We are not therapists nor experts. We are “consumers” of various therapies which have not worked. Not only they did not work, they caused you considerable distress and left a bad taste in our mouths (“Oh, I am no good!”)! Therefore we wish to offer some ideas as feedback for your consideration.
Evidence Based Therapy
We expect therapy and therapeutic claims, to be based on good reproducible research, not on anecdotal evidence (“I have cured thousands of stammerers”).
And therefore, we suggest that the clinical practice should go beyond “Before and After Videos of a stammerer” during a two week session. These are misleading and hide the fact of frequent relapse over the long term. We also expect ISHA to take the charge of cleaning its home: misleading adverts on cure, on Speakeasy gadget etc. etc.
We also request you to consider that stammering in adults is a highly psychological phenomena (like Obsessive Compulsive Neurosis) and therefore should not be treated as a pure speech disorder. Finally, looking at stammering as a speech diversity, may help you to step out of the medical model of disability, which is so rampant and insidious. In this regard, you will benefit by reading this article:
Most people now agree that setting FLUENCY as a therapeutic goal is no good. It leads to disappointments. A better goal is to focus on COMMUNICATION – being able to convey what you want, when you want, efficiently.
“.. I’ve met a number of people who speak with excellent fluency — never heard them stutter at all. But they live in daily fear that they MIGHT stutter – and go through all the shame and guilt and avoidance that severe stutterers do. For some people, fluency skills are just another way to hide their stuttering — all because of the traditional mind-set that stuttering is a bad thing to do…” (Jim McLure, SLP)
Here are some very relevant write ups for you:
Promise of Cure
Assuring client, the pws, before hand that stammering can be cured could be an expedient approach to get compliance and cooperation but in the long run it leads to complications, distress and distrust. Concept of CURE should always be discussed upfront- that there is no universal scientific cure at present. Relapses should also be discussed. Multi factorial aetiology of stammering should be shared. An informed client will be a distinct advantage to himself and to the therapist, in the long run.
Economics of Therapy
We totally respect your right to charge a suitable fee but in a chronic condition like stammering, where a pws may require help repeatedly for many months, if not years, the cost of clinical therapy becomes too much. Therefore, we suggest that after a few introductory sessions, you should refer the client – not necessarily to TISA! – but any self help group or to a group therapy format. One to one clinical sessions are no good beyond a certain point. They do not force the pws out of his/her comfort zone. Finally, stammering happens when there are others around, not when we are alone. As such, the recovery process should be embedded in SOCIAL settings.
We have not come across any SCIENTIFIC study which proves that interventions in childhood are beneficial – or significantly different from the support given by family and society traditionally. (If you have any such study please share with us at firstname.lastname@example.org) On the contrary, many adults say that therapy was forced upon them in childhood and it did not help. Please consider your decision from the child’s perspective as much as from any other perspective. On the other hand, sensitization of teachers, other children and society at large may help to some extent. Can you turn your attention to that, please?
Struggle Vs Stutter
If people felt free to stammer, they will do so just like a 3 year old child- without struggle, without secondaries, without shame, guilt and fear- without cognitive distortions – may be with great beauty and elegance, as children do. Can you, as a therapist convince your client that s/he is free to stammer as and when they want, exactly on the word they want? Since stammering is not a simple speech disorder, it is only fair that you keep learning about it and PRACTICE it. Vivian Sisskin is the ideological heir to Van Riper, who was a pws, a SLP professor and who later came to be known as grandfather of stuttering therapy in USA.