Another Perspective of Therapy

Another way to think about fluency therapy is to consider three elements of the overall process: Information Gathering, Building Fluency and Structuring for Continuing Success. This premise is based on the following assumptions:

People who stutter lack objectivity in evaluating their stuttering. Most have acquired misinformation (distorted perceptions) about their stuttering. Therefore, establishing a good information base about their stuttering is an important fundamental step.
There are many ways to build fluent speech. No single way appears to work for everyone. The techniques used are probably less important than the clinician's ability to encourage the client to change his or her speaking habits in a direction which enhances fluency.
Rebuilding attitudes and repairing feelings are important components of laying a foundation for long-term success and continuing improvement. Many have gained fluency only to lose it later. Others struggle to be able to change habitual speaking patterns and find implementing therapy techniques to be a sincere challenge.

INFORMATION GATHERING

It is important to learn general information about the normal processes of speaking and stuttering. There is considerable misinformation about the nature and cause of stuttering which often serves to needlessly complicate the client's ability to understand and cope with their stuttering. Knowledge is power.

Clients need to be able to identify the specifics of their own stuttering as well as see how the disfluencies of others that stutter are similar and different from their own. This may be accomplished by learning to:

Identify the core behaviors of their stuttering and how it differs from and interferes with fluent speech production
Recognize their secondary characteristics as they relate to core behaviors and their feelings and attitudes about stuttering
Rebuilding attitudes and repairing feelings are important components of laying a foundation for long-term success and continuing improvement. Many have gained fluency only to lose it later. Others struggle to be able to change habitual speaking patterns and find implementing therapy techniques to be a sincere challenge.

BUILDING FLUENCY

Clients need tools to help them change their speaking patterns. Their attempts to control and manage stuttering have resulted in maladaptive habit patterns from which they are unable to escape. The clinician provides new, more productive speaking techniques designed to more compatible with the goal of fluent speech. The fluency tools chosen need to be productive and acceptable to the client.

	In general, regardless of which fluency tool is utilized, the instructional paradigm for gaining control over stuttering and developing fluency patterning progresses through the stages of:
Identifying --> Modifying --> Control and Shaping Fluency
	Becoming desensitized to the fear of speaking and stuttering, as well as readjusting the self-perceptions of the person who stutters, are integrated with the speaking techniques.
	Each individual needs to assume responsibility for speaking fluently and for making changes.

STRUCTURING FOR CONTINUING SUCCESS There are probably as many reasons for fluency therapy to be unsuccessful as there are people who stutter. Relapse is very common. Therefore, effective treatment programs must work to develop self-rescue skill to prepare clients for likely relapses in the future. Prepare the client to always be a person who stutters; it is unlikely to go away at this point in their life. The following ideas therefore, might benefit all people who stutter.
	Preparation - use focused, controlled speech as you enter your most difficult speaking situations; don't wait for disaster to happen; be prepared and plan to be fluent.
	Attitude - view speaking as rewarding; find satisfaction in communicating orally; define your success in terms of the information you communicate, rather than your fluency.
	Challenges - actively seek out new speaking situations to maintain your skills and develop of new speaking skills; be willingness to take risks. Like typing, the more you practice and use your skills, the better they become. The less often you use them, the rustier you become.
	Confidence - you can develop a sense self-assurance while speaking; cultivate a sense of self, a personality, as a speaker · Spontaneity - increase your inflection and intonation as you gain more and more fluency; learn to reflect the new you in the way you speak.
	Relapses - in life as in stuttering, not everyday is a good day. Develop a plan in preparation for bad speaking days; network with others who stutter; become active in support groups; be self-reliant by being your own advocate and speech coach.
Stuttering is a complex problem with many facets. Adults and adolescents who stutter have come to learn many negative things about their stuttering; many have internalized their lessons. The process of becoming a successful communicator is lengthy and challenging.