This is a threaded discussion page for the International Stuttering 
Awareness Day Online Conference panel, Paths Toward Recovery, by 
Kristin Chmela, Geoff Johnston, Walt Manning and Bob Quesal.. 

Have to's, shoulds, and musts
From: Gunars K. Neiders, Ph.D.
Date: 9/30/98
Time: 6:45:18 PM
Remote Name:
Your statement, "It has been about eliminating "shoulds", "musts" or 
"have to's", letting go of judging, and learning to talk and even laugh 
about stuttering." is similar to Rational Emotive Behavioral Therapy 
thesis. Did you yourself come up with this or were you exposed to 
cognitive behavioral psychology? 

Re: Have to's, shoulds, and musts
From: Kristin Chmela
Date: 10/13/98
Time: 9:32:19 PM
Remote Name:
Dr. Neiders: My name was not on this post but I think it is directed 
towards me. I actually have had counseling from a psychologist that 
practiced cognitive behavioral therapy. It was a very important piece 
of my recovery process (which of course is still continuing). I 
especially benefited from learning about cognitive distortions and 
changing the way that I perceived various situations related to my 
stuttering. Thanks. K. Chmela

Bob: Attitudes and beliefs...
From: Gunars K. Neiders, Ph.D.
Date: 9/30/98
Time: 7:26:01 PM
Remote Name:
I agree partially with your statement that "New skills, beliefs, and 
attitudes take time to develop." But if we present to the client a set 
of attitudes, such as unconditional self acceptance, decatastrophizing 
;-), and deawfullizing stuttering per se, wouldn't the process be 

Re: Bob: Attitudes and beliefs...
From: Bob Quesal
Date: 10/4/98
Time: 2:00:35 PM
Remote Name:
I guess I don't see how we "provide" a client with new attitudes. My 
take is we develop our attitudes based on our own experiences and 
history. If we try to introduce a new attitude, we're telling someone 
how to think. That's not how it should be done, IMHO. 

Re: Bob: Attitudes and beliefs...
From: Gunars
Date: 10/5/98
Time: 8:39:43 PM
Remote Name:
Bob, You are quite right! I misspoke! I only meant to say that 
removing some of the highly negatively charged attitudes about 
stuttering can be addressed by both experiential as well as cognitive 
behavioral therapies.

Common Treatment Strategies
From: Krista Affeldt-Bacon
Date: 10/3/98
Time: 7:40:09 PM
Remote Name:
After reading the three different treatments that were completed, I 
was wondering how you felt about "common" treatments for all 
stutterers? I was under the impression after reading the three 
entries that you each had your various reasons for overcoming your 
dysfluencies and that possibly not everyone would be able to utilize 
that particular method of treatment.

Re: Common Treatment Strategies
From: Walt Manning
Date: 10/5/98
Time: 10:53:30 AM
Remote Name:
Regarding a "common" treatment for all people who stutter. There 
are more or less comprehensive treatment strategies, I think, each 
with different associated techniques. The strategies and techniques 
all have value and I don't know that one is better than another. It's 
up to the clinician do decide what the client needs and when and 
why, choosing from among the strategies and techniques. Trying to 
find the ONE technique or especially, arguing that one is better than 
others is like comparing religions, political systems or coaching 
techniques. It depends on people, timing and experience. And maybe 

support groups
Date: 10/4/98
Time: 7:40:53 PM
Remote Name:
Did any of you have an opportunity to be part of a support group 
when you were younger, say between 9-14? Would that have been 
helpful? If so, what discussion topics, problems or activities would 
have been most helpful? I am asking these questions because I'm 
about to begin a group therapy for kids, and Barry Guitar is going to 
simultaneously work with their parents. Any input is greatly 
appreciated!! Many thanks. Julie

Re: support groups
From: Walt Manning
Date: 10/5/98
Time: 2:24:59 PM
Remote Name:
No, I had never had an opportunity to become a member of a 
support group....there wern't such things when I was young. There 
were barely any SLPs and most of them were afraid of somehow 
hurting the child who stuttered! Having taken part in some NSP 
programs with parents and children in the past few years, I wish I 
would have had such an opportunity. I believe it would have gone a 
long way toward helping me deal with the shame and would have 
helped my parents to deal with the guilt and enabled them to 
understand much more about the problem. The only advise they 
ever received (from a psychologist) was a suggestion that I stop 
swimming (something I loved) because it was a bilateral activity!

A self help group
From: Benny Ravid
Date: 10/9/98
Time: 10:16:49 AM
Remote Name:
I'm not an SLP and my academic degree has nothing to do with 
speech therapy. I'm just a simple stutterer :-). I agree with the 
statement that "Client must become their own problem solver". But in 
my opinion , a PWS may become it's own problem solver, only if the 
strong emotions of guilt or shame which are connected to the 
stuttering are removed or at least are significantly reduced. Seems to 
me that a self help group provides a space, in which such emotions 
are being gradually reduced which changes the stuttering from being 
a shame or a guilt into a problem to cope with. Please comment. 

Re: A self help group
From: Bob Quesal 
Date: 10/9/98
Time: 2:45:46 PM
Remote Name:
I agree that shame, guilt, etc. need to be dealt with. Self-help groups 
are but one option for help in this area, however. I think a good SLP 
can provide help with this, and there are other places, as well. I 
agree with your point that these factors should be addressed if one is 
to solve one's own problem(s). I hope this response answers the 
point you were making. 

Re: A self help group
From: K Chmela
Date: 10/13/98
Time: 10:22:16 PM
Remote Name:
I do believe that self help groups help many individuals deal with 
difficult emotions such as shame and guilt that may surround 
stuttering. I know that whenever I attend an NSP function I grow as 
an individual in terms of dealing with my own stuttering. For myself, 
some of my greatest growth has come from dealing with the issues 
related to shame, guilt, etc.. 

Re: A self help group therapy
From: Les Anderson
Date: 10/16/98
Time: 11:13:56 PM
Remote Name:
If I may interject here with a word of modest caution. Care and 
caution should be taken as to what form of therapy is gained from 
self-help group members. Most self-help group sessions are attended 
by lay people who stutter and share their personal feelings, 
aspirations and goals with each other. These are great emotional and 
encouragement factors in dealing with our stutter. Many times 
however, one or two of the group's members become self-appointed 
therapists and can inadvertently cause many problems with the 
advice given. I think a step of caution should be taken when 
accepting diagnostic advice from someone who is not properly 
trained. I agree most strongly that it is a very important step in our 
fluency process to join a self-help group but one should not dive in 
blindly. Our provincial Association in British Columbia encourages, 
that professional people be invited to attend and give seminars at 
group meetings from time to time. 

Les Anderson 

Kristins Story
From: Julie - Denver, CO
Date: 10/11/98
Time: 7:08:28 AM
Remote Name:
Kristin, I am curious if you still stutter at all. I can identify with most 
of what you say. I am 27 and didn't get proper speech therapy 'till 3 
years ago at the University of South Florida. Before going into 
therapy, I had spent the last 3 years trying to deal with problems 
that had haunted me for years. With the combination of good speech 
therapy and continueing to work on deep seeded troubles, my 
stuttering has gone from severe to mild. Today,I do technical support 
over the phone and am a member of Toast Masters International 
(joined 2 months ago. Told them I had a stuttering problem in my 
first speech). Though, moving back in with my parent and getting 
yelled at and either I do what they say or live in the streets (finally 
getting my own place in December) has put me back a few steps, I 
truely believe by the year 2000 I will be completely over stutter. 
And as long as I continue to work on certain things for a bit longer, 
my stuttering should not return. I enjoyed reading your story and 
I'm sure others have as well. 

Best Wishes, Julie

Re: Kristins Story
From: Kristin 
Date: 10/13/98
Time: 10:20:41 PM
Remote Name:
Julie..I was not in a support group when I was younger (between the 
ages of 9-14). I think it would have made a tremendous difference in 
my life had I had one. I say that because of what I have seen happen 
to the children who are in our group. I usually carry between 12-18 
school age children on my private caseload and last year we had a 
group that met once per month. The benefits for the children are 
many...we did not use our group as a "place" where they needed to 
"practice" their speech tools (although that is one great way to use a 
group). We used the group as a place where the childrne could meet 
others with the same problem and feel a sense of great support. 
Many of the kids chose to work on their tools which was great but 
we had no "expectations" for their fluency. Last year we decided as a 
group to write a newspaper to teach teachers about stuttering. The 
children developed twelve sections for the paper and at each 
meeting we would work on it. It was a wonderful experience for 
everyone. Many of the kids have continued to ask me when the 
group will be starting again. ( I will specify here that of course not all 
children would be ready for a group or would benefit from one) One 
thing I firmly believe is that if we are going to fomr special 
relationships with children we must have fun with them. We usually 
included pizza/pop/ice cream sundaes..whatever at the group. 
Whenever possible we included sports activities (easy fo rme to do 
being that my husband is co-owner of an indoor sports complex. One 
of the neatest things we did was go indoor rock climbing. That was 
an activity that had alot to do with working on stuttering!!! Most 
children love physical activity and it's a great way to utilize "team 
building" and relate it back to speech. Good luck! PS. Teh younger 
kids usually benefit greatly from having the older kids there as role 
models. I have clients that have been out of therapy for years and 
they still call to come back to the group. 

Kristen Chmela- Recovery
From: Lee Caggiano
Date: 10/13/98
Time: 7:31:49 AM
Remote Name:
Your story of personal recovery was absolutley inspiring. Kristen 
thank you for sharing your journey with us. As a mother of a teen 
who stutters and as a clinician with the awesome gift of being 
allowed to share this journey with others your story brings a great 
feeling of peace to me. I am thankful for yet another opportunity to 
learn from you. Lee 

Re: Kristen Chmela- Recovery
From: K Chmela
Date: 10/13/98
Time: 10:21:37 PM
Remote Name:
Thank you, Lee. One of the greatest things is to realize that the 
"journey" becomes the most special gift of all. 

From: Speak Easy, Inc.
Date: 10/14/98
Time: 12:50:24 PM
Remote Name:
Your paper is very interesting and would also be of interest to those 
stutterers not participating in this online conference. As Canada's 
organization for people who stutter, may we publish a copy of your 
paper in a future issue of our monthly magazine, "Speaking Out"?

Re: Newsletter
From: K. Chmela
Date: 10/22/98
Time: 9:23:50 PM
Remote Name:
You asked it you could publish the paper in your newletter. 
Absolutely. I am honored. Thank you.

From: Jean O'Conor
Date: 10/16/98
Time: 8:14:29 AM
Remote Name:
What do you think the struggle to "accept" stuttering experienced by 
many adults who stutter tells us about how to treat young children? 
Is the prevention of fear and negative feelings enough or do they 
still have to go through years of therapy to manage the disfluencly? 
Is it even possible to prevent the negative feelings or does one 
always have to confront them at some time in one's life?

Re: Recovery
From: Bob Quesal 
Date: 10/17/98
Time: 5:37:01 PM
Remote Name:
Jean asks an extremely good question. I wish I had an extremly good 
answer. I don't think that "prevention" of negative feelings and fear 
would be possible in a child who had any more than a mild stuttering 
problem. Some people who stutter are not affected by it much at all. 
Others are deeply bothered by it. And the depth of despair is not 
directly linked to the severity of the stuttering in many cases. So on 
the surface it would seem that if we could lessen the fear and 
negative feelings, that might be an important step. It still seems to 
me, though, that you need to have some sense of "control" over your 
speech. A person unable to control their stuttering, or modify it, is 
not very likely to be able to avoid the negative feelings and fear. 

The other issue about acceptance, that I talk about in my paper, is 
that in many cases it does just come with maturity. We change our 
perception of how important things are as we are exposed to more 
and more things in our lives. What was a big deal at age 16 may not 
be a big deal at age 36, or 56. I don't know if I could have been 
"taught" or "encouraged" to accept my stuttering when I was 
younger. It'd be interesting to travel back in time and see if different 
therapy when I was young would have led to changes in the way my 
life has progressed. 

I know that Kristin Chmela and Bill Murphy (as well as others) do a 
lot to help reduce the shame that children feel about their stuttering. 
I think it's an important component to therapy. I'm not sure how 
well it works by itself, however. 

A very long, convoluted answer to a very good question. BQ

Newsletter..Speak Easy
From: K. Chmela
Date: 10/16/98
Time: 10:51:42 AM
Remote Name:
You asked it you could publish the paper in your newsletter. 
Absolutely. I am honored. Thank you.

Walter Manning: My Story of Achieving Fluency...
From: Heidi Thorson
Date: 10/18/98
Time: 2:51:56 PM
Remote Name:
Thank you for sharing your story. I enjoyed very much. My question 
to is the following: When you changed some of your attitudes about 
your speech and yourself did find that it also changed the 
attitudes/reactions of listeners or did it have little or no effect among 
listeners. Sometimes I think attitudes can have a ripple effect and I 
am curious to know if you experienced that.

Re: Walter Manning: My Story of Achieving Fluency...
From: Walt Manning
Date: 10/19/98
Time: 10:08:47 AM
Remote Name:
Heidi- I'm not sure just what my listeners may have thought. I know 
that the more I accepted myself as a person who stuttered and the 
more I was "open" about it, the easier it was for others to accept and 
discuss my speech. There is some research indicating that if a person 
with a disability is able to accept their problem and be up front 
about it, listeners are more likely to take this approach also. If the 
person who stutters opens the door for discussion we find that most 
people want to talk about it since stuttering is, in fact, a very 
interesting syndrome. I guess it's true that the more OK you feel 
about yourself & the brighter you shine (whether you happen to 
stutter or not) the more likely it is that you will attract (rather than 
repel) others. 

Geoff Johnston- smooth speech
From: R. Flicek
Date: 10/19/98
Time: 4:48:27 PM
Remote Name:
Mr. Johnston, you mentioned "smooth speech" as being the most 
effective fluency technique for you. As I am unfamiliar with this, 
could you tell me more about it? Thank you.

Re: Geoff Johnston- smooth speech
From: Geoff Johnston
Date: 10/21/98
Time: 5:03:29 AM
Remote Name:
Smooth Speech is the primary fluency shaping technique used in 
Australia. The main elements of Smooth Speech are: 
1. Easy Onsets / Beginnings Breath into the beginnings of words so 
that your speech sounds somewhat like a sigh. Must be a totally 
passive airflow! Say first word very slowly! 
2. Soft Contacts  All consonant sounds should be made with your lips, 
tongue, teeth and palate (roof of mouth) resting very lightly together. 
3. Aspiration of Vowels All vowels at the beginning of phrases (ie 
when you begin speaking or after you have paused to take a breath) 
should have an "h" sound before them. Vowels produces in the 
middle or end of phrases should be joined to the sounds which 
precede them. 
4. Blending of Syllables through: 
o Continuous Airflow - breathing should be from the diaphragm and 
ribs, and not short and shallow. When speaking, you need to use a lot 
of easy, continuous airflow; and 
o Continuous movement of your speech muscles - your tongue and 
lips should be moving all the time while you are speaking. Sentences 
should be produced with smooth, continuous blending of each 
syllable into the next. 
5. Reduce speech rate to under 200 syllables per minute  Slow 
speech gives our speech mechanisms time to do what is necessary for 
fluent speech. Main emphasis should be on slow speech with linkage 
of words in phrases. 

Remember: Stuttering is something I DO as I talk, NOT something that 
magically "happens to me". I will remain a stutterer as long as I 
continue to pretend not to be one. 

Ready for treatment
From: Kristi Bongaarts
Date: 10/20/98
Time: 11:42:29 AM
Remote Name:
Dr. Manning, you mentioned that a client needs to be ready for 
treatment and want to alter their response to a situation. I agree 
with that but I work with some adolescents and I find that they are 
not ready to work toward change. What do you suggest I do to help 
them? Should they be dismissed from services until they are ready 
for help or do I keep having them come to speech even though they 
don't want to and are not making any progress?

Re: Ready for treatment
From: Walt Manning
Date: 10/20/98
Time: 3:24:29 PM
Remote Name:
Kristi- Teenagers are usually not ready for treatment, as I probably 
mentioned in an earlier post. Other things take, "What 
am I going to do Friday night!" I don't think we can force them, 
although sometimes we can lay some groundwork for future change. 
At least they can find out that there are competent clinicians out 
there who really do understand what's going on with stuttering and 
are excited about helping. The internet is a great source of 
information for adolescents as well as the information provided by 
the Stuttering Foundation of America in the form of video and 
booklets. National Stuttering Project videos, printed materials, 
workshops, and web page are wonderful ways for a teenager to find 
out that he is not alone and that there is much to learn, and maybe 
change, about his situation. So, your are right, it is often very difficult 
to get teenagers to commit to the treatment process and all we can
do is give them the opportunity.

From: Anita S. Blom
Date: 10/22/98
Time: 6:46:47 AM
Remote Name:
Wow, what a day. We didn't have time to have a big seminar, but 
contacted over 300 tv and radio stations and newspapers: the phone 
hasn't stopped!!! It was on the first news bulletin this morning and 
will be on almost every local station during the day. We really have a 
tool here. Wipe me up when this day is over....... Thanks and happy 
Anita S. Blom

Common treatment strategies
From: Dick Curlee
Date: 8/22/99
Time: 4:31:38 PM
Remote Name:
The effectiveness of specific treatment strategies and procedures 
reflect the skill with which they are used as well as the 
appropriateness of their use for specific clients. I suspect this could 
be demonstrated empirically if 10 similarly qualified clinicians were 
each assigned a group of 30 randomly selected persons who stutter 
and if each clinician employed the same strategies and procedures 
with each person in his/her group. I am confident that not only 
would there be a range of outcomes in each group, but the groups' 
average outcomes would also differ.