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From: Walt Manning
Date: 10/13/00
Time: 10:21:47 AM
Remote Name: 141.225.97.53
Your question and the problem is a commone one. Transferring desired performance from the treatment room is the usual situation and especially so for some speakers. Even maintaining some reasonable level of performance when moving from the treatment room to a lobby or a group treatment setting is a big step for many people. I have always felt that the best clinicians were those who did relatively little therapy in a treatment room. The speaker may demonstrate greater fluency because they have adapted to the clinical setting and their role in the treatment process. Experienced clincians should be doing treatment - to the degree possible at least - in the client's world. I know that this may be difficult for logistic, time, or insurance constraints. However, at the very least, the clinician can accompany the client to several locations and conduct "walking and talking" therapy. There are some measures that have been developed for assessing extra-treatment confidence and performance that provide some information about real world behavior. But, of course, there is no substitue for actually doing it with the client. At last that has been my experience both as a client and a clinician.