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From: Greg Snyder
Date: 19 Oct 2006
Time: 20:16:16 -0500
Remote Name: 207.68.248.51
Hi Sara. Even at our best, our existing stuttering treatments provide (IMHO) marginal results. Even a recent survey of over 1,000 people who stutter revealed that the preferred stuttering “treatment” was self acceptance. I can’t fathom that type of response in the medical model. (You must learn to accept your kidney stone…) Subsequently, stuttering treatment a pretty complex balancing act of any number of issues. … … … … … If one reads Bloodstein, he evaluates some 450 different treatments, most of which provided at least somewhat positive results. This even caused him to pontificate that any treatment could be made up at a moments notice, and produce equivalent efficacy to the real “scientific” treatments used by professionals. This is a pretty damning statement, as it suggests that the act of therapy (and perhaps the therapist) may have more impact on the success of therapy, rather than what is done within therapy (i.e., the treatment itself). … … … … … … As such, this is an uphill battle for any SLP to face. Providing efficacious stuttering treatment is difficult! So to try to respond to your therapeutic situation, I think one would optimize a client’s commitment to therapy by targeting issues in which the client values. If the client doesn’t value the short-term therapeutic targets established by your or Dr. Van Riper, then they will not get done. And this is likely to be so, because the client may not recognize or feel that these targets will significantly change or improve their quality of life. The client has hope for improvement, but they may feel (or know) that therapy objective X isn’t going to take them there. This isn’t the client’s fault, as the current paradigm of stuttering treatment cannot remove the pathology, but rather aims to limit the scope in which the pathology affects the person. So as a person who stutters myself, as well as a stuttering researcher and clinician, I wonder what good reporting incidents of stuttering actually provides? Without a pertinent context in which the client identifies, this exercise may seem fruitless to the client. Subsequently, it may not get done. Especially when there isn’t a clear connection between this activity and whatever “job-related” issue that drove her to seek treatment in the first place. … … … … … I guess the point in which I am trying to establish (and admittedly poorly so) would be to suggest that following someone else’s pre-existing stuttering treatment protocol is not the path that I would choose. It may have worked for Dr. Van Riper, but it may not work for me (as the therapist). I will happily and readily admit that there are many a therapist that are orders of magnitude better than I, but my little experience thus far has taught me that successful stuttering therapy is when I help the client achieve their goals- -rather than the client following a prescribed protocol that may or may not be in alignment with their values, short term objectives or long term objectives. Finally, I will suggest that the idiosyncratic nature of stuttering treatment may suggest that not all SLPs (regardless of their proficiency) are appropriate for all stuttering clients. And if there is a stuttering client and an SLP that cannot (for whatever reason) find that common ground or establish that collaborative team effort, then a referral to another SLP qualified to provide stuttering therapy may be the best course of action.