The presenter of this paper has consented to have a personal email address
posted here if you wish to raise further questions and/or comments. Contact Gunars Neiders at
neiders@halcyon.com 

Congratulations

From: Lieven Grommen
Date: 10/1/99
Time: 2:21:32 AM
Remote Name: 212.190.7.13

Comments

As always,Gunnars, your survey of the field is very logical and impressive. As a health care worker I appreciate the
theoretical and scientific back-ground you gave to the delicate field of counseling in stuttering therapy.


Re: Congratulations

From: Gunars
Date: 10/1/99
Time: 2:24:49 PM
Remote Name: 206.63.34.18

Comments

Thank you. My ardent hope is that some of the authors whose work I quote will find it advantageous to explain their ideas
in more detail and correct any misinterpretation of their work. I acknowledge that as a fallible human being, I might have
missed some important points. :-)

Counseling in Stuttering Therapy

From: Edward G. Conture
Date: 10/1/99
Time: 3:20:43 PM
Remote Name: 129.59.6.245

Comments

To help update as well as refine understanding of E. G. Conture's approach to the counseling of people who stutter and
their families, a few remarks may be made. First, since 1990, Conture has published several other clinically-oriented
articles on the topic of assessment, evaluation and treatment of stuttering. It is worth noting, therefore, that at least two of
them (Conture & Kelly, 1991, Intervention with school-age stutterers: A parent-child fluency group approach. Seminars
in Speech and Language, 12, 309-322; Conture & Melnick, 1999, Parent-Child Group Approach to Stuttering in
Preschool Children, In M. Onslow & A. Packman (Eds.) The Handbook of Early Stuttering Intervention (pp 17-51, San
Diego: CA) discussing counseling with people who stutter and their families. Second, Conture works routinely, on at
least a weekly basis, with an experienced (Nashville, TN area) child psychologist who assists him, with not only
psychosocial assessment and evalution, but also, when appropriate, counseling of both preschool through high school
clients and their families. Thus, he is keenly aware of and appreciative of the psychosocial concerns and needs of people
who stutter and their families. Third, "counseling" is a many faceted word and concept, with not all parameters of
"counseling" being restricted to psychosocial, emotional and related variables/issues, for example, the counseling needed
to help parents understand and accept that some aspects of their child's behavior are not the sole property or result of
stuttering but other concomitant issues such as ADHD, temperament, etc. Hopefully, the above brief remarks will assist
in evaluation of comments made within this paper. Thank you for the opportunity to comment on this issue, E.G. Conture

Thanks for the update, refinement of views, and excellent references.

From: Gunars K. Neiders
Date: 10/3/99
Time: 11:58:14 AM
Remote Name: 206.63.34.162

Comments

Professor Conture, Thank you for the valuable additional information. I am looking forward reading the papers and the
chapter in the book. Gunars

Counseling and the treatment of stuttering

From: Dick Curlee
Date: 10/1/99
Time: 5:48:00 PM
Remote Name: 128.196.62.98

Comments

I enjoyed reading this review of counseling as it is discussed in a relatively large number of current texts on stuttering. I
understand, also, your reasons for inferring that the text that Gerald Siegel and I edited, its contributors, and editors must
see counseling persons who stutter as taboo. I cannot speak for the contributors or my co-editor, but I view "counseling"
as an integral aspect of the relationship that clinicians should try to establish in working with children and adults who
stutter and involved family members. Such a relationship involves maintaining a focus on the person who stutters while
helping the person discover how to change how he/she speaks or stutters and provide the support(i.e., conceptual,
behavioral, interpersonal) each one needs to effect that change. 

Some of what I do is instructional, some is discussing the alternatives that are available, and a lot is listening, so that I
gain a better understanding of the expectations, concerns, problems, and successes he or she is experiencing. The
techniques that one uses to help someone learn how to change and control his or her speech have little to do, in my
opinion, with whether or not the relationship established can be accurately characterized as counseling. 

I think that you may gain a different idea of my clinical style if you read another text I edited, the 2nd edition of Stuttering
and Related Disorders of Fluency pubished by Thieme. persons 

Thank you for your gracious comments and reference to your book

From: Gunars Neiders
Date: 10/3/99
Time: 12:10:20 PM
Remote Name: 206.63.34.162

Comments

Professor Curlee, 

Thank you for your gracious comments. I am really looking forward to reading your book. Although I overrun my book
budget, my wife promised to buy it for me for Christmas. :-) 

Gunars

How to get there from here

From: Ed Feuer
Date: 10/2/99
Time: 1:43:50 PM
Remote Name: 216.81.25.71

Comments

Gunars, You say: "Lastly, much could be gained by elevating the topic of counseling in stuttering therapy to a bona fide
subject for learning, teaching, and research." To cut to the chase here, how is that worthy goal achieved? We can wallow
in the miasma of the status quo and pretend that SLPs can do it all — or we can finally get serious about the treatment of
stuttering and work to create multidisciplinary teams. As one of the ways of getting this started, I have proposed the
concept of joint practicums whereby grad students from speech-language pathology, counselling and psychology share
stuttering clients under the supervision of their professors. Those professors would of course have to work together .
And that of course stands as the greatest impediment. — Ed Feuer edfeuer@escape.ca 

Re: How to get there from here

From: Gunars K. Neiders
Date: 10/3/99
Time: 12:52:26 PM
Remote Name: 206.63.34.162

Comments

Dear Mr. Feuer, I respectfully, but firmly, disagree with some of your views. I have found that both the practicing SLP's
and their professors have been very open to practical suggestions. Great strides are being made in the field of stuttering
therapy. These have been enhanced by the establishment of specialty in fluency disorders, and the establishment of SID4.
You asked how is my goal of elevating counseling as a subject of teaching, learning and research achieved. The answer
lies in allocating time in the specialty curriculum to do this. As your guru, Van Riper, said, stuttering therapy is a
specialized form of psychotherapy. So along with various speech techniques in the graduate school the students could
study brief cognitive psychotherapy. Furthermore, the doctoral students could perform meaningful research on the
various types of brief therapy. Gunars Neiders 

Re: How to get there from here

From: Ed Feuer
Date: 10/6/99
Time: 10:15:12 AM
Remote Name: 134.29.30.79

Comments

Gunars, You say, "The answer lies in allocating time in the specialty curriculum." Why must this be the only way to
increase the counselling compent? What specific objections do you have to the concept of joint practicums? — Ed Feuer
edfeuer@escape.ca 

My view

From: Gunars K. Neiders
Date: 10/15/99
Time: 7:27:10 PM
Remote Name: 12.13.226.15

Comments

Ed, 

You ask, "Why must this be the only way to increase the counselling compent?" 

My answer is that my erstwhile opinion is that it is hard for me to separate the two fields, i.e. stuttering therapy from
psychology based stuttering therapy. As I have mentioned in the article the early workers in the field thought of stuttering
therapy as a specialized branch of psychology. So it remains today. Divorcing speech exercises from motivations and post
exercise feelings about an assignment is too arbitrary, too mechanical. 

Gunars

Intentional, Theory-Based Counseling

From: Winton Bates
Date: 10/3/99
Time: 12:42:39 AM
Remote Name: 139.134.123.196

Comments

I found your survey to be very interesting. I get the impression that the speech specialists generally don't have a great deal
to say about counseling. I wonder whether a survey of publications by psychologists about counseling of clients who
present with problems related to stuttering would provide a different perspective. Regards Winton 

Good question!

From: Gunars K. Neiders
Date: 10/3/99
Time: 11:51:09 AM
Remote Name: 206.63.34.162

Comments

Does anybody know if such a survey has been done in the recent years. I think the last one to do this was Barbara of
Karen Horney Clinic in New York. Reference: Barbara, D.A. (1962). The psychotherapy of stuttering. Springfield,
IL:Charles C. Thomas.


Gold in the shadow of stuttering

From: Thomas David Kehoe
Date: 10/3/99
Time: 1:11:44 PM
Remote Name: 216.160.168.244

Comments

Gunars asked me to comment on his paper. I'm finding this difficult, because it's not clear what Gunars' views are. I see
what a lot of other authors think about counseling stutterers, but what does Gunars think? That some stutterers need
psychological counseling in addition to stuttering therapy? Of course. That different clinicians use different approaches to
counseling? I can't argue with that. That there's no consensus as to the best type of psychological counseling for
stutterers? That's no surprise. 

I'm the author of "Stuttering: Science, Therapy & Practice" (Amazon.com #1 bestseller about stuttering) and I'm in my
third year studying transpersonal counseling psychology. My book's chapter on "Psychological Self-Therapy" includes: 

- Being open about your stuttering. - Reducing time pressure by not interrupting people. - Changing your work and social
life to create more opportunities to talk. - Writing an autobiography about how stuttering has affected your life. -
Improving your awareness of stuttering by transcribing a video of your speech, marking each type of disfluency. -
Reading Dale Carnegie or other books about improving communication skills, and recognizing that no one is born a "great
communicator" -- everyone can work to improve their communication. - And, my favorite, improving your self-esteem
and your fluency skills by practicing therapy techniques on telemarketers. Get over you fear of wasting listeners' time by
intentionally wasting the time of someone who tried to waste your time! 

Another point I make (thanks to Francis Freeman) is that psychotherapy is "the talking cure" -- and if you can't talk, you
won't get much from psychological counseling. A severe stutterer shouldn't start counseling until he or she has
progressed in speech therapy to being able to talk (or he or she should be given an electronic anti-stuttering device). 

Unlike the authors that Gunars reviewed, my book focuses on what stutterers can do to help themselves, not what speech
pathologists can do with clients. 

Another difference is that I take a transpersonal (Jungian) approach to psychological therapy. My book emphasizes the
"gold in the shadow." Stutterers too often see stuttering as a bad thing, something to hate, a part of themselves they try to
run away from. I tell readers to begin with the long chapter on "Famous People Who Stutter" and see that stuttering was a
gift that each celebrity used to his or her advantage. James Earl Jones overcame stuttering by reciting Shakespeare alone in
the fields of his family's farm -- and became one of our greatest actors. Carly Simon couldn't express her feelings
verbally, so she put her emotions into songs. Mel Tillis changed his fear of people laughing at his stuttering into sharing
the humorous side of his stuttering, to make people laugh. 

The last chapter of my book is "Ten Advantages of Stuttering," with the tenth being John Ahlbach explaining how
stuttering makes you a better person. 

My book has psychology integrated throughout the Therapy and Practice sections. There are chapters on Zen Buddhism,
Carl Scott's guided imagery visualization work with stutterers, Neurolinguistic Programming (NLP), the stuttering
modification therapies of Charles Van Riper and Joseph Sheehan, and Barbara Dahm's experiences with Gestalt therapy.
A psychologist who stutters and specializes in marital counseling wrote a chapter for stutterers to improve communication
in relationships. My chapter on teenage stuttering is based on Carl Jung's stages of ego development, telling teenage boys
that stuttering is not a dragon to fight, but a sword to use to fight dragons. 

In conclusion, I agree with Gunars that psychology and counseling should be a part of adult and teenage stuttering
therapy. I agree that different stuterrers need different forms of psychological counseling. Where I disagree with Gunars
is that counseling is something done by the therapist to the stutterer. I advocate that adult stutterers should learn as much
as they can about stuttering, and make their own decisions about which therapy (motor, psychological, or combined) to
pursue. -- 


Response to Mr. Kehoe's comments

From: Gunars K. Neiders
Date: 10/13/99
Time: 10:09:10 AM
Remote Name: 206.63.34.73

Comments

Mr. Kehoe gave me the biggest compliment when he wrote that "I'm finding this [the commenting on my survey paper]
difficult, because it's not clear what Gunars' views are." In an objective survey of other authors' work it is not the
accepted academic practice to intersperse one's own views. (In the conclusion, though, I am very specific to say that I
believe counseling best be studied using the scientific method.) 

However, since Mr. Kehoe suggests that I comment on what others write, I thought I would point out some differences
in our views: 

Item #1 Mr. Kehoe's statement in paragraph #4: "... if you can't talk, you won't get much from psychological
counseling." My view: Having earned an MA in psychology, I have had the opportunity to study various means of
delivering psychological services to various populations. It is a very narrow view of counseling that excludes: a) group
therapy where a client can observe other people being helped in solving their problems, b) group dynamics where the
group accepts the stuttering client as a participant/observer, since this may lead to the stuttering client also unconditionally
accepting himself whether he stutters or not (note this does not include mindlessly accepting his struggled stuttering, or
any other of his self-defeating characteristics), c) the one on one sessions the where the therapist's patience with the client
as well as his unconditional acceptance of the client again helps the client to accept himself unconditionally whether he
stutters of not, d) the many non-verbal group exercises that lead to the client's de-awfulizing of stuttering and his
disputation of self-rating, e) the therapist recommendation of readings, which are called bibliotherapy, f) the
recommended listening to various audio tapes that are available which explain certain philosophies of life, g) the learning
that takes place when the client gets frustrated with his speech, and the therapist demonstrates his patience with the client's
disfluencies by the way he acts, h) paper and pencil exercises, such as keeping a psychological diary and, especially, the
Rational Emotive Behavioral Therapy homework using the ABC paradigm which is one of the most effective and efficient
ways of changing emotional overreaction, self-downing, self-rating, conditional self-acceptance (I can only accept myself
if I succeed at doing something worthwhile or am approved by other people), etc. 

The delivery of psychological services is only limited by the lack of imagination of the therapist. REBT, Gestalt therapy,
Twelve step self-help groups, dance therapy, role playing (in mime, if necessary) are only a few examples where a client
can gain insights on his irrational and self-limiting beliefs as well as his self-sabotaging over-emoting. 

Item #2 Mr. Kehoe's statement in paragraph #6: "Another difference is that I take a transpersonal (Jungian) approach to
psychological therapy." My view: Jungian therapy by no means is the sole possessor of belief that running away from
stuttering is a bad thing. In fact, I would be hard to put of naming any psychological theory which advocates to do that.
The objective of most if not all therapies is to work through the problems, while squarely accepting that they exist and that
they may have some practical disadvantages. 

Item #3 Mr. Kehoe's statement in paragraph #7 includes the implication that he believes that stuttering makes you a better
person: "...explaining how stuttering makes you a better person. " My view of this: There are many scientific reasons and
philosophical reasons which fly in the face of this concept: 

Firstly, science cannot prove one person to be any better than anybody else, and the sentence implies that somehow
because a person does something, in this case stutters, he becomes a more valuable or worthwhile human being cannot be
proved by empirical evidence or scientific deductive or inductive logic. 

Secondly, philosophically it is equally untenable. People just cannot be rated, except with respect so some arbitrarily
defined, usually culturally based standard. Thus, there are some people who arbitrarily value Bill Gates more than a
physician because they have adopted, again arbitrarily, his wealth to be a better measure of worth than the doctor's
helping out his clients. But if we arbitrarily value a physician more than an industrial mogul, the Ayn Rand fans will argue
with us that this is not a valid standard. The truth is that there are no valid standards on two counts: a) all standards are
arbitrary chosen by a person or a group of persons, and b) people are so complex that there is no way to take everything
into account to rate them (their deeds, their characteristics, their potentialities, etc.) For a good philosophical paper on this
topic, please, visit the following website: http://www.rebt.org/essays/value1.html. 

Thirdly, although there are some people who have accomplished great things at least partly due to the fact that they
stuttered, i.e. Charles Darwin failed as a preacher because of his stuttering, became a heavy drinker probably because of
stuttering, and in order to sober up went to the Galapagos Islands as a ship's naturalist and, thus, gained some vivid
examples to buttress the theory of evolution, by and large, however, stuttering, especially, severe stuttering is nothing to
cheer about. It is intellectually dishonest to say that stuttering "makes you a better person". Granted, for some persons
Friederick Nietsche's dictum holds, "Anything that does not kill me, only makes me stronger." But overall, if somehow
stuttering made one's life better (note how I eschew using the phrase "makes one a better person") we would all be trying
to make our kids into people who stutter. 

Fourthly, ending on a whimsical note: Does that mean when a person who stutters encounters a good stuttering therapy
and stutters significantly less, that he becomes a significantly worse person? 

Item #4. Finally, in paragraph 8 Mr. Kehoe ascribes to me something totally alien to my thinking. "Where I disagree with
Gunars is that counseling is something done by the therapist to the stutterer." Say what?? I reread and reread my paper,
and I could not find anywhere where I have either stated or implied such a view. 

As you can see, Gunars holds his own views, but the forum for Gunars views is stutt-x. 

Gunars 

Your review on counseling.

From: Dorvan H. Britenfeldt Co-arthor  SSMP
Date: 10/4/99
Time: 3:42:07 PM
Remote Name: 198.104.232.26

Comments

May I congratulate you on the huge task you undertook to review the many texts and summarize so much information so
well. Nicely done. The SSSMP, although not specifically refering to "Theory-Based Counseling" certainly does not treat
counseling of the stutterer as "taboo". A large portion of the therapy program is devoted to word and situation fear
reduction, self image development and improvement and feelings and attitude changes. Certainly, you would agree that a
program does not have to subscribe to a specific Counseling Theory to include a great deal of counseling in it's orientation
and practice. In fact it may even be better if it is not based on a narrow, specific theory. Thank you for allowing me to
comment. Dorvan H. Breitenfeldt PhD. 509-235-6453 


Thank you for taking the time to clarify your stand.

From: Gunars K. Neiders
Date: 10/15/99
Time: 7:18:56 PM
Remote Name: 12.13.226.15

Comments

Dr. Breitenfeldt, 

Thank you for taking your time to clarify your stand on counseling in SSMP. 

Gunars

Gunars Neiders

From: Jerry Johnson
Date: 10/6/99
Time: 8:26:52 AM
Remote Name: 205.188.196.39

Comments

I enjoyed reading your paper on Intentional, Theory-Based Counseling. Reviews of the literature with an attempt to make
sense out of it all is never an exciting task, at least not for me. I do have some comments that I'd like to share with you.
People are hardly ever intentionally rational since they bring spontaneous psychological needs each time--these needs are
often unpredictable. However, having said that, I would offer a thought that inherent in every Rx structure might be a
predictability of what they might say but hardly ever when they might say it. For example, I have heard the statement: "I
tried It and It didn't work" as an outcome of their trying a particular technique with all the powerful excess emotional
baggage they have developed over their years of stuttering. The trigger for this statement must be rooted out and dealt
with. This is were the individual needs of the client comes into play and no two people have the same need. I would also
add that counseling of any type starts with the written or oral report of the client and his/her caregivers or partners. These
reports can be so varied that it makes the clinician do some soul searching as to what to do, what to say, how to ssay it
and to whom. The challenge is not so much the stutterilng modification itself as it is the maturity, experience, knowledge,
and humanistic values of the clinician. How to teach this stuff to students? Good question isn't it. We might teach the
mechanics to young budding SLPs but they then must "get" the rest of the stuff like we all did: through doing it over and
over and really caring about the client. I have heard so often people talk about emotional distance between client and
clinician. I view this type of attitude as hogwash. Of course caring about each and every brother and sister is tougher, but
it is also more rewarding. Thanks for your efforts as brought forth in your paper.

Thanks for sharing...some sharing on my own...

From: Gunars K. Neiders
Date: 10/13/99
Time: 10:01:46 AM
Remote Name: 206.63.34.73

Comments

ISAD_replies 

Dear Jerry, 

Thank you for sharing the meaningful thoughts. Let me just share some of my thoughts in turn. These are not meant as an
answer of a critique to your thoughts, but something that spontaneously reminded me of some of my real or Gedanken
(thought) experiences. 

"I tried It and It didn't work" is a statement that runs throughout the history in many fields of human endeavor. Each
instance when it is used it usually has a different nuance, a different validity. In my observation of human nature, often it
can mean, "How long must I try voluntary stuttering?" "How much practice do I have to apply to my practicing this
cancellation technique, before I become totally fluent?" "When I did easy onsets in the laboratory, I was able to do it, why
is it that when I go out in public I fall on my face?" People who mean the above are willing to work, to experiment to take
risks. 

It is more discouraging when "I tried It and It didn't work" really means, either the childish plea for help, "Mommy,
mommy, I hurt. Please fix me." Or "Fix me you, so and so. What am I paying you good money for!" Answering your
other comment this is the time for Tough Love. This is when the therapist explains to the client that she can
unconditionally accept him, with his penchant for childish pleas of help or with his downing attitude toward the therapist,
but in reality only if the therapist and client can establish a working relationship, and the client is willing to honestly try
and honestly share his disappointments and his triumphs, is there a chance that the stuttering client can work on his a)
impairment, b) disability and c) handicap. (See Yaruss 1998 ISAD paper.) 

Tough love also is prescribed for people who demand miraculous solutions. As Ellis in one of his irreverent humorous
songs sings, "Perfect, perfect rationality, is the, is the only thing for me"(to the tune of Finiculi, finicula), it is then time
to say, "Get real dude. You don't have to be handicapped by your speech, it may not be even a disability, but some
impairment may last at least for a while. People have led both creative and enjoyable lives with handicaps worse than
yours. Just stop comparing and rating yourself. Suck in your stomach. Tighten your seat belt, take some risks, and
develop philosophical attitudes." 

How to teach the mature, philosophical attitude to your students without life experience. The answers will evolve.
Remember, "Keep faith, baby! Keep faith!" 

Gunars 

SLP counseling roles

From: LaVonne Reed
Date: 10/7/99
Time: 2:03:01 PM
Remote Name: 134.29.22.53

Comments

Thank you for the wonderful quick resource to stuttering theory/therapy books. It is evident counseling is a crucial factor
in therapy when working with a fluency client. SLP's may also have a counseling role when working with other types of
clients as well. My question is, as students, shouldn't psychological counseling be included in our coursework? When
working with a client, how do you know where to draw the line? What is going beyond our scope of practice and when is
it appropiate to refer to another professional (psychologist)?

Some questions with no pat answers

From: Gunars K. Neiders
Date: 10/13/99
Time: 10:12:18 AM
Remote Name: 206.63.34.73

Comments

Dear LaVonne, 

Thank you for asking the questions. I do think that students would be well served to be taught psychological counseling
as a part of their course work. Taught both what can and what cannot be achieved by brief psychological counseling. The
other two questions on drawing the line and when to call in a psychiatrist or a psychologist in my opinion do not have a
pat, concise answer. Your judgment, as a therapist/helper will evolve with your experience. Meanwhile, do some reading
on your own. And if you feel adventurous undergo some theory based counseling. 

Gunars 

author's attitudes

From: Janell Larsen
Date: 10/8/99
Time: 10:22:05 AM
Remote Name: 204.72.75.234

Comments

I would like to thank you for comprehensive summaries of various author's attitudes toward intentional, theory-bassed
counseling. It was very helpful to compare and contrast the different viewpoints. I didn't realize how similiar the views
would be.

Re: author's attitudes

From: jerry johnson
Date: 10/8/99
Time: 4:27:50 PM
Remote Name: 152.163.232.31

Comments

Janelle: hope you dont mind my responding, but I cant resist. The harder we try the behinder we get. Now, all the
researchers aside, we still have to deal with the obvious. Even tho individual stutterers ARE individual, we only can do so
much to "adjust" the psyche, as Mannings paper suggests, and only so much to adjust the speaking ability of the person
who stutters. I have come to believe, after some 45 years, that there is not much magic in the process. The Tough Love
people might not be too far from reality. Just some food for thought. Cheers.

Response to Janell and Jerry

From: The proof is in the pudding
Date: 10/15/99
Time: 7:39:21 PM
Remote Name: 12.13.226.14

Comments

Janell and Jerry, 

I am always interested not only what a researcher and an author of textbook handles the topic of therapy versus how they
handle the actual clients. Unfortunately except for a few video tapes of Van Riper, Barry Guitar et al that are available
through SFA, we really have no valid feedback of what a certain person says as compared to what he does. Having had
many therapies myself both via stuttering therapist contacts and via psychologists, I often find out that the individual
personalities and characteristics shine through any theoretical leanings. So even though the attitudes may appear to be like
minded, I would still like to see the various therapists styles, both in front of a camera and away from it. 

As a follower of Epictetus the stoic and Epicurean, both Albert Camus and Albert Ellis, as well as Bertrand Russell, I find
the same philosophy and actions in all of them. Note, try to determine what the reality is, then what you can do about it,
and above all distinguish between short range and short range/medium range/long range hedonism i.e. be willing to suffer
some inconveniences now for the greater gain both in short/medium/and long range. That is my tough love self love. :-) 

Gunars

Speech therapy or speech pathology

From: Patti Bohlman
Date: 10/9/99
Time: 7:09:37 PM
Remote Name: 205.188.192.172

Comments

Gunars, Your paper brought out the important part of treating the person who stutters. Often times, students in speech
pathology do not get any training in counseling. When we became speech pathologists, rather than speech therapists, it
appeared to me that we lost the human touch. Stuttering became a behavior in the mouth to be modified, changed or
cured. It appears that the trend is beginning to change and the whole communication process is being looked at now. 

Some added thoughts

From: Gunars K. Neiders
Date: 10/15/99
Time: 8:07:49 PM
Remote Name: 12.13.226.15

Comments

Patti, 

We all journey through this world. The phenomenologists understand we are both of this world and we experience this
world through being human. When we, both as therapists and as people who stutter, start to focus too much on one
aspect of a person, such as speech and even communication, we miss out a lot of other things. Like friendships, love, and
little wet puppies. Like sunsets and sunrises. Summer rain and sunshine. The biggest problem with persons who stutter,
as with most people in our culture, is that they have fallen in the trap or comparing and rating. By starting out a therapy
with assuring a person who stutters that he is not a less worthwhile person because he stutters, even if his peers and
parents are of this belief, and showing him that there is no scientific or philosophical evidence that he is less or more
worthwhile just because of his idiosyncratic thoughts, behaviors, or personality traits, we go a long way toward healing
him. Starting with this point that all of us are of equal value, just because we are alive and kicking, we can stop wasting
our time devilifying or deifying ourselves and just proceed to live life to its fullest. And then we can calmly work on what
is in our mouths or in our heads, so as to enhance our enjoyment of life, but not make ourselves better...because with
sometimes thinking ourselves better because of a success we assure that we will think of ourselves worse because of
some of our failures. In other words, our speech does not make us either good or bad, just human. And learning how to
both change our speech and our adaptation to life with our speech better, will not make us into something more valuable,
but it will help us enjoy the many things this world has to offer (the flowers, the puppies, the friendships, the interactions
with other people on our terms, not on their terms...) 

Gunars 

My comments

From: Michael Burrows
Date: 10/13/99
Time: 11:36:21 PM
Remote Name: 207.167.2.123

Comments

Gunars: 

Thanks for the invitation to make some comments on your literature review. I'd like to offer some positive comments as
well as a bit of critique. 

The critique first: This article is a good starting point for more in-depth work. You've shown me that counseling has been
addressed by writers (of textbooks) and that it's obvious we have to consider it when we approach stuttering therapy. I
was a little disappointed by your conclusion. Not by the content or your points, but by the lack of detail. I want more
elaboration, more opinion, more you (we’ve all seen it). It all seemed very tame and not very challenging. I would like to
see the review be more of a review and less of a list. 

Now the praise. What I did like were the points you made in your conclusion. 

1. "Counseling, in fact, does occur in almost every therapy encounter..." 

Yes. We (speech-language pathologists) counsel. We offer advice. We learn about our clients and we teach them to help
themselves. We might not call it "counseling" all the time, but there is no denying that it is part of our jobs. 

"Secondly, intentional, theory-based counseling makes more sense than spontaneous, unguided counseling." 

Right. Why rely on winging it? It doesn't seem very professional. 

"Lastly, much could be gained by elevating the topic of counseling in stuttering therapy to a bona fide subject for learning,
teaching, and research." 

This is the logical next step. The program I'm finishing now did include explicit teaching on counseling as a major part of
a course on clinical practice. Would I have liked more? Yes, but how much would be enough? A full course? Another
term? There are all sorts of issues here that could be a paper all of their own For example, does a course in counseling
techniques produce better clinicians? Do speech-language pathologists with a course in counseling techniques do as good
of a job as a phsychologist with a PhD? These are silly questions, but the point remains: how much training do we need to
do a good job as counselors? 

Your article is a bright flag signaling an area that needs to have more people thinking and writing about it. Who is it going
to be? 

Michael 

Good questions

From: Gunars K. Neiders
Date: 10/15/99
Time: 8:26:10 PM
Remote Name: 12.13.226.14

Comments

Michael, 

Thank you for taking the time to review the article and raise some very good questions. The only questions that are silly
are those not asked. 

The answers to these questions will evolve as more attention is focused on treating the person who stutters in a wholistic
manner. Stuttering is based on our attitudes, fears, habits, and past and present interactions with people. In other places in
this ISAD conference the questions of motivation, persistence, and evolution away from bad habits has been discussed.
These are not just centered in our voice mechanisms, these are resident in our central nervous system. Speech is also
resident there as are abnormalities in speech. 

Two questions I will handle, the rest of them will evolve as more attention is focused on counseling in stuttering therapy. 

The first question you implied, although not asked overtly. Where will we, the SLP's or other helping professionals,
learn the counseling techniques? Some basics you might learn at a University, the rest of them will evolve as you come in
contact with more and more clients and learn what works and what does not. If an SLP is really interested they will pick
up much from their reading, from conferences they attend, from special short courses, from friends, and, especially, from
enemies who will pounce on every error you make. 

The other question you asked was "Who is it going to be [to advance the status of intentional, theory-based counseling in
the field of stuttering therapy]?" 

It will be you, other interested professionals and non-professionals, and me. Things do not get magically done by
themselves, nor can they be arrogantly delegated to some proverbial SLP, professor, NSP or SFA professional. 

Yep, you and me buddy! :-) If you want anything to get done you best start on it yourself, and hope that help will come. 

Gunars 

E-mail with permission to post

From: From William Murphy 
Date: 10/18/99
Time: 10:39:37 PM
Remote Name: 206.63.35.110

Comments

This is an e-mail I received from Bill Murphy. Since, it clarified some of my misunderstanding I thought I should add it
so that others could also understand his approach better. I asked and received permission to post it. Gunars 

p.s. Here it is: 

Hi Gunars, Thanks for including my work on shame and guilt in your paper for the ISAD conference. You are correct in
your assumption that the guidelines I was given for writing the paper did not include therapy procedures. However I
would have a slight disagreement with you in that I do believe I included some therapy approaches and indeed counseling
approaches to reducing and/or preventing shame and guilt. On pages 139 to 141 I (briefly) talk about interaction styles
which are basically psychodynamic in nature, used to decrease or prevent the development of negative emotional feelings
long associated with stuttering. These are counseling procedures used with young children. Do I think this is an adequate
description of counseling procedures for children who stutter? Heck no!!!!!!!! We need to develop tons more and that's
why a paper like yours for ISAD is so important. Your review of the literature was quite good. If you would like to view
some more psychodynamic counseling approaches for working with children who stutter, you might want to check out
two new video tapes($5 each) produced by the Stuttering Foundation of America. One is by me, Dealing Effectively With
Guilt and Shame With Children Who Stutter and the other is by Kristin Chmela and Nina Reardon. It's title is something
like, Reducing Negative Emotions in Children Who Stutter. I've rambled on long enough but thanks again for writing
your comprehensive paper and including my short chapter. Bill Murphy 


SLP counseling

From: Brenda Harguth
Date: 10/20/99
Time: 4:48:16 PM
Remote Name: 208.149.249.68

Comments

I agree that counseling is a very important part to therapy. If SLP's are doing so much counseling, are graduate programs
in Speech Pathology offering adequate training in this area?

SID4, Stuttering Specialty, and Coursework

From: Gunars K. Neiders
Date: 10/21/99
Time: 11:33:50 AM
Remote Name: 12.13.226.16

Comments

Brenda, 

Next SID4 Leadership Conference, to be held in Charleston at the end May, will discuss this matter. Please attend the
conference and express your opinion or contact people who you know are going and let them know how you feel. 

My own opinion is obvious. Would others care to express their thoughts? 

Gunars