Self Help Group Facilitators and the Art of Listening
Rita D. Thurman, M.S., CCC-SLP, BRS-FD
Raleigh, North Carolina
I survived my three daughters’ teenage years by pretending there was a large, invisible
zipper adhered to my lips. Heated arguments diffused more quickly if I remembered to
close that zipper, replacing it with a shrug, a smile, or sometimes a wince. Most
importantly, I heard more when the zipper was closed. They talked more and I
Listening is a crucial skill for facilitators of self help groups geared toward children and
adults who stutter. Training in listening skills is rarely taught and not always intuitive. As
facilitators we spend a great deal of time listening to children, parents, adults, wives,
sisters, brothers, and each other.
If you do not listen, you cannot understand.
In this chapter I will discuss some basic counseling and listening skills that group
facilitators and attendees should consider when participating in self help groups for
children and adults who stutter. Self help facilitators are typically people who stutter or
speech-language pathologists with a special interest in stuttering. The following
information is directed to those individuals interested in becoming effective group
Challenges for Learning to Listen
experience and knowledge; however, there are obstacles to consider. I have isolated what
I consider the four main challenges to achieving these skills.
1. Know What I Know
Young therapists emerge from graduate school to this new world of speech and language
therapy with a vast, unique knowledge base. They have learned so much and want to
impart that knowledge to others. I have seen this when students from local universities
are invited to my National Stuttering Association (NSA) chapter and when I host
graduate student interns. They are in the initial stage of listening skill development and it
is a challenge for them to learn yet another aspect of treatment.
A graduate student attended one of my recent NSA chapter meetings. A member said to
her, “I feel as though I am in the recovery process and feel that I finally have a handle on
what I need to do to manage my speech naturally.” The student responded by stating the
statistics for spontaneous recovery in preschoolers and the fact that recovery does not
occur after the age of eight years.
The student was anxious to demonstrate her knowledge of stuttering; however, her
comments did not apply to the speaker’s situation and distracted from the topic. She
failed to recognize the member’s view of acceptance. Even some experienced
professionals make the mistake of offering information at the wrong time.
Facilitators and other group members can make the mistake of supplying content when it
is not needed or dominating a group. During another meeting, a young man who stutters
had just completed an intensive fluency program. He was eager to describe his experience
and convince others that they should attend the fluency shaping program. He
monopolized the meeting and the tone of the meeting changed from supportive to
confrontational. The group member wanted everyone to know what he knew.
Allowing for ways to be inclusive and involve all members of the group can be a difficult
task. To change direction, a facilitator may comment, “That sounds like a good
experience for you; I would like to hear about other’s experiences;” or turn to another
group member and ask, “What are your thoughts?” An effective facilitator can help
circumvent a dominant speaker by encouraging other group members to comment on
their experiences and directing the discussion towards their perspectives.
2. Feel What I Feel
Another challenge is developing perspective through listening. Often when you hear
someone’s comment, you naturally turn it into something that relates to you so that you
can understand it better. That is the easy route that may validate your emotions while not
fully addressing the feelings of the speaker. It is much more difficult to try to understand
the speaker’s perspective because there is more information to process; for example: their
age, their family dynamics, and their life experiences.
In a recent counseling session, a father of a child who stutters said, “When he [the son]
stutters, I just make him say the sentence over and over until he gets it right.” As a
mother, my first reaction was to become angry and say, “I can’t believe that you did
that!” Instead, as a therapist, I started with a few probing questions: Tell me what “gets it
right” sounds like. How does he (the child) react to that situation?
The dad spoke for the next fifteen minutes about his relationship with his own father,
how detached his father was throughout his life, how that has affected his relationship
with his son now, and how he often overreacts to his son’s stuttering. I suspect that those
insights would not have evolved had I gone with my initial reaction to chastise instead of
3. Let Me Make Everything Better
Few of us have entered the field of speech and language therapy or decided to become
support group facilitators because of the vast monetary rewards. We did this because we
want to make people “better.” We want to “fix” lives and feel the reward that comes from
doing so. However, whenever you fix a situation, you are the one who benefits.
As facilitators, it is not our job to provide a solution, but to guide towards resolution;
helping people explore their own feelings and find their own answers. It does not always
go smoothly and it is hard to not let your emotions take over.
The idea of a personal agenda has no place in listening. If you want that parent to admit
her child who stutters will do fine in middle school, if you want that adult to conclude
that stuttering has made him a better listener, if you want that teen to embrace and
advertise his stuttering, you have turned the situation into your goal, not the individual’s.
“The process of coping is not dependent on the success or failure” of the outcome
(Plexico, Manning & Levitt, p. 88). Coping is an asset that must be achieved regardless
of the final outcome. We should guide that process, not try to control the result. When
you guide a person to independent resolution, you have empowered him. It is wonderful
to feel needed. However, watching someone learn to understand himself better and
become self reliant is more rewarding.
We were discussing avoidance behaviors one night at our adult self help meeting. As the
group members talked about different situations that they had avoided, one member said:
“I have a confession to make. I saw Jane (another member) at the ice cream parlor the
other night and I didn’t say hello because I was with my mother-in-law and I didn’t want
to admit that I knew this other woman from a stuttering support group.” Rather than
provide what I felt to be a solution at the time, I just allowed for him to expand. “And?…”
was all I needed to say before he explained his feeling of unease in revealing that he
stuttered or that he attended a self help meeting for people who stutter. He even provided
a solution and steps toward that goal.
4. Dispensing Unsolicited Advice
Before you dispense advice, say to yourself, “Is this person asking me to tell him what to
do?” Most times, you will find the answer is no. There are two destructive types of
unsolicited advice. The first is: You should do it this way because I do.
At a recent teen self help group, a father made the following comment: “When John is in
a block, I don’t know what to do. He has been in speech therapy for years and he knows
the techniques. I don’t understand why he won’t use them.”
I knew what I would advise, but then realized that he did not say, “What should I do?”
Instead, I turned to the other parents and said: “Do you ever feel this way?” The
discussion turned to further exploring this father’s reaction to his son’s stuttering and the
feelings that his son may have in those situations. Soon he arrived at his own solution:
“Maybe I should ask John what he thinks.”
In a counseling or support group situation, you might hear someone say, “I just order
lasagna whenever I go out to dinner, even though I want a cheeseburger, because I know
that I will stutter on the ‘ch.’” You may think, “Maybe you should just order the
cheeseburger and desensitize to the sound and situation. That is what a lot of people do.”
But unless that comment is paired with a request for help, you should not dispense
advice. Instead, a facilitator could help that individual find his own solution by simply
asking, “So, how does that work for you?” Most likely this will lead the individual to
explore his own reaction (perhaps avoiding the word makes him feel guilty or frustrated)
and arrive at his own solution or coping strategy.
The second type of detrimental advice is: Just do these simple (for me) things – it will
help. This advice sounds like this: “You just need to relax,” or, “Just take a deep breath.”
One woman I worked with when she was a teen reported that her mother would tell her,
“Just breathe.” Then, the mother would raise her hands in a huge display of air going in
and back out again. The mother later moved to just using the hand cue. The teen’s
response was, “That never helped. In fact, it infuriated me.”
Although this mother wanted to help, she was simplifying a very complex process and
the teen felt sure that there was no way the mother could understand what she was
experiencing. An important message to send as a parent, therapist, or facilitator is that
you are there to hear what the person needs to say, not how they say it. Don’t provide
advice when it isn’t requested.
Becoming a Listener
To truly listen, you need to limit the number of times you think or say “I.” Stop trying to
make the client’s situation relate to your life just so that you can understand it. Tetnowski
(2003) explains that many speech-language pathologists “lack the confidence to provide
counseling services that truly are in our clients’ best interests” (p. 7). I will go one step
further and say: Some self-help facilitators and participants lack the confidence to know
when to listen and simply process information. We lack the confidence to explore beyond
our personal experiences.
A parent at last year’s self help workshop of FRIENDS: The Association of Young People
who Stutter reported: “I used to stutter, too, and I just overcame it with diligence and
strength.” I thought about the message that sent to his son as the son was struggling
through his next sentence. The message that father sent was: “You must not be diligent
and strong like me because you still stutter. That simple word I is a powerful and often
detrimental one in communication and can interfere with understanding.
What started out as an icebreaker for our TWST (Teens Who Stutter) group, turned into a
great listening activity one night. It is called “Two Truths and Lie.” A person starts by
telling two truths about themselves and one lie; the other group members guess which is
the lie. When it came time for one teen to guess, he said, “I wasn’t listening to him
because I was thinking about what I was going to say.” I used this as an example of the
need to listen to other people in the group, think about what you know about them, and
understand their perspectives. The teen later said, “I am often so worried about how my
speech will sound that I miss what the other person is saying. I realize now that does not
make me a good communicator.”
Acquire a Support Alliance
As facilitators and members of self help groups, you must share goals, agree on tasks, and
develop a “collaborative relationship.” The group process is dynamic and you must be
flexible to change when needed. If you are a facilitator for a self help group, you may not
know from one session to the next who will come or what issues will be raised.
I choose a discussion topic each month for my adult self help group. Although we rarely
adhere to the topic all night, I always have several adults contact me to ask, “What is the
topic this month?” This is a goal that we share. We will talk about a subject relating to
stuttering. We start each meeting with “Welcoming Words” and introductions, even when
the members know each other. It is a task that we have agreed on completing each time
we meet. The most difficult task for me then becomes staying flexible and allowing the
group to become cohesive.
Our October adult self help meeting had a listed topic of: “Mindfulness and How It is
Used in Stuttering Management.” During the introductions one member talked about a
job interview that she had that morning. It was a group interview with four candidates
and three interviewers. She described the manner in which the other applicants easily
answered the questions quickly and rarely allowed her time to interject. I dropped the
intended topic and turned to the other members of the group without saying anything.
They immediately validated (“That must have been terrifying”), affirmed (“Did you feel
like running away?”) and allowed for her to expand (“What did you do?”). I smiled as I
thought “They sure don’t need me!”
If you are truly listening to the group, you will know when to intervene. If you see your
role only as the director, you impede the process
Learn the Skill of Gestures
So many things can be communicated with gestures. We can use these to redirect a
group, indicate agreement, probe for more information, and encourage disclosure. A great
strategy for learning to communicate through gestures is to watch a television program
with the sound off. You can figure out what is happening just by watching the non-verbal
Try using more gestures and facial expressions in your meetings. By using gestures, you
limit your vocal input and allow for more “talk time” for your members. Gestures such as
leaning toward the person while maintaining eye contact, uncrossing your arms, or
simply nodding are more inviting for discussion. Each time you open your mouth, you
take away from the other’s opportunity to talk.
Likewise, be careful what you communicate with your gestures. I work with a teen whose
mother begins pumping her leg and tapping her hand whenever he is in a stuttering block.
I watch his eyes as he sees this and you can feel the time pressure increase in the room.
As elementary as it sounds, keeping a calm body while someone else is talking is crucial.
Know When to Talk
When a parent or group member has an emotional reaction in a meeting, our first
response may be to fill the void with talk. We may want to provide more information,
reassure the client, or divert the emotion. As Luterman (2008) points out, when a person
is reacting emotionally, he or she cannot take in more information because cognition has
shut down. Whenever a person is upset, “fight or flight” takes over and reasoning
strategies are impaired. If you do not allow that person to process his or her feelings, you
are circumventing closure and the formation of a person understanding their own
reaction. If in doubt about what to say, do not say anything. If you do provide input, this
is a great time to validate that person’s emotion.
One parent of a second grader in my parent-child counseling group started to cry during a
session and said, “I am worried that he will never get a job, get married or be happy in
life.” A natural response would be to say, “Everything will be fine.” But a better response
to validate that mother’s feeling is, “It sounds like you are very worried for your child.”
This statement allows the parent to see that you listened and understand.
Know When to Ask Questions
Knowing when to ask questions is just as important as knowing how to ask them. One
effective question or statement starter is, “I wonder.” It presents less pressure on the
speaker and elicits more detail: e.g., “I wonder if your mother knew how you felt.”
I also like to use the “minimalist” question. Instead of “How did that make you feel?”,
you get more elaboration from, “How did that feel?” By removing that simple pronoun,
you will get their reaction and help them develop perspective of others. A teen told me
that whenever he was blocking on a word, his mother would say the word for him in a
prolonged, easy manner. When I asked: “How did that feel?” He replied: “Well, I knew
that my mother wanted to help me, but it drove me crazy.”
Another important aspect of asking questions is being genuine. I have given suggestions
of comments to make, but you should think about whether the things you say genuinely
reflect what you feel and whether they say it in a way that you are comfortable with. For
example, a colleague of mine frequently responds to children’s comments by saying,
“How did you get so smart?”, which I do not feel comfortable saying. Instead, I might
say to a teen, “That was pretty insightful for you.” Think about the way you say things so
that you sound, and are, authentic.
Understand Through Listening
When you can listen to someone, view their perspective, and allow them to find a
solution, you understand them. I often have people tell me that I must have a lot of
patience to be a speech-language pathologist. Quite the contrary; I am the most impatient
person on earth. I change grocery store lines at least twice each time I go, always
searching for the fastest route. But more important than patience is understanding.
As self help group facilitators and members, we need to understand when someone is
searching for the answer and allow them to find it. It is in their best interest to find the
answer themselves. When a person is emotionally distraught, it is better for them to tell
themselves, “Everything will work out,” than for you to do this for them.
At times what may seem like a question is really insight into someone’s thinking. One
time I had an eight-year-old girl ask me, “Can you catch stuttering?”, as you would
“catch” a cold or flu. Although my first response was to say, “Of course not!”, instead I
said, “What do you think?” She said, “When I was five I made fun of someone who was
stuttering by talking like him and then it stuck so now I stutter.” I gained insight into her
regret and guilt as well as her lack of knowledge.
There Is a Time and Place for Listening
You should always speak up when you are protecting, seeking help or advocating for
yourself or others. However, these behaviors are not typically part of a self help meeting.
There, your goal is to hear more, encourage more disclosure and understand comments
more completely. So, get your zippers ready.
Rita Thurman has worked with people who stutter and their families for 34 years. She is
in private practice in Raleigh, North Carolina and is a Board Recognized Specialist in
Fluency Disorders. Ms. Thurman is an NSA Adult and Teen Chapters leader. She also
sponsors an annual, state workshop for FRIENDS: The National Association of Young
People Who Stutter. Ms. Thurman was awarded the 2012 N.C. Speech, Hearing and
Language Association’s Clinical Achievement Award for her work in providing services
to people who stutter.