The Van Riper Approach
By Angie Sawall and Lindsey Swanson
The client should identify and explore the core behaviors, secondary behaviors, and feelings and attitudes associated with his or her individual nature of stuttering. This can be done through self-observation, modeling by the clinician, or oral reading.
During this phase, clients are prompted to confront the disorder and desensitize themselves to stuttering behaviors and listener reactions. This reduces the negative feelings and anxiety associated with their stuttering, externalizing their negative internal feelings.
This Phase involves the client learning how to use Van Riper’s modification techniques:
Cancellations- after stuttering, there is a pause and the word is said a second time using an “easy” stutter.
Pull-outs- when a person begins to stutter, they are to say the rest of the word with ease.
Preparatory set techniques- when the person anticipates a word to be difficult, they are encouraged to work through all sounds of the word slowly and calmly.
In order to promote generalization and maintenance, clients are encouraged to independently and confidently monitor their own stuttering behavior. Therapy is gradually reduced as they become more effective in this task.
The strategies and skills acquired through these phases are to be maintained by clients after all phases have been completed. Once confidence is achieved and daily disfluencies are manageable, clients are dismissed from therapy. However, if relapse becomes a problem, the phases of therapy should be repeated using a pseudostutter.
Clients should be able to generalize strategies and skills into everyday life situations. Further effort should be focused toward facing environments and circumstances that were previously feared.
(The following first appeared in Letting GO, the NSP Newsletter, and is reproduced below with the permission of John Van Riper, son of Charles Van Riper).
A Message from Charles Van Riper
Having recently suffered congestive heart failure, my doctor has suggested that I put my affairs in order since my days are numbered. I have done so.
Yet one thing remains and perhaps your newsletter that I have enjoyed reading for many years may take care of that. I want very much to share with other stutterers what I have learned about the disorder in my 85 years before The Reaper cuts me down.
During my career I have worked with thousands of stutterers, done a lot of research, and published several books and many articles on the subject. More importantly, I have stuttered myself all of those years and have tried almost every sort of therapy ranging from rhythmic controls and relaxation and slow speech and breathing exercises to psychoanalysis and hypnosis. All of these failed to help me attain any more than some temporary fluency followed by relapse. Nevertheless I finally managed to become very fluent even though I continued to stutter.
The basic idea that led to my living a very successful and happy life came to me while hitch-hiking my way home from Rhinelander, Wisconsin, where I had spent a month as the hired man on a farm, pretending to be a deaf mute because my stuttering was so severe and grotesque I could not get any other employment. I had hoped thereby to be able to live without talking, but after a month I couldn't bear it any longer and left to return to a home where I felt I would not be welcome.
After walking several miles I sat under a tree to rest near a field where a man was plowing. Soon an old man in a Model-T Ford pulled up beside me and he got out to talk with the farmer. I noticed that he had an odd way of speaking with many little hesitations but didn't think it was stuttering. When they finished their conversation, I accosted the old man with the thumb gesture for hitch-hiking and he told me to get in the car. Then of course came the inevitable question: “What's your name, son, and where are you going?” Oh, how I stuttered when I tried to tell him with gasping, facial contortions and body jerks! And then the old bugger started laughing outrageously. I could have killed him! Seeing my anger, he said, "Take it easy, son. Take it easy. I'm not laughing at your stuttering. I've been a stutterer all my life and I used to jump around and make faces like you do but I'm too old and tired to fight myself now so I just let the words leak out. And they do!"
Well, that hit me hard. All my life I'd been trying to talk without stuttering and avoiding it and hiding it whenever I could and all that had happened was that I got worse. That old man was telling me that what I should have been seeking was a way of stuttering that would be tolerable both to others and myself, that it was possible to stutter so easily and effortlessly that it wouldn't matter, that I could stutter and be fluent anyway. The insight that I should learn how to stutter hit me like a bolt of lightning. I wouldn't just wait until I was too old and too tired to stutter hard.
It wasn't easy unlearning all my struggling and avoiding but every time I stuttered I had an opportunity to change it to a more fluent form and so I persisted. At first the gains were small and the failures many but successes, even partial successes, encouraged me. Moreover, my fears and embarrassments melted away. Most of my listeners do not even recognize that I've stuttered when I do and I probably stutter as much now as I ever have but it's no big deal anymore.
Well, that's the message I'd like to pass on to my friends of the tangled tongue. Merely accepting one's stuttering is not enough; speaking out is not enough.
Learn how to stutter!