Theoretical Development of a Proposed Rational Emotive Behavior Therapy Based Model to Treat Persons with Chronic Perseverative Stuttering Syndrome Gunar Neiders, 2010 (a Ph.D. dissertation under the direction of Norman Mar, Ph.D.) This work was motivated by meta-analyses of outcome studies in which a third of individuals who received current stuttering therapies experienced minimal positive results. These individuals remain afflicted with life-long chronic stuttering.

This theoretical work approaches chronic stuttering from a new, revolutionary point of view. First, the stuttering problem is defined holistically as Chronic Perseverative Stuttering Syndrome (CPSS) that includes dysfunctional ideation, emoting, behaviors, perceptions, and life choices of the person who stutters. The holistic definition addresses abnormal visible or audible speech and non-speech producing muscle functioning during speech production, avoidance behaviors while speaking, self-defeating attitudes and unhealthy negative emotions, and self-limiting life choices.

Second, building on the bio-psycho-social model, based on the neuropsychological and Rational Emotive Behavior Therapy framework, a stage-by-stage model of how developmental stuttering begins and perseveres throughout the lifespan is constructed. The model begins with epigenetic systems theory and subsequently addresses the pre-natal, birthing, and early language acquisition stages, while also addressing the classical conditioning associating speech with danger and operant conditioning associated with the development of secondary symptoms. The developmental model includes both unsuccessful and successful therapy experience stages. Third, focusing on REBT techniques, the stutterer's self-concept and beliefs that interfere with his/her speech production are examined. A detailed step-by-step therapy protocol is presented to modify the client's speech, as well as modify the "wiring" of his/her brain that interferes with fluent speech. At each step the techniques used are explained in detail and the reasons for using each specific technique are given. Throughout, the client is taught how to change the irrational (unhelpful) beliefs and unhealthy emotions--beliefs and emotions that interfere with fluent speech and self-actualizing life choices--into more rational (helpful) beliefs and healthier emotions. From this detailed material a therapy manual to test out the effectiveness and efficiency of therapy can be readily built.

Because the therapy protocol is presented in precise and coherent detail, it is accessible to both psychologists and speech-language pathologists. Additionally, this dissertation captures the current zeitgeist of evidence-based practice and is compatible with current search for the application of psychology to the problem of chronic stuttering.

added March 3, 2010