthening. If SLPs are honest -- and I implore them to be honest -- they will admit that is not being achieved in almost anything that passes for stuttering therapy today. Some SLPs know something about stuttering but they lack the tools. Other professionals, who have the tools, know nothing about stuttering. I’d like to see some of these people working together for the benefit of people who stutter. The SID-4 specialty certification is a step in the right direction but it should be seen only as a beginning. SLPs with such a specialty would make the best facilitators for what I advocate. My modest proposal would involve such SLP recruiting other professionals willing to use their skills to help achieve the goals of the stuttering-therapy model. Yes, cost is the objective issue but even before that obstacle is considered, the selfish impediment of “professional domain” as well as ego, fear of change, fear of rejection, comfortable inertia and to be candid, laziness, would all have to be overcome. But it all comes down to that item in the ASHA Code of Ethics about putting the needs of the client first. For elaboration, read my essay In The Year 2025, on Judy Kuster’s Stuttering Home Page at: http://www.mankato.msus.edu/dept/comdis/kuster/TherapyWWW/In2025.html To John Paskievich: Yes, cost is the objective issue but imagine, if you will, what would happen if someone developed a highly effective but also highly expensive treatment of cancer or AIDS. Would the other practitioners tell their patients, “Yes, there is something much better but it’s too expensive, so I’m going to keep giving you the old primitive stuff”? Or would those practitioners with integrity move heaven and earth to try to bring the cost down? I think you know the answer. And, yes, it’s true that nobody dies from stuttering although the accumulated effects of decades of anxiety and misery probably serve to take a few or more years off a life. However, I ask you, John, should we be content to be forever relegated to treatment that is second-, third-, or fourth-rate and inadequate or worse? As for your suggestion that people who stutter should form their own multidisciplinary team, that, sadly, is what is necessary now. But it is a highly inefficient way of doing things. Knowledgeable SLPs could do a far, far better job of recruitment and the creation of a pool of necessary professionals from other disciplines -- IF THOSE SLPS WANTED TO. If . . . — Ed Feuer edfeuer@mts.net


Last changed: 10/23/06