Living with Stuttering and Anxiety: Coping Strategies to Assist People who Stutter

sugarmanAbout the author: Michael Sugarman.  Honored by American Speech and Hearing Association, International Fluency Association, National Stuttering Association, International Stuttering Association and Stutterers Hall of Fame. Wrote “Peer Counseling and Self Help Group Facilitation for People who Stutter” and “Self Help Workbook for People who Stutter” and various articles on how people change and peer activities.

The format to this article is a “hands on” approach to be used by People Who Stutter (PWS) and Speech Language Pathologists (SLPs) to address anxiety while empowering attitudes and beliefs about coping with stuttering. Benefits may include improved self-image, communication skills and enhanced self-awareness and self-esteem.

In 1995 the Self Help Group Facilitation Manual was self-published and included mindful activities,  for example Yoga, Mindful Walking, Meditation or Acupuncture. This topic was met with skepticism and comments by some in the professional community as well as people who stutter, PWS, “What does this have to do with speech?

Katherine Preston states, “Stuttering is not caused by psychological trauma, unsupportive parenting or mental neurosis. Rather stuttering is a genetically influenced neurological condition.” Further she sites Dr. Scott Yaruss, Director of Speech Language Pathology at University of Pittsburgh, “PWS are not doing anything wrong: they are simply doing the best they can with a neurological system that is not wired for the production of smooth speech.” On personal note, Ms. Preston commented “that is not to say that a lifetime spent on stuttering might not make us prone to anxiety. And that anxiety may in a vicious, escalating cycle, ignite more stuttered speech.”

The exercises provided in this paper are suggested as effective ways for PWS to analyze and manage the anxiety that so often seems to be a part of our stuttering.


Session 1

Review articles on current stuttering research available by going to http://www.asha.org/public/speech/disorders/stuttering

Topic: Overview of Stuttering

Goal: Increase knowledge and understanding about stuttering

Activity: Discuss your understanding with friend, therapist or in a group


Session 2

Create a chronology of your experiences with stuttering:

Using lined paper, divide the paper in two parts: left column list significant dates in your life and to the right memorable experiences you had.

Topic: My Stuttering Story

Goal: Validate experiences and share common concerns

Activity: Share your story with friend, therapist or in a group


Session 3

Describe situations in which you stuttered in the last two weeks.

Topic: Personal Awareness

Goal:  To increase personal awareness

Activity: Discuss what you learned about your stuttering with friend, therapist or in a group.


Session 4

Write down three times when you felt you took a risk in the last month?

Topic: Taking Risks

Goal: Identify a risk taken.

Activity: Discuss Risk and devise a risk you are willing to try with friend, therapist, or in a group


Session 5

List three times you said to yourself or another person “Yes.”

Topic: Self esteem

Goal: To increase self esteem

Activity: Share when and what situation did you say “yes”. Share with friend, therapist or in group.


Session 6

Record three positive daily activities you did for yourself: example, meditate, mindful walking, ate breakfast or took a shower

Topic: Daily Holistic Approach

Goal: To increase feeling “good” about yourself

Activity: Identify three daily positives that make you feel good with friend, therapist, or in group


Session 7

Write a short paragraph answering: “What happens to me when I am stressed?”

Topic: Stress management

Goal:  Increase coping skills

Activity: Discuss benefits of coping with stress with friend, therapist or in group


Session 8

Describe: “What I do to cope with stuttering?”

Topic: Living with Stuttering

Goal: Develop coping skills to deal when you stutter

Activity: Discuss coping management with friend, therapist or in group


Session 9

Explore how your stuttering affected your expectations in personal relationships, marriage, and education and employment opportunities

Topic: Offense

Goal: Identify how you protect yourself from being “hurt”

Activity: Share your protective mechanisms with friend, therapist or in group


Session 10

Address the topic of “letting go” and what that means?

Topic: Letting Go

Goal: Separation

Activity: Make two columns and label one side “PWS” and the other side “Stutter.” Share whether you feel the two are same or different with friend, therapist or in group.


Session 11

Discuss how anxiety affects you. What activities do you do to relieve your anxiety? Do you consider mindful walking, breathing exercises, aerobic classes, meditation, yoga, or massage and acupuncture?

Topic: Anxiety

Goal: Coping management

Activity: Participate in anxiety reducing management program and share with friend, therapist or in group


Session 12

When daily tasks pile up our anxiety levels increase. Create a list of 10 things you need to accomplish during the day.

Topic: Prioritizing and Letting Go

Goal: Coping management

Activity: Rate each task from absolutely crucial to unimportant. Cross out the unimportant ones first. Focus your attention on the most important matters. Share with friend, therapist or in group.


Session 13

Nearly all of us have been guilty at one time or another and of “catastrophizing” a type of thinking. In Ms. Gregoire’s article,  Dr. Frank Ghinassi, Associate Professor of psychiatry at the University of Pittsburgh, suggests “Our emotions start with our interpretation of events and it’s not so much the facts that drive what we feel, it’s what we think about. It’s the cognitive interpretations we make about the events of our lives that end up driving how we feel.” He introduced probability into our thinking. Ask yourself “What’s the probability of something truly bad happening here?” Castrophic thinking turns from compulsion into a conscious choice. A person has a right to worry, but the question is how much time do you want to spend?”

Topic Mood Monitoring

Goal: To recognize themes that comes up again and again in your life.

Activity: Make two columns and one on the left: describe anxiety inducing situations and the other column calibrates your emotional reaction. Share with friend, therapist or in group.


Session 14

Write down a short paragraph answering “What happens to me when I am stressed?”

Topic: Stress

Goal: To recognize how stress plays in your health

Activity: Discuss how you can cope with stress with a friend, therapist or in group.


References

Gregoire, Carolyn “Work Stress: 5 Tension-Busting Tricks from Cognitive Behavioral Therapy”   http://www.huffingtonpost.com/2013/06/18/managing-work-stress_n_3454501

Preston, Katherine, “Stuttering is No one’s Faulthttp://www.huffingtonpost.com/katherine-preston/stuttering-is-noones-faul_b_7236154.html

Sugarman, Michael “International Stuttering Group Project” International Stuttering Awareness Day online conference 2005

http://www.mnsu.edu/comdis/isad8/papers/sugarman8.html

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Comments

Living with Stuttering and Anxiety: Coping Strategies to Assist People who Stutter — 67 Comments

  1. Thanks, Michael. The coping strategies will be very helpful with my High School teen stuttering group. They’ll benefit from discussing ways to decrease anxiety while empowering attitudes and beliefs about coping with stuttering. The prompts and activities for improving self-image/esteem, communication skills and self-awareness are great. Lourdes

  2. I am surprised the manual was met with such skepticism, especially from professionals. These seem like fantastic tools for working through anxiety associated with stuttering and great for group discussions. How often do you refer clients to an MD or Psychiatrist for anxiety medications or do you try to avoid that as much as possible?

    • The therapy landscape was a lot different 20 years ago. As to your question…I would refer to mental health professional to assess and have the person to complete Zung self rating anxiety scale to help evaluate the severity of the anxiety. And then mental health professional can evaluate a referral to psychiatrist or medical provider.

  3. Thank you for the great ideas. These are activities that can easily be carried out in support groups or on your own. It’s useful to sit back and reflect upon what you are doing and why you are doing it. Identifying a problem (being self-aware in this case) is the first step to solving that problem – or learning how to effectively manage your stuttering.

    What happens after the last session? I can see these skills becoming part of a life-long change.

    Courtney

    • Courtney,

      Thank you for your kind comments. Suggest to go through the exercises again. You are absolutely right on your comment on skills becoming part of a life long change. However, At the end of the second time through and you and PWS feels he/she wants more coping strategies. I suggest referral to mental health professional and for PWS take Zung self test for anxiety to determine severity of his/her anxiety. And whether mental health professional referral be appropriate for individual/ group counseling sessions.

  4. Thank you for this very helpful approach! I am a SLP graduate clinician, so this a great step-by-step approach for me to bring to my sessions with clients who stutter. I have one question about Session 10. What is the purpose of “letting go”, and making the comparison chart between PWS and stutter? Is this to separate the individual from the stutter?

    Thanks in advance for your response!
    Dana

    • Dana,

      Good luck in completing your studies and becoming a SLP. Session 10 your observation is right. The session is to empower the PWS to explore stuttering from a different perspective that he or she is person first who wants to pursue emotional well being, personal, career and academic goals. And not to let stutter
      Stop him or her.

      Kindly,
      Michael

  5. Examining the relationship between emotions (negative or positive) and stuttering is very interesting to me because they are so interconnected that it is almost impossible to separate them. I have three children who stutter on my caseload right now and the relationship between the severity of their dysfluencies and the emotional turmoil impacting them at home has a lot to do with the approach that is taken in therapy that day. Sometimes it is difficult to discuss the covert aspects of stuttering with them, not only because they are still very young but also because I don’t want to impede on the scope of practice of a counselor. I have learned that in becoming an SLP, you are also taking on other roles such as a counselor; especially in treating clients who stutter. The truth is, with any communication disorder there will most likely be negative emotions connected with an experience related to their disorder that must be discussed before dealing directly with the overt features of stuttering. In class, we learned that the impact of creating just ONE positive experience related to a client’s stutter may make the difference in the way they view their communication abilities overall. The steps you have provided allow for an easier way to approach some of the more difficult topics associated with treating a client who stutters.

    • Jaime,

      Thank you for your professional desire to help PWS change their perception of self and incorporate skills to manage stuttering. And thank you for your positive approach to treatment. Compassionate fatigue…take care of yourself by mindful activities.

      Warmly,
      Michael

  6. Dear Michael,

    Thank you very much for posting this excellent approach. I’m currently a SLP graduate clinician interning in a rehabilitation clinic. I have at least two clients who would benefit from this program, and I’m very excited to try it out!

    One question I have for you, regarding Session 5 (“List three times you said to yourself or another person “Yes.””): Can you explain how/why this would work to increase self-esteem, and, how does this relate to stuttering?

    Thank you again for posting this very helpful strategy! I look forward to hearing back from you.

    Be well,
    Brittany

    • Thank you Brittany for your kind comments. By saying yes to activities a PWS may feel empowered to complete a task whether he or she stutters. For example look at your own life and when do you say yes ( out loud). And how does that make you feel? More empowered maybe?

  7. Michael,

    Thank you for posting this step by step session guide! I am currently in graduate school for speech-language pathology and am interested on general mental health in conjunction with communication disorders. How do you determine if increased anxiety is causing increased or overt stuttering, or if stuttering is increasing anxiety and so on? How do you stop that cycle?

    • Rachel,

      Mental health and SLP’s are merging as I write this…Ross Menzies a psychologist from Australia trains SLP’s in cognitive behavior therapy. As well, as you peruse this online conference you will read about clinical social workers collaborating with SLP’s. Very exciting times.

      In regards to PWS/ anxiety I would have him or her take Zung self rating anxiety scale to determine severity of anxiety. And then make appropriate referral if needed.

      Good luck in your adventure

      Michael

  8. Dear Michael,

    I really liked your session about deciding how much time we spend worrying. Many people with anxiety (not just PWS) can benefit from this exercise. I think taking action (such as practicing a new fluency technique with a friend) that will lessen the worry is a good replacement when our mind begins to stress. Also, engaging in activities that promote mindfulness such as yoga, running, meditating, watching ASMR videos, cooking a meal or doing a craft can bring a centered spirit and will permeate into the stressful moments stutterers are bombarded with so often. Have you used any of these mindfulness techniques with your clients? What have been the results?

    • Jill,

      Thank you for your comments. I am not a SLP. I am a social worker. Facilitated dialectical behavior therapy group and currently facilitate stress management group at a county ambulatory clinic. The client load have been diagnosed with mental health and/or substance abuse issues. I use all your mentioned mindfulness techniques. And when he or she incorporates practices into daily life have seen improvements. And for some change diagnosis to remission. And for others returned to school or found employment.

      Please peruse this online conference and you will read about others mental health professionals and SLP’s collaborating services. As well Ross Menzies a psychologist is training slp’s in cognitive behavior therapy.

      All the best
      Michael

  9. Michael,

    I am currently a graduate SLP student. Thank you for provided such a clear and concise instruction guide. In a typical therapy session, would you spend the majority of the time working through and discussing these activities or would you incorporate other approaches in addition to the activities?

    Danielle

    • Danielle,

      Thank you for your comments. And of course good luck in becoming SLP. I facilitate a stress management group at a ambulatory clinic so I integrate many of the activities. However, in individual therapy …. I am a social worker and use problem solving, CBT and other therepuetic approaches. As well. When appropriate incorporate these activities.

      The therapy landscape is changing..mental health professionals are collaborating with SLP for clients…peruse the online conference. Ross Menzies from Australia is training slp’s in CBT.

      All the best
      Michael

  10. Micheal,

    Thank you for sharing strategies to decrease anxiety in PWS! I am a SLP graduate student and I found your outline to be very useful for helping PWS manage their anxiety. I was just wondering which strategies you have found to be the most effective in decreasing anxiety in PWS? Thanks in advance for your response!

    Michelle

    • Hello,

      I am not a slp. I am a social worker. And integrate exercises in individual and a stress management group. I work in ambulatory care clinic. See people with mental health issues.

      I wrote the workbook for PWS in peer support groups.

      I have found using mindful activities and to write three positive activities before bedtime to be helpful.
      Kindly,

      Michael

  11. Michael,

    What a great article to read! Reflect on emotions and experiences and having the ability to share these experiences and emotions can be really powerful experiences in helping PWS become more confident and empowered. I am a graduate student working toward becoming an SLP, and there are many great topics and activities listed in this article that I think can be beneficial for topic conversation either group or individual therapy.

    My questions to you is that do you find people have more difficulty opening up to you or talking about a certain session, topic, or goal? And which session do you think is the most beneficial to clients you have worked with in the past?

    • I am not a SLP. I am a social worker in ambulatory care clinics. And clients are referred by medical providers for mental health issues.

      I begin my initial session with what brings you here?

      Mike

  12. Hello Michael,
    Thank you for sharing these thoughtful exercises. I am currently a graduate student studying to become a speech-language pathologist and your approach resonates with issues that we have discussed in class.
    Have you heard from anyone who has gone through these sessions on his or her own (as opposed to working through it with an SLP or in group therapy)? Do you think there are additional benefits to having a professional involved in guiding an individual through these steps, or not necessarily?

    Thank you for your time.
    Kari

    • Kari,
      Thank you for insightful question. I wrote a self help workbook and Stuttering Foundation has a self help book. I did not receive feedback from folks using self help workbook by him or herself.

      I do think there are more benefits by having a professional or support groups. PWS will be able to explore strategies. And most likely discuss more coping and management skills….

      All the best
      Michael

  13. Hi Michael,

    I enjoyed reading your “hands on” approach to treat the whole person. I think the listed activities are great opportunities to work through anxiety and create a more positive outlook for PWS.

  14. Hi Michael, I’m a student Speech and Language Therapist, and just wanted to say I love seeing that mindfulness, meditating, letting go, and general focussing on the role of thoughts and anxiety in the experiences of people who stutter, are prioritised and addressed in these sessions. Thankyou, best wishes
    Elinor

    • Thank you. FYI

      Ross Menzies from Australia is traing SLP’s in cognitive behavior therapy. As well thank you for changing therapy landscape for PWS.

      Kindly,
      Mike

  15. Hi Michael,

    Thank you for sharing this practical approach to addressing the anxiety and worry a person may experience surrounding stammering. I think a large component of therapy for PWS is addressing the psychological aspects of stammering, as well as fluency. The openness about stammering these sessions encourage is a great part of desensitisation too. Sharing stressors, anxieties and fears with family/ friends promotes awareness in the immediate environment.

    Best wishes,
    Olivia

    • Olivia,
      Thank you for kind and thoughtful comments. As well, changing therapy landscape for PWS.

      FYI Ross Menzies a psychologist from Australia is training SLP’s in cognitive behavior therapy. Please peruse the conference and read about mental health professionals involvement with SLP’s.

      All the best
      Michael

  16. Thank you Michael for this helpful article. As a graduate student of communicative disorders, I was looking for suggestions and materials to target stress/anxiety/negative feelings about stuttering and ways to improve the client’s attitude about coping with stuttering. I found this guide to be very helpful. I specifically liked session 11 and the suggestion for looking at activities to relieve anxiety. I think mindful walking, breathing exercises, aerobic classes, meditation, yoga, massage and acupuncture are wonderful suggestions. I have previously received good feedback from clients on using mindfulness meditation in therapy.
    I look forward to using these activities in therapy with my future fluency clients.

    • Cristina,

      Thank you in helping to change therapy landscape for PWS. As well, please peruse the online conference for further collaboration between SLP’s and mental health professionals.

      Ross Menzies psychologist from Australia is training slp’s in cognitive behavior therapy.

      All the best
      Michael

  17. Thank you for the activities, I will keep them handy to put them to use in my future profession as an SLP. I’m still uneasy about the grey area of overlap that exists between speech language pathology and counseling. I want to be sure that I’m not working outside of my scope of practice.
    Can you offer any advice regarding some clear signs of anxiety that we can look out for in our clients that would warrant a referral to a mental health professional? I assume if the client is reporting symptoms of panic attacks that would be reason to refer; are there any other clear-cut signs or symptoms that we should be aware of? I’m not sure if the Zung self-rating scale is appropriate for an SLP to administer and interpret.(I’m not taking a stance here, I really don’t know).
    Any advice you have in this area would be greatly appreciated.
    Christine Ratke

    • Christine,
      Thank you for pertinent question. I want to address you first with thank you for acknowledging scope of practice. Research is focusing on anxiety in stuttering. For example, Ross Menzies psychologist from Australia is training SLP’s in cognitive behavior therapy. As well, I am going to refer you to clinical social worker and SLP collaborating–check out their article self advocacy…peruse the online conference.

      As well, therapy landscape in communicative disorders are changing. Mental health professionals are beginning to address this issue with SLP’s.

      Please refer to Mental Health professional to assess PWS anxiety level.

      Maybe we’ll see each other at one the conferences to continue this valuable discussion.

      Kindly
      Michael

  18. Micheal,

    Thank you for sharing this approach and making it so user friendly. I am a future SLP and though I know you are not an SLP I wondered if you picture this therapy done in separate sessions from helping the clients learn techniques to control stuttering or if it could be done in the same session?

    • Angela,

      I am a social worker and facilitate stress group and provide individual therapy sessions in ambulatory clinics in alameda county. Have been a social worker for 30+ years.

      Co-founded NSA in 1977 and been involved in stuttering community in various roles.

      I think you can integrate ideas into the same session. I think you will develop skills.

      All the best in your future as a SLP.

      Michael

  19. Hi Michael,
    This is a great approach to use with PWS and I feel this would be very beneficial to use in a clinical setting. I am currently working toward my masters in speech-language pathology and had a question about your experience using this approach. I have seen that sometimes a PWS can have a negative experience that can cause them to regress a bit. For that reason do you ever find that you have to frequently go back and revisit some of the steps during this process or how would you handle that “new” anxiety?
    Thank you, Sarah

    • Hello Sarah,

      I am not a slp working with PWS. However, co founded National Stuttering Association and created this isad.

      I am a social worker working in ambulatory care clinics. And have individual sessions and facilitate a stress management group.

      I review my previous session with my client. He or she has a mental health diagnosis. So to answer yes. Always review the previous session to determine how to proceed. Check self advocacy article by clinical social worker and slp.

      Best wishes,
      Michael

  20. Hi Michael,

    Great paper! It is wonderful to finally see mental health issues getting the attention they deserve in the stuttering world.
    I am very interested in your advocacy of Zung self rating scale. As you know for several years there have been calls in the self help and professional communities for the use by SLPs of a screen for Social Anxiety Disorder with their stuttering clients. The Liebowitz Social Anxiety Scale and SPIN survey have both been validated against clinical diagnosis of SAD. (This is relevant because SAD has been shown to impact negatively on speech therapy and quality of life, and is a treatable condition -as you have highlighted in your many references to Ross Menzies.) What do you see as the advantage of the Zung self rating scale which I understand is a measure of general anxiety?
    Apologies for the curly question. I promise to buy you a beer in Atlanta. Cheers, Mark

    • Mark,

      Look forward to seeing you again. I was disappointed NSA or ISA did not hold conference in LA or San Francisco.

      Thank you for your comments. You have to feel good that your efforts in addressing anxiety are discussed.

      For me. I am not in private practice. I work with others in a behavioral health team in three ambulatory care clinics. 3 social workers and 3 psychiatrists. We facilitate stress management groups and DBT group. And provide individual sessions

      We r referred by medical providers for mental health assessments. For evaluation I/ we use Phq9 as assessment tool. after interview we determine diagnosis. It was suggested to use Zung scale. However, when determined after interview I can try the scales you suggested. Will let you.

      I may have seen less than 10 PWS in 20 years in the county facility. However, I know there are more….

      Thanks

  21. Thank you for sharing this approach. I am a graduate student and find the information to be very helpful. I can see how this approach can help an individual cope. However, I did have a question. What is the purpose of session 4, writing down times the person took risks?

    Bailey

    • Hello Bailey,

      I am trying to instill confidence and the experience of taking a risk. A risk can be taking a walk around a lake or applying for employment.

      Trying to invoke positive experiences. Take a look at Cognitive reframing.

      Good luck and thank you in helping to change the therapy landscape for PWS.

  22. Hi Michael,
    I really enjoyed reading your article and going through your suggestions for PWS therapy. This will be a great reference to turn to when working as a graduate clinician. These activities are extremely self-reflective and seem geared towards adults who stutter. I could see these activities also being beneficial for children who stutter, if they were modified. I have heard of clinicians having children who stutter draw pictures to describe how stuttering makes them feel. These activities help dig into the emotional side of this disability and how it affects the client’s life personally. Thanks again for all the suggested activities. They will be a great place to start as a young professional.

    • Melissa,

      Thank you for your kind comments. And thank you in helping to change the therapy landscape for PWS.

      Kindly,
      Michael

  23. Hi Michael,

    As a future SLP, this would provide me a great snapshot of how my future client’s are dealing with their stutter and what we can do to break free from the anxiety. It is important to not only increase the client’s fluency, but to give them an outlet to express the emotions behind stuttering. I think this would would be great to employ during therapy!

    Thanks for sharing
    Erin Maloney

    • Erin,

      Thank you for your comments and changing the landscape for stuttering therapy.

      Good luck,
      Michael

  24. Hi Michael,

    The exercises you provided are not only practical but also very helpful in addressing the thoughts and feelings behind stuttering. I’m a graduate student studying to become an SLP and I’ve learned that treating people who stutter involves more than just treating the disfluencies. Often times, clinicians must start by addressing the individual’s thoughts and feelings toward his or her stuttering because emotions play a key role in moving forward with therapy. I also like how some of your exercises work to improve self-esteem. It goes hand in hand with what my professor says which is “Give your clients opportunities for success.” Having them experience success let’s them know that they can improve and it is possible.

    • Thank you for your insight. I agree …”give clients opportunities for success.” Thank you in helping to change the landscape in stuttering therapy.

      Good luck and future success

      Michael

  25. Hi Michael,
    I am currently a second year graduate student to be a Speech Language Pathologist and I found this paper to be helpful. I enjoyed the outline of your hands on approach to addressing anxiety of individuals who stutter. The break down of each lesson makes it user friendly and more applicable to clients. How long does each “session” last for? If I saw a patient twice a week for 45 minute intervals, would I work on one session per therapy service? Or does the progress of sessions depend on the progress of the patient, in which they move through sessions at his/her own pace?

    Thanks for the resource,

    Elyse

    • Elyse,

      Thank you for your comments. You can use the session and repeat same session if you feel there is more to be disclosed by PWS. I am not a SLP. I am a social worker and facilitate stress management group and individual session for people with mental health issues.

      Good luck in changing the landscape for PWS.

      Michael

  26. Hello Michael,
    Thanks for sharing your ideas! It is always great to get new fresh ideas for therapy. This is one that can be easily integrated into the therapy already provided. I really like that you addressed the anxiety related to stuttering. I think addressing this aspect is essential in contributing to therapy. The step by step process you provided is very easy to follow and implement. I had the same question as someone else asked you regarding session 5 and saying ‘yes’. Thank you for clarifying why that is used. I think many of the sessions could possibly be slightly modified to fit each client also. Thanks so much for the resource.
    Kendra S
    SLP Graduate Student

    • Kendra,

      Thank you for your comments. Please modify any of the session. Good luck in changing the therapy landscape for PWS.kindly,
      Michael

  27. Hi Michael,
    I love your ideas for treating covert aspects of stuttering in PWS. I am a SLP graduate student and have recently been introduced to the depth of these covert aspects in my fluency class. Up until that time I focused on the overt aspects unknowingly. I have been pondering how to address these aspects along with the overt aspects. Your session outline is going to be a great resource for treating the vicious cycle of anxiety in PWS.
    Thanks,
    Dorene

    • Dorene,

      Thank you for your kind comments. And thank you for integrating some of these sessions with PWS. You r part of the young professionals changing the landscape for therapy withPWS.

      Good luck in becoming slp.

      Kindly,
      Michael

  28. Hi Michael,
    This is an excellent progression to help build trust and open communication with our clients. Most of these really seem like they could be adapted for about any age, so thanks for sharing your ideas. I think teaching clients who stutter to communicate their feelings from a young age will serve them well, even if their stuttering resolves. I could see using some of these ideas to facilitate conversation between kids and parents or between spouses/partners. I also think a good clinician needs to be mindful of the entire person in our clinic room, not just their communication disorder. In order to be able to treat holistically, we have to be grounded ourselves. I may occasionally use these myself to keep my own ship righted, so I appreciate the prompts!

    • Thank you Christine,

      I liked your approach of holistic thinking. And thank you in changing the therapy landscape for PWS.

      Good luck,

      Michael

  29. Hi Michael,
    Thank you for your ideas! I think your approach is very user friendly and easily outlines ideas to use in a clinical setting. Thank you!

    • Stefanie,

      Thank you in changing the therapy landscape for PWS.

      Good luck in your future endeavors,

      Michael

  30. Michael, thank you so much for sharing this program! I am in graduate school to become a speech language pathologist and this is an excellent resource for me as I encourage my fluency clients!

    • Thank you in choosing a challenging and worthwhile profession. And changing the therapy landscape for PWS.

      Good luck in your future endeavors as a SLP.

      All the best

      Michael

  31. Hello Michael,

    Thank you so much for sharing this program. I am currently a graduate student studying communicative disorders and I find resources like this so helpful. It is incredible how organized the program is session by session. Anxiety can be a big issue for people who stutter and having such a structured and organized way of addressing it is great. The program is so in depth and touches on so many important emotional aspects about stuttering. Thank you for sharing your insights. I will definitely keep this resource handy!

    Thanks again,

    Rosario

    • Rosario,

      Thank you for your kind comments. I look forward to the future and you helping to change the therapy landscape for PWS. Please integrate any session exercise you feel can be helpful.

      Good luck in your future endeavor as a SLP.

      Best to you,

      Michael

  32. Hello,

    thank you so much for sharing this. I found it really useful and have taken a lot from it. I am currently a Speech & Language Therapy student in the UK and I have found this really helpful for my learning!

    • I am glad you found the session exercises helpful. Thank you for helping to change therapy landscape for PWS.

      Best of luck in your future endeavor as a SLP.

      All the best,

      Michael

  33. These activities are fantastic. As someone who lives with anxiety I can safely say that it’s bad enough that it creeps up on you out of nowhere. But I can only imagine it is worse still when tied to a regularly occurring event that one has little choice but to face.

    The techniques here could be very useful for my clinical sessions next semester. In fact, much of this could be applied to many different communication disorders. Focusing on the emotional needs of the client and helping them become more comfortable with their own challenges should make tackling things like stuttering much easier; or at least less stressful and more productive.