Faith and Fluency: Inviting a Closer Look (Amanda Glover, David Shapiro)

amandaAbout the author: Amanda M. Glover is currently a second year graduate student striving to attain her Master of Science degree in Communication Sciences and Disorders (CSD) at Western Carolina University (Cullowhee, North Carolina, USA). For her Bachelor of Science degree, she studied CSD at the same university. She is honored and blessed to study at such a beautiful institution with devoted and experienced faculty members. Amanda is fortunate to have a loving, supportive family encouraging her to pursue her goals and aspirations. She is eager to work with all people who have communication disorders, including people who stutter.
davidAbout the faculty sponsor: David A. Shapiro, Ph.D., CCC/Speech-Language Pathology, is a Fellow of the American Speech-Language-Hearing Association, a Board Certified Specialist in Fluency and Fluency Disorders, and the Robert Lee Madison Distinguished Professor at Western Carolina University (Cullowhee, North Carolina, USA). For 39 years, Dr. Shapiro has taught workshops and presented papers, provided clinical service, and conducted research on six continents. His book, Stuttering Intervention: A Collaborative Journey to Fluency Freedom (2nd ed., 2011, PRO-ED, www.proedinc.com) continues to find a wide international audience. Dr. Shapiro is actively involved in the International Fluency Association (IFA) and International Stuttering Association (ISA), received IFA’s Award of Distinction for Outstanding Clinician, and served as IFA’s President from 2012-2014. Most recently, Dr. Shapiro received the 2016 Oliver Max Gardner Award, the University of North Carolina Board of Governors’ highest honor for faculty in its 17-campus system. Dr. Shapiro is a person who stutters, has two adult children with his wife, Kay, and lives near the Great Smoky Mountains National Park.

There seems to be an element of magic in stuttering therapy, an elusive, ephemeral, and yet powerful force which most clinicians acknowledge but few can precisely identify.” (Emerick, 1974, p. 92)

This paper emphasizes the importance of academic, clinical, and supervisory instruction within professional preparation of speech-language pathologists (i.e., SLPs, clinicians) who provide clinical service to people who stutter (i.e., PWS, clients). It also acknowledges the uniqueness of stuttering and stuttering intervention, which requires specific knowledge and skills to address the necessary affective, behavioral, and cognitive elements of stuttering and communication.

The purpose of this paper is to take a closer look at one elusive yet powerful element that operates within the clinical interaction, indeed an aspect of the interpersonal relationship between the client and the clinician that may in part determine the outcome of treatment. Specifically, this paper will define faith, also referred to as confidence and hope, and its relevance to stuttering treatment. To do so, I will describe briefly the professional preparation I am experiencing as a graduate student in speech-language pathology and the SLP I aspire to become, share the personal beliefs that guide everything I do, define faith as a clinical variable, and finally, raise questions that invite clinicians and clients to take a closer look at an aspect of the client-clinician interaction that impacts the process and outcome of treatment.

Professional Preparation

As a graduate student studying speech-language pathology, I have completed the first year of the two-year Master of Science degree program at Western Carolina University. Our program requires 60 semester credit hours of extensive academic coursework and 400 hours (including 25 hours of observation) of supervised clinical practicum. Among other courses, last year I completed the Fluency Disorders seminar and participated in a group treatment experience combining self-help and modified direct treatment, all of which Dr. Shapiro coordinated. Five graduate clinicians met weekly with teens and young adults who stutter. Initially meeting as strangers, the clients soon realized their many commonalties, only one of which was that they all were PWS. Similarly, the clinicians soon realized their commonalities, including that all were new to fluency intervention. Furthermore, both the PWS and clinicians began a new journey together. These discoveries contributed to a relaxed, comfortable, genuine environment, leading to trusting relationships among all participants of the group. Such trust developed a shared sense of confidence in the abilities of all to succeed. That trust and confidence generated respect, dignity, and recognition for oneself, each other, and the collaborative commitment to positive change.

More specifically, clients and clinicians initiated topics for discussion and related activities. The clients elected to receive modified direct treatment from the clinicians. The clinicians regularly involved the clients in planning, implementing, monitoring, and reflecting upon each treatment session. Data were collected to monitor measurable client progress, including behavioral (i.e., use of fluency facilitating controls and self-corrections) and both affective and cognitive (i.e., feelings and thoughts regarding oneself as a person and as a communicator) aspects of communication.

As part of the instructional experience, I am encouraged to reflect on what I learned and what it means, namely the type of SLP that I aspire to become. I want to be the type of professional who never replaces the most essential elements of human interaction and best practice with expediency. In other words, I want to be as true to my profession as to myself. For me, service is a calling. I want to have the type of relationship with all of my clients where they feel comfortable with me not only as a professional, but as a person. Hopefully my clients will consider me to be a friend. Reflecting further on the academic and clinical experiences, I have begun to wonder if faith, which will be defined shortly, should be looked at more closely as a variable that could significantly impact the process and outcome of treatment.

Who I Am and What I Believe

I am a person who is fortunate. Growing up in the southern USA, I am surrounded by two types of people: fisherman and Christians. My father is both. Our frequent father-daughter time on the lake always begins with his familiar remark, “We’re gonna catch ‘em today.” Despite often reeling in an empty lure, he remains confident. THAT is faith. On a more serious note, my dad has experienced challenges in life; he has had his heart broken too many times. Whether the challenges are large or small, he leans heavily on the promises of God. As sure as he will catch a fish, he remains sure of the truth that lies within the promises.

My father’s faith is a welcome influence on me to the present day. Like my dad, I see the world as full of possibilities. I believe that the Lord has led me to where, what, and with whom I am studying. I know that He will lead me to a bright future. When I meet new clients, I see their positive potential. Nevertheless, I have my doubts occasionally. For example, having never stuttered, I wonder if I can come to understand – as fully as I must – the world of someone who does. Can I become the competent clinician I want to become? Yet I know He has a plan for me, and my faith in that plan, combined with ongoing instruction and professional experience, will lead me on a path to the full understanding that I seek.

Faith Defined

A Biblical background has molded my personal definition of faith as simply believing before seeing or possessing. Faith enables me to believe in the potential of others, particularly my clients, even before we begin. For example, I knew before participating in group treatment that the clients and clinicians would learn, succeed, and have a positive experience.

I realize, however, that what I believe is not necessarily shared by others. I have seen faith, or confidence yielding to hope, result from various other sources. In more secular terms, faith may be viewed as shared confidence between individuals before the manifestation of successful results. This seems to be essential within the clinical process, particularly when working with PWS. PWS benefit from having confidence that the clinician possesses the necessary qualities (i.e., knowledge, skills, abilities, and temperament, among others) to help him achieve communication success. PWS also benefit from a clinician who believes in the client’s potential for positive change (Daly, 1988; Shapiro, 2011).

Faith as a Clinical Variable

Faith within the clinical process can come from various sources. Data increasingly reveal the importance of the client-clinician interaction, as well as specific clinician attributes that elicit mutual hope, confidence, and more positive treatment outcomes. For example, DiLollo, Manning, and Plexico (2010) analyzed the characteristics of SLPs whose treatment resulted in their clients achieving fluency improvement compared to SLPs whose treatment was less successful. One characteristic of SLPs whose clients achieved success was the clinician’s belief in the client’s potential. Similarly, Daly (1988) indicated that one of the most predictive factors of treatment outcome is the clinician’s attitude toward the client’s ability to reach his communication objectives. Shapiro (2011) structures treatment so that the PWS experiences success at each stage of intervention and within each treatment activity. Nothing motivates more than success itself. Success begets success; success leads to confidence and hope in positive change. Shapiro (2011) reviewed attributes of effective clinicians, including empathy, warmth, genuineness, personal magnetism, and realistic optimism, among others. Cooper (1997) also delineated characteristics of effective clinicians. These qualities include being honest, positive in their attitudes, reflective, open-minded, informative, perseverative in their pursuit of goals, and detailed.

From my clinical experience, I learned that PWS often take on the confidence of their clinician. Fortunately, clinicians and clients each possess significant roles within the therapy session. In conversations with two bright, insightful men in our fluency group, I asked what role (if any) faith played in their achievement of fluency success. One remarked, “If someone has confidence in me, then my confidence is built, which positively affects my fluency.” The other explained, “If I am confident in myself and my clinician, my speech will get better, and it will be reflected in the numbers,” in reference to the numerical data taken on his fluency. Both clients make reference to their own ability to express faith in themselves and their clinicians.

Summary and Implications

In order to consider the relevance of faith (i.e., confidence or hope) within treatment for PWS, I have reflected on my experience as a graduate student in SLP, shared my personal beliefs, and defined faith as a clinical variable. What I have learned particularly is that sometimes things that are considered small can have a huge impact. My father couldn’t know the extent to which his life of faith has influenced my outlook and the way I live my life. Similarly, faith within the clinical context might possess more significance than we often assume. From the literature and my initial clinical experiences, I have made an important discovery: the clinician’s confidence in the ability of the PWS to succeed and the extent to which the PWS perceives that confidence both impact the process of treatment and its outcomes. Now more mindful of the importance of these variables, I reflect on a number of related questions. I invite you to share your thoughts with me.

Questions to Consider

  1. What role, if any, does faith, also defined as confidence or hope, play within the clinical realm? How might faith contribute to fluency improvement, motivation, and continuation in treatment?
  2. In what ways might faith within the clinical realm present in different forms, functions, and at different levels?
  3. How can a clinician create faith in a PWS who, from previous treatment or life experience, feels that communication success is impossible?
  4. As a PWS, what advice would you offer a clinician to create a faith-filled clinical environment? As an SLP, how would you enable every PWS to develop his own sense of faith and to achieve maximum communication potential?
  5. What possible role might God play in the treatment experience and its outcome? How can personal faith (i.e., religious interpretation as believing before seeing) and evidence-based practice (i.e., seeing before believing) merge?

References

Cooper, E. B. (1997). Fluency disorders. In T. A. Crowe (Ed.), Applications of counseling in speech-language pathology and audiology (pp. 145-166). Baltimore: Williams & Wilkins.

Daly, D. A. (1988). A practitioner’s view of stuttering. Asha, 30 (4), 34-35.

DiLollo, A., Manning, W.H., Plexico, L. W. (2010). Client perceptions of effective and ineffective therapeutic alliances during treatment for stuttering.  Journal of Fluency Disorder, 35, 333-354.

Emerick, LL. (1974). Stuttering therapy: Dimensions of interpersonal sensitivity. In. L.L. Emerick & S.B. Hood (Eds.), The client-clinician relationship: Essays on interpersonal sensitivity in the therapeutic transaction (pp. 92-102). Springfield, IL: Thomas.

Shapiro, D. A. (2011). Stuttering intervention: A collaborative journey to fluency freedom (2nd ed.). Austin, TX: PRO-ED.

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Faith and Fluency: Inviting a Closer Look (Amanda Glover, David Shapiro) — 45 Comments

  1. You mention that “PWS often take on the confidence of their clinician.” I wonder how we might build faith and confidence in clinicians who work with fluency clients, given that many SLPs rate fluency as their least favorite area to treat. Have you ever felt a sense of pessimism or negativity from clinicians around you regarding working with fluency clients? Despite your background of faith, did you feel that as a new (graduate student) clinician, you had to reestablish a sense of faith in yourself?

    • Alex,

      Thanks so much for taking the time to read and share your comments!

      To answer your question, yes, I have felt a sense of negativity from other clinicians, but also, myself! I would be lying to claim never feeling negative emotions about certain aspects of fluency treatment.

      However, I like your statement regarding “reestablish[ing] a sense of faith.” I wouldn’t say that I reestablish a sense of faith in myself; however, I often reestablish or remind myself of the faith I have in the other clinicians, clients, and fluency group as a unit to change my negativity. Additionally, I draw encouragement from the positive remarks, ideas, and actions of all individuals involved with the fluency group.

      You caught one of the main discussion points of my paper within your remark regarding how clinicians/clients could create such an atmosphere for individuals with less optimistic views about fluency treatment. (I wonder with you)! Although I’m not sure a correct answer exists, my personal opinion, based on personal experience, is that those involved in fluency treatment must continue to remain confident in the abilities of other members. I think all members should count on the success of all members! I believe this is contagious- it encourages and changes negativity.

      Thank you again for reading and sharing,
      Amanda

  2. Hello, Amanda,

    I am glad to see you are beginning to explore the influence of what I feel comfortable calling the “presence” of the clinician on the life of the client with help of Dr. Shapiro.
    Certainly, presence has a vital influence if we are to believe what quantum physics is telling us about the relationship of the observer to the observed.

    And exploring the effect of the clinician’s faith in the clinical enterprise, if parsed down to “held expectations for the client,” is a reasonable way to start in an empirical environment.

    But more than that – your interest and, perhaps, concern expressed here highlight the dynamism within the clinical relationship to help many of us enlarge our perception of it truly is that extends far its representation in flat, grey, and untenable tones when portrayed in stimulus-response gradients.

    Your paper was a pleasure to read and more so is knowing of your interest and you work.

    – Ellen-Marie Silverman

    • Ellen-Marie Silverman,

      I appreciate your kind remarks! You speak/write so elegantly. I have enjoyed studying and exploring the effect of the clinician’s “presence” on clients and the client/clinician relationship and am pleased you also find interest. Thank you for sharing your thoughts with me! Your related comparisons and parallels were interesting thoughts I had never considered. Specifically, the relationship of the observer to the observed. I’m so pleased the paper evoked further contemplation on the client/clinician relationship!

      Thank you again for reading and sharing your thoughts.
      Amanda Glover

      • You are very welcome, Amanda. I am glad made statement about the relationship between the observer and the observed piqued your interest. I think that the client-clinician relationship is the most critical dimension in diagnosis and in treatment and that it starts with the relationship we cultivate with ourselves most certainly.

        My very best wishes,
        Ellen-Marie Silverman

  3. Thanks for writing this paper on faith and stuttering therapy. Developing confidence, faith and determination that one can overcome obstacles is powerful therapy. I agree with your statement that that confidence impacts the process of treatment and its outcomes. Do you have any good methods that help to arouse these qualities within the client, in secular terms?

    • Lourdes Ramos,

      Thank you for reading and commenting! One “method” I believe creates confidence within the client is one of Dr. David Shapiro’s. Dr. Shapiro suggests that “success begets success.” Having had the opportunity to learn both clinically and academically from Dr. Shapiro, I was able to witness this method create confidence within my previous clients. According to one of my previous clients, some of the qualities that have aroused faithfulness or confidence within himself is that of a genuine and realistic, yet positive outlook on future achievement.

      Does this address your question? Thank you again for sharing your thoughts and questions, as well as taking the time to read the paper!

      Amanda Glover

  4. Amanda,

    I enjoyed reading your thoughts on faith and stuttering. Being a graduate student, I have had little experience working with PWS, and know that it might be difficult for me at first to know what to do. I love everything you said about being positive and having faith and confidence in your client. What has been your biggest struggle with faith and stuttering in your clinical experience and what advice would you give to new clinicians?

    • Amanda,

      It is so good to hear from you! We miss you here at WCU and hope you are well!

      I have found that it is most difficult for me to exercise faith in the success of my client when the client does not reciprocate faith in me or his or herself. In this situation, the clinician cannot force the client to be confident. However, I believe the clinician can encourage faith by continuing to express their own confidence in the client’s success, as well as continuing to provide opportunities for the client to succeed. When the client experiences success, I believe his or her faith in their own abilities to succeed will grow.

      Although I feel unworthy to offer advice, I would encourage you to provide opportunities for your clients to be successful. Assert your faith in your clients’ success even when he/she does not share that same confidence.

      So good hearing from you. Thank you again for reading and commenting!
      Amanda Glover

  5. Amanda,

    Thank you for sharing your thoughts about faith within therapy; I could not agree with you more. Faith and confidence are always important within speech therapy, but especially important when working with a PWS. Since there can be underlying problems it is crucial that the PWS feels comfortable enough to share their past with the clinician. I am currently in my first year of the graduate program to become a speech language pathologist. Is there anything that you have found to work well when building a good relationship with a PWS? Have you ever found it difficult to build that “friend-like” relationship with a client, and if so, what factors do you think made it difficult? I look forward to your response as it will likely help me in my future!

    • Annie,

      Thank you so much for taking the time to read and share your thoughts!

      To answer your first question, I feel that one of the best ways to build rapport with your clients is to be yourself! Entering into a professional environment as a first year graduate (and second year) student can be very intimidating. At times I was, and am, tempted to withdraw due to a lack of experience; however, I feel one of the best ways to build a good relationship with clients is to be genuine and honest with them. Just as we try to be accepting and understanding of our clients, I have found that the same has been reciprocated towards me when I am honest and genuine.

      Secondly, yes! I have found it difficult to form meaningful relationships with certain clients. The factors that made the relationships difficult have included age gaps, lack of similar experiences, and pragmatic exceptionalities. These factors often made it difficult to relate to the client in meaningful ways. In order to overcome these factors, I often had (and have) to remind myself to see through my clients eyes. If I consider their perspective or life experiences, I can often come to an empathetic frame of mind that allows me to develop a better relationship with them.

      Thank you again for reading and sharing!
      Amanda Glover

  6. As an SLP graduate student I enjoyed reading about your perspective. Your fathers attitude about fishing really stuck with me. I have had similar experiences fishing, it seems my attitude plays a major role. To quote Bob Proctor, “Thoughts become things. If you see it in your mind, you will hold it in your hand.” PWS often have a great deal of doubt, fear, and negative self-talk. As clinicians it is extremely important that we have a positive outlook as we seek to help our clients overcome these emotional covert aspects of stuttering. This type of thinking opens the door to mindfulness exercises and other non-traditional approaches to therapy, resulting in a more holistic approach.

    • Jeremy,

      Thank you for taking the time to read and share your thoughts! I so enjoyed reading your quote. Similar to PWS, I think we all have, or do, struggle with doubt, fear, and negativity in some sense. I believe these negative emotions create common ground for building the foundation of meaningful relationships with clients.

      I’m glad to see you are already adopting methods which will assist you in accomplishing your goal of creating a positive atmosphere for your future and current clients. Best wishes!

      Thank you again for your time.
      Amanda Glover

  7. Amanda,

    Thanks so much for sharing a personal account of your experience and your faith heading into your future career as an SLP. I, too, am a graduate student who does not stutter and has never been exposed to an abundance of disfluency. I have the same thoughts you do about wondering how I can fully understand the world of someone who stutters. I completely see the importance of having faith in our clients and creating an environment that fosters positivity. In contrast, I can see the importance of fostering faith within our clients who stutter.

    What do you think are the most important things we should keep in mind or use in order to foster faith in our clients who stutter?

    • Haylee,

      Thanks so much for taking the time to read and share your thoughts!

      I think it is most important to be empathetic, genuine, and honest in order to foster faith within PWS. By practicing empathy, I think clients recognize their clinician as an individual who truly cares and desires to help. Genuineness and honesty go hand in hand in that the client feels the clinician has nothing to hide and is being upfront about his or her prognosis. In my opinion, all of these attributes working together establish rapport and create a clinical atmosphere that fosters faith and success.

      Thank you again for your thoughts!
      Amanda Glover

  8. Amanda,

    Thank you for inviting me to look at my future in speech-language pathology in a new light. As a person of faith, I have not been conscious of using this as a clinical variable to instill faith and hope within my clients. In question 1 you ask how faith might contribute to fluency improvement, motivation, and continuation in treatment? I think this develops through a sense of hope and belonging first with the clinician before the PWS begins to feel this in their everyday life. Faith can be a powerful tool for clients to begin looking at their life in a more positive light starting with their clinician’s overt confidence in faith and optimism.

    Thank you again!
    Cassie

    • Cassie,

      Thank you for reading and sharing your thoughts! You might have already guessed that I agree with your statements whole-heartedly. It excites me to know that other clinicians are concerned with faith in the clinical process.

      Thank you again for spending time reading and commenting!
      Amanda Glover

  9. Hello Amanda,
    As current second year graduate students in COMD, we share a common understanding of the learning process and the variety of factors potentially designed to effect a treatment session. Throughout our curriculum, we have learned how to analyze our therapy sessions and improve upon our weaknesses. One factor of therapy that has been continually reinforced in us is the importance of the client-clinician relationship. We have not only learned the importance of this relationship, but we have also learned many ways in which we can establish, maintain, and improve this specific relationship. However, never have we ever been presented with the idea of how faith impacts that relationship. As people from Southern USA, we share a commonality with you in the fact that faith plays a large part in our lives. Despite the importance that faith plays in our everyday lives, we never took the time to step back and see the importance of faith in our chosen profession. Our patients have faith in us, and we have faith in them. This creates a bond that helps not only the patients but also us as graduate clinicians achieve our goals. We would like to thank you for providing us with such a powerful insight, one that we will incorporate in all aspects of our professions from here on out.

    • Hello,

      Thank you for reading and sharing your thoughts!

      I think it is wonderful that you are spending time reflecting upon and analyzing the client-clinician relationship. I believe analysis of the client-clinician relationship will lead to the most successful, meaningful relationships. Dr. David Shapiro encourages his graduate students to do similar reflections upon beginning and ending the clinical process with PWS. Thank you for reminding me and other readers of the importance of this analysis. I am glad the paper proved helpful in this process for you.

      Again, thank you for taking the time to read and comment!
      Amanda Glover

  10. Amanda,

    I loved reading your paper on faith and fluency! As a fellow Christian I see where it is so important to instill faith in our clients no matter their reason for coming to therapy.

    As a current graduate student myself, I want to be able to instill faith in my clients. What are some ways that you have found or believe will instill faith in our clients as we move forward into being working clinicians?

    Thanks, Emaly Cox

    • Emaly,

      Thank you for your kind words!

      In previous responses I have mentioned three clinician attributes and one “method” that I feel are of utmost importance in establishing faith within our clients. (I hope I am not being too redundant)! You might also consider the possibility of a fluency group.

      I think empathy, genuineness, and honesty are three very important attributes in establishing a faith-filled clinical environment. Empathy allows the client to understand the clinician’s desire to help him/her succeed. I feel that genuineness and honesty are related in that both help the client realize there is no hidden agenda, thus allowing a trusting relationship to develop. When all of these attributes are working together, I believe faith is fostered within the client.

      Dr. David Shapiro suggests “success begets success.” I also believe success begets confidence. By providing opportunities for your clients to succeed, the successes will create confidence within the client.

      Finally, within the paper, I mentioned that I felt the commonalities between the clinicians and clients within the fluency group helped foster a more relaxed, trusting environment. I believe this type of environment also leads to the development of faith within the clients. Forming a fluency group where such an environment can be established might also be a positive consideration in efforts to instill faith within the clients.

      Thank you for taking the time to read and share your thoughts!
      Amanda Glover

  11. Amanda,
    I really enjoyed reading this paper about the faith based methods of treatment for fluency. I too am a Christian and a second year graduate student in Communication Sciences and Disorders. As a new clinician, I often doubt myself in therapy because I haven’t been exposed to all the disorders. In order to instill faith in my clients, I first have to have faith I know what I am doing. What are some things you personally do to have confidence in yourself when treating clients in new situations?

    Thank you,
    Jordan

    • Jordan,

      Thank you for your kind comment!

      I think your question is very interesting, but also difficult for me to answer! I think the concept of having faith in yourself is exactly contrary to what is taught in the Christian faith. For example, we are taught not to place our faith within ourselves or our own abilities, but rather in Jesus.

      As a parallel, I think I have developed and continue to develop a sense confidence in myself as a result of placing faith in my supervisor and clients. In order to indirectly develop faith in myself, I place confidence in the abilities of others. Although this seems backwards and I have no evidence-based support for such an idea, I have found it to be particularly helpful as an SLP in training.

      Thank you for helping me reflect and organize my thoughts on this matter, as well as for taking the time to read and share your thoughts!
      Amanda Glover

      • You are right! I am working on my confidence in my placements now and getting better at it. It is great to hear how other clinicians gain confidence in new situations and how I can better myself as a clinician. Thank you for the advice and good luck to you in your future career!

  12. Amanda,
    Thank you for sharing your faith, you passion for speech, and how you have worked to combine these to contribute to your success as a clinician and the success of your clients. I think all too often we can become caught up with the literature of providing therapy, that we fail to address the soul needs of our clients. I am delighted to here a bit about the research and results you have seen by imparting faith, and faith in your clients, into therapy. This is certainly something I will take with me into my practice as an SLP. Thank you! – Bethany

    • Bethany,

      Thank you so much for your kind words!

      I agree that we can often become bogged down with documentation and literature. Although these are important aspects of the speech-language pathology career, I think other important aspects (such as faith) are often placed on the back-burner. It encourages me to hear from someone who realizes the importance of both realms.

      Thank you for taking the time to read and share your thoughts!
      Amanda Glover

  13. Hi Amanda,

    Thank you for sharing how faith has influenced you as a clinician and how to incorporate a mutual faith between client and clinician. I am a first year graduate student for speech-language pathology, and I’m beginning to build on my own confidence as a new clinician. I am interested in your question about how to create faith in a person who stutters that believes communication success is impossible. Do you feel that establishing rapport initiates this process of shared confidence and is something that develops throughout therapy?

    Thank you again,
    Kristin Cross

    • Hey Kristin!

      Thanks for reading! To answer your question, YES! I do believe that establishing rapport is critical in initiating a shared confidence between client and clinician. In fact, I believe faith or “shared confidence” is closely related, if not a component, of rapport. When rapport is established, a trusting relationship is formed. A trusting relationship, in my opinion, is a type of faith or shared confidence between two individuals. Also, I feel establishing rapport is a natural process that takes place over time and cannot be rushed.

      Again, thanks so much for reading and commenting!
      Amanda Glover

  14. Amanda,
    Thank you for sharing your thoughts about your faith and how it has greatly influenced your journey toward becoming a competent clinician. I truly related to this aspect of your paper as I, myself often wonder that same thing. But just as I do with any difficult circumstance that life throws my way, I approach it with a sense of positivity and am hopeful that things will get better even in the darkest of situations. Thanks to you and your insightful paper, I will now be more attentive to the role faith can play within the therapy setting of PWS.
    -Jaynie

    • Jaynie,

      Thank you for reading! I am glad to hear that the paper sparked your interest and led to helpful reflection. It encourages me to hear your concern and respect for the client-clinician relationship, as well as faith within the clinical realm.

      Thank you for sharing your thoughts and kind words!
      Amanda Glover

  15. Hi Amanda,

    I really enjoyed reading about your work. I am currently a first year graduate student, and although I have never worked with a PWS I am currently taking my second fluency course and your approach seems to embody what I have learned thus far. I have learned that working with PWS is much more about counselling than specific techniques and I think this is a perfect example of that. I think that it’s also important to realize that this idea could be applied to other disorder areas as well. When we believe in our clients, they are much more likely to believe in themselves!

    • Ciara,

      Thank you for reading and sharing!

      Although I could never discredit the importance of utilizing evidence-based methods within fluency treatment, I do agree that clinicians must consider and address the thoughts and feelings of PWS within the clinical realm. I agree that faith could be rendered in all clinical contexts, not solely with PWS. I am glad to hear the paper’s content has proven relevant to you in a broader sense. I also make efforts to exercise faith in the abilities of all my clients no matter their communication exceptionality. It encourages me to hear that you value faith within treatment!

      Thank you again for taking time to read and comment!
      Amanda Glover

  16. Hi Amanda,

    I really enjoyed reading your paper and appreciate the time and effort you devoted to writing about this topic. I am also extremely interested in how faith can be a factor in therapy. I know my personal faith is highly valuable to me, and, while I haven’t been in therapy for fluency, I have participated in mental health therapy for depression and anxiety. From personal experience, it was very beneficial for me to feel comfortable talking about my faith and how I believed it was related to/impacting my struggles. My therapist chose not to tell me about her faith, but just her respecting mine was a beautiful aspect. I do wonder if my therapist and I shared the same faith, if that would have connected us more and made sessions more progressive? This would be interesting to do further research on for fluency and faith. However, even if my therapist and I did not share the same religious faith, I think sharing the same faith regarding therapy improving my struggles did increase positive outcomes. My personal opinion in general with faith and therapy is that if the clinician and client can share a mutual respect about faith (possibly concerning religion), and also create a common faith (possibly concerning the trust of improvement with fluency with therapy) this creates a warm and welcoming environment for clients to feel comfortable in, which would increase the positive progress in therapy.

    Again, thank you for bringing this topic to the spotlight. I would like to continue to researching and learning more about it!

    Casey Hindman

    • Hey Casey!

      Thank you for taking time to read and comment!

      Your thoughts are very interesting to me. I do believe respect of an individual’s religion is necessary in order to create a trusting, pleasant relationship. Obviously, if the client or clinician feels disrespected, the relationship will be dramatically affected which could, in turn, affect treatment outcomes.

      In my opinion, commonalities draw people to one another. It makes sense that a deeper relationship could be formed if the client and clinician knew the other party shared similar beliefs; however, I realize that this may not be an option considering professional boundaries. You pose an excellent question that I would love to explore further with you!

      I agree that the client and clinician must, at least, share a mutual respect for the other’s personal beliefs; however, I wonder with you how known, shared beliefs between client and clinician would impact the relationship and treatment outcomes. You think insightfully and I appreciate you challenging my perspective/thought process!

      Thank you again for reading and sharing,
      Amanda Glover

  17. The first word that jumped out to me from this paper was “dignity”. As a clinician, giving the sense of dignity to the client is just as important as the client feeling dignified in their life and communication. Therapy is a two-way process, not one person leading the other. There has to be a commonality in the belief of “faith”, and that good will come from the therapy experience. Faith can also mean more than one thing to different people, and should be utilized, even in a merely clinical sense. Continually, respect, trust, confidence, and optimism should all be present in therapy from all parties. I was left feeling so enlightened by this paper, and similar to Amanda, I feel my profession as an SLP is my calling to serve others. I am thankful that there is a voice that includes the importance of faith in life, because it is often so underappreciated and ignored.

    • Kathryn,

      Thank you so much for your kind words!

      My goal for this paper was to bring to light your last statement – that faith is often “underappreciated and ignored,” and why I believe it should be appreciated and recognized! I am so glad that you were able to gain a fresh perspective. Your kind words and concern for the immeasurable aspects of the clinical relationship such as “respect, trust, confidence, and optimism” encourage me!

      Thank you again for reading and sharing!
      Amanda Glover

  18. Thank you for being so open about your beliefs and how you integrated them into a clinical setting! I am a first year graduate student studying Speech-Language Pathology and currently taking a fluency course right now. I was able to relate very easily to this article, as I am Catholic and faith plays a big role in my family, as well as I am still growing in my clinical experience. The way the perspective and definition of faith was explained and intertwined with therapy made me reflect on my own views and how I can use this as an asset to my practice. I also appreciated the fact that faith was addressed in other ways so that everyone could relate it to therapy. Faith is also believing in your client wholeheartedly and I love that.

    • Hello,

      Thank you so much for your kind words about the paper! I am glad you found the content relevant to your own life both within and outside the treatment context. I am also pleased to hear that the content provided you with an opportunity to reflect on yourself as a developing clinician. I think personal reflection is the first step in becoming the best you can be!

      Thank you again for taking the time to read and share!
      Amanda Glover

  19. Dear Amanda
    Your “unusual” paper resonated with me deeply enough to make me write a somewhat longer response, if you don’t mind!

    I think your assumption is quite often true: one man can impart faith in oneself, sense of self-worth etc. to another, as truly as handing someone a book etc. Also, faith can help a clinician truly believe that “wholeness” and “healing” is already within the client – and clinician’s role is just to take away the obstacles to its manifestation. This could be seen as something like a huge final step in “client centered approaches”. Instead of putting something in, we are helping it to come out – like wiping clean the chimney of a lantern, so that light shines better. This can happen only when we believe that others, however sick, disturbed or different than us- have the same core of perfection and potential as we ourselves have. Describing this relationship as “clinician-client” relationship might miss the whole point.

    Faith is also needed by the clinician to cope with disappointments and the stresses of being responsible for others’ well-being. To the client, such a faith will also communicate: “No response” from God is a response too. It only means- God may have better things for him/her – not fluency! Also, it is said – pray as if you have already received it! The only worthy prayer is thanking God, expressing gratitude every moment… etc. “Three gratitude” and such practices transform the affect, removes the negativity and benefits therapeutic process in many ways.

    In other words, a clinician with faith, will present the big picture and prepare the client for setbacks too: you may never get fluent… so what? PWS like Marty Jezer too, would be discussed as potential role models. (http://www.mnsu.edu/comdis/isad/papers/jezer.html)

    Finally, a faith, which can connect with the other person- and communicate on these deeper issues, will have to transcend sectarian narratives and be rooted in a deeper and universal spirit. One more thing- the clinician will have to be pretty deeply and regularly imbued with such faith, in order to use it in clinical settings, to others’ benefit. There is an Indian saying: A little knife is enough to kill oneself, but you need a sword to kill others!

    Tough job- but doable, I think. Wish you all the success!
    (stammer.in)

    • Hello,

      I do not mind the lengthy response at all! In fact, I appreciate you sharing your thoughts to help me further reflect on and explore my own thoughts.

      First, I love your analogy of the clinician “wiping clean the chimney of a lantern” so that the client’s already-present light within can shine. This was a beautiful way to express my thought.

      I couldn’t agree more that the clinician MUST prepare the client for setbacks and MUST provide a realistic prognosis. In previous comments I have mentioned that I believe honesty and genuineness are two critical characteristics which facilitate a faith-filled clinical environment. I think your thought is directly related. A clinician that is not honest about him/herself or is not honest about the future is a clinician that is dishonest, and therefore, cannot be trusted.

      Although your last statement “tough job-but doable, I think” is short, I believe it holds much power and truth. This faith being discussed is NOT always easy; however, I too believe that it is possible.

      Thank you for taking the time to read and share, as well as making me think.

      Amanda Glover

  20. Hi Amanda,

    Thank you for openly sharing your faith in Jesus. I appreciate your honesty and openness, which is an attribute of any great clinician! I am also a Christian, and my faith in God is first and foremost in my life. I was thrilled to a see a paper which so eloquently depicted a balance between personal faith, faith in our clients, and clinical application.

    I believe that it is essential to help instill feelings of hope, acceptance, self-forgiveness, love, and faith in our clients. I think Faith is amazing avenue through which these encouraging feelings can be shared. If every client could realize that they were beautifully created to be exactly who they are, then I believe so many clients could let their burdens and barriers fall away.

    Of course, there is an important distinction to make between one’s professional life and personal life. My Christian faith certainly falls within the personal life category. But if we can allow our faith to influence our actions, if we can let our hearts show the condition of love, then we can touch our clients hearts without ever imposing our beliefs on them.

    Thank you for posing this thought process of how to instill faith, self-belief and acceptance into our clients in the most comfortable way possible. If we can embody those qualities ourselves because of Christ’s love, we can be a light for a person who is experiencing darkness. This is one of the most rewarding parts of being an SLP!

    Thank you for sharing,

    Shannon Schield

    • Hello Shannon,

      Thank you so much for your kind words and compliments!

      Thank YOU for sharing your faith in Jesus! I agree with you that honesty is an essential characteristic to be possessed by clinicians. I LOVE your statement regarding how we can allow our faith to influence our hearts, thus affecting the hearts and lives of our clients without imposition. What a wonderful thought!

      You speak beautifully and I appreciate you sharing. Thank you again for reading!

      Amanda Glover

  21. Hello Amanda,

    Thank you so much for writing such an inspiring peace. The first thing that caught my attention, was when you stated that you “see the world as full of possibilities”. Even though some may just read over that, it brought a smile to my face. What an awesome way to look at the world, and that is how others should see it as well. Not only could every individual benefit from thinking that way, but SLPs should always keep that in the forefront while working with clients, so there can be a positive environment set up for success. Another point that you made also caught my attention, and that was “PWS often take on the confidence of their clinician”. This again, hit home to me because it correlates so nicely to seeing the world as full of possibilities. It makes so much sense thinking about it now, but not sure that it would have come to me without someone like you pointing it out. Having faith in clients will enable me to create a positive environment for success to be achieved. You mentioned building confidence among your clients and I was wondering, from your experiences so far, how long does that usually take? Also, how do you present yourself in a way that it different from the rest of the SLPs this client may have already been to but did not succeed? Thanks again for sharing your experiences so far and I look forward to hearing from you.

    -Amber

    • Amber,

      Thank you so much for your kind words!

      Although I do see the world as full of possibilities, this is not to say that I have not had my off-days! However, I agree with you that we should try our best to keep this thought on the “forefront” while providing treatment.

      To answer your first question, I think the time it takes to build confidence within a client is dependent on the client as an individual. For example, some clients already possess a level of confidence initially while others exhibit shame, embarrassment, and fear upon beginning treatment. I think the time it takes to build confidence is dependent on the individual.

      I hope I am not redundant to my other comments in saying that there are three critical characteristics I believe each clinician should possess: honesty, genuineness, and empathy. I believe these characteristics facilitate a relationship of trust and openness between the client and the clinician, thus leading to a faithful relationship. I think many client-clinician relationships have failed because the clinician did not exercise these three characteristics, leaving the client feeling defeated and lied to. I believe that these could set a clinician apart from previous clinicians.

      Thank you for taking the time to read and share your thoughts!
      Amanda Glover

  22. Dear Amanda,
    I was initially drawn to this article because of the title. I do consider myself to be a person of faith and was intrigued by the idea of how my faith may intertwine with fluency intervention. I truly enjoyed your definition of faith as “shared confidence between individuals before the manifestation of successful results.” What an awesome understanding of not only spiritual faith, but also the therapeutic alliance between an SLP and his or her clients. I am a first year SLP graduate student and am currently taking a fluency disorders course. In class, we have talked a lot about how important establishing a therapeutic alliance is to the success of therapy, and this paper elaborated on that point. I look forward to exploring how my personal faith can influence the faith I bring to the table in therapy and the faith I can help foster in my clients.

    Thank you for your insightful thoughts!

    Breanna Helminski