La Petite Mort

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Re: therapeutic implications

From: LH
Date: 10/13/01
Time: 6:49:08 PM
Remote Name: 24.237.149.8

Comments

Hi, Judy. Thanks for a good question. It's a harder question than it sounds because efficacy of therapy has not yet been defined in a way that is really useful for research. Is a therapy effective if the client stops being dysfluent? Some would argue so, even if the client is not real happy with his or her speech, and remains scared of interactions. Is it effective if the client stutters like an old engine but plunges in with a big grin and at least gives the impression of not caring? There are those who argue that very effectively.

Here is a very rough outline of what I'd like to see. I hope I am not doing myself harm by putting it out here, and that nobody preempts the idea before I'm in a position to become involved. Before I can really consider further research, I need to publish the formal version of the study,get it properly critiqued and perhaps replicated or refined, and be sure that I didn't just stumble on a particularly dissociative group of respondents due to some fluke in the sample.

That done, though, if I were to have the opportunity to design a research program to test whether the presence of dissociation while stuttering really has therapeutic implications, I would choose some admittedly rather arbirary standards by which to define success. These would include both reduced dysfluency and inceased ease of communication for the clients, and increased ease of listening for the client's usual communication partners. Then I would do a very thorough intake interview, which would include a psychological measure of dissociative tendencies, along with more standard stuttering inventories and narratives. Those who indicated through a combination of narrative and more objective indicators to be likely to experience dissociation while stuttering would be offered one of the therapies that has components that can address dissociation along with speech factors, while those who do not seem to be high dissociators would be steered towards a control based therapy. There would have to be a control group of course, probably assigned different therapies on a random basis.

This wouldn't be a quick project, or a cheap one. It might take the coordinated effort of a number of researchers to pull off.

Now, Judy, do you know of any rich foundations looking for a nice, useful, and ongoing research project?

Regards,

LH


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