About the presenter: Gary Rentschler, Ph.D. CCC.SLP is the Clinic Director in the Department of Speech-Language Pathology at Duquesne University in Pittsburgh, Pennsylvania, where he directs the Adult and Adolescent Stuttering Program. A board-recognized Fluency Specialist, Gary also was recognized as Speech-Language Pathologist of the Year 2002 by the National Stuttering Association.

You can post Questions/comments about the following paper to the author before October 22, 2008.

"Listen" to What I Do

by Gary J. Rentschler
from Pennsylvania, USA

To provide the most effective therapy for people who stutter, clinicians must be responsible to ensure that clients view their stuttering objectively and that feelings and beliefs about their stuttering are aligned with reality. Clinicians should be mindful, therefore, of discrepancies between what clients say and what they do.

Discrepancies may reveal that the client is unaware of or has a skewed perception of the realities of their stuttering. Or, discrepancies might indicate a client's attempt to conceal something about their stuttering. Over time, contrasting what we see the client do with what we hear the client say can be an effective way of identifying incongruities. This is important because to be able to help the client, clinicians need to have a clear and accurate picture of the problems the client faces.

Many people find their stuttering to be embarrassing. It's human nature to try to hide the parts of us that differ from society's norm. As a consequence, clients may "talk around"or provide misinformation about aspects of their stuttering problem. Further, our ego works to protect us from embarrassment, and in so doing, can limit our conscious awareness of certain realities. Some clients have "tricked"themselves into believing misinformation about their stuttering in order to protect their ego. By listening carefully and observing our clients closely, we may uncover meaningful inconsistencies between how they talk about their stuttering and the way they act and behave as a result of it.

Working with emotionally-laden problems like stuttering is usually complicated and frequently perplexing. The life of someone who stutters is often a mediated balance of habits, rituals, fears, anxieties, feelings, and beliefs about their stuttering. Avoiding situations associated with stuttering is a common reaction to this disorder. Avoidance sometimes results in speaking "untruths"or misleading others in order to circumvent feared situations. So be weary when a client's statements are "out of line" with things we commonly observe. For example, being told, "I don't have trouble talking on the phone, so we won't have to work on that in therapy." In my experience, the majority of people who stutter have more trouble on the phone; certainly not all, but most. This client's speaking ability on the phone then becomes something I will want to tactfully test out in the future to gauge its accuracy and better understand the client.

There is an expression in English which relates to this: "Actions speak louder than words." When there is a difference between an action and words spoken, it may be prudent to investigate further. This enables us to form a better picture of the impact that stuttering has on the client and to learn more about how they cope with it. Observing what the client does and contrasting it with what he says can permit us to better help them find the best resolution to their difficulties. Listen with your ears and eyes -- "listen" to what I do.

You can post Questions/comments about the above paper to the author before October 22, 2008.

SUBMITTED: August 2008
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