Self-Empowerment of Acceptance and Commitment Therapy for People Who Stutter (Scott Palasik, Dan Hudock)

palasikAbout the authors: Dr. Scott Palasik has been a Certified Speech-Language Pathologist for fifteen years. He’s an Assistant Professor at the University of Akron (UA) where he teacher graduate Fluency Disorders course (on campus and distance learning), Voice Disorders and Cleft Palate, and Support Systems for Families and Individuals with Communication Disorders, along with supervising graduate students in clinical Education. He also is the director of the Mindfulness ACT Somatic Stuttering Lab, and performs research with Acceptance and Commitment Therapy (ACT), unconscious and conscious attitudes about stuttering, and environmental and social effects pertaining to dysphagia. He has presented at many local, regional, state, and national conventions about mindfulness and ACT. He has been a member of the ACBS (Association of Contextual Behavioral Sciences) for eight years and is the President of the Ohio ACBS Chapter. He is also the co-founder of the UA Campus walk for Suicide Prevention.
hudockAbout the authors:  Dan Hudock, Ph.D., Certificate of Clinical Competence of Speech-Language Pathology (CCC-SLP), is an Assistant Professor at Idaho State University in Pocatello, Idaho, USA. As a person who stutters himself, he is very passionate about fluency disorders and helping those with fluency disorders. One aspect of his research interests resides in exploring effective collaborations between Speech-Language Pathologists and Mental Health Professionals for the treatment of people who stutter. He is also Director of the Northwest Center for Fluency Disorders, which hosts a two-week interprofessional intensive clinic that uses Acceptance and Commitment Therapy (ACT). For more information about research, clinical, or support opportunities please visit http://www.northwestfluency.org/.

Note this submission is presented in two parts by video within the transcript shown below.

Dan’s video:

Stuttering Pride; Respect, Dignity, Recognition. These terms, with the overarching theme of stuttering pride means something drastically different to each of us. As Scott and I were discussing a possible topic that aligns to this year’s theme, we talked about how the idea of self-empowerment really connects these topics.

Scott’s video:

Empowerment: Empowerment…What a unique and fantastic word. It means to give authority to or permit. Self-empowerment, well, that means to permit ourselves to do what they belief based on their own thoughts in order to be the best they can be. Dan and I wanted to explain how Acceptance and Commitment Therapy, also called ACT, can self-empower yourself to live a values based life and also develop a flexible mind as a person who stutters.

You may ask what is Acceptance and Commitment Therapy, or ACT. Well it can be a way of life to develop our thoughts and actions and have them connect.

Acceptance and Willingness: The first principles I started with as a person who stutters is acceptance and willingness. I spent most of my childhood avoiding my stuttering. And I got so angry about this that it led to a very dark place in my life, I had suicidal thoughts and actions. Psychology lets us know that the more we try to avoid a thought, the more it comes back. So for all those years I spend experientially avoiding my stuttering both mentally and physically, I was holding on to it that much more. The first step I learned was being  WILLING to look at my thoughts. To be WILLING to my own stutter. That took time, because, it’s hard being willing to do or see things that we don’t like. Acceptance itself does not mean that you have to like something. It just means that you can be able to walk with it. Not like it, but be with it with as little judgment as possible, and for me, just being able to listen to myself stutter and see those negative thoughts and not needing to hang onto them, judge them, was moving towards acceptance and that idea of being willing to do it.

Being Present: The next principle I learned from ACT was being present. The moment is such an important part of our lives, don’t you think? I learned this right before I started a PhD. I lost a cousin to suicide and a friend to cancer and I realized in that moment how important every moment really, really is and how worrying about things just didn’t fit me anymore and so I learned mindfulness and how to be present and for me, meditation. That’s not a religion, it’s just a practice of being present. This has helped me allow my stuttering to come and just happen. I am self-empowering my own speech, my own thoughts about my speech, because I’m not spending as much time worrying about it anymore.

Thought Defusion: The next principle of ACT I’ve been working on is called thought defusion. Language is a powerful thing, and if we keep creating negative thoughts in our mind, it fosters and feeds those negative thoughts. For me, being willing to see those thoughts as just language, just words, just sounds and being present in that moment of seeing those thoughts with as little judgment as I can, I’m then able to play with those words and thoughts, and not hang onto them so much. Those thoughts held me back from talking on the phone to a friend, or meeting new people. By seeing these thoughts as just words and language, options that I could think, I’m then empowering myself to move forward into the person I want to be.

Dan’s video

Self as context: For many years I believed that I was a stutterer. This is to say I held the negative belief that my stuttering was all of me. It was what people knew of me and what I knew of myself. Every thought, action, and belief was guided by my stuttering. It was all consuming. Through time, experience, and being open to other perspectives of potential realities I began to re-conceptualize my stuttering as just a part of me, not the entirety of who I was. I began stepping outside of my thinking, analyzing, and critical self to experience my observing self by changing the words and language I was using to describe me in the context I was in. The more I did this the more I noticed that I was enjoying these newly described aspects of myself. I began directing my internal monologue to see the full context of most situations. For example, yeah I may have stuttered a lot while ordering my meal, but I said was important and I got my meal how I wanted, so I framed that as a success.

Defining values: Understanding your values and value system will help you know what really drives you and what makes your life worth living for you. Values are individualized to you and they are not the same from person to person. They are different than objects we want or choices that we make due to a variety of situations or reasons. For example if you make a choice that is easy, let’s say not disclosing the fact that you stutter when you talk to someone new, instead of openly talking about your stuttering and maybe even pseudostuttering. It may increase the thoughts of self-judgment you have. Whereas if you clearly understand your values and your value system, you can choose live a value guided life by making choices that will lead you closer to what is most meaningful to you and the direction you choose your life to take.

Committed Actions: Living a value guided life requires committed actions. Planning and enacting change in our behaviors, which could include thoughts or actions, likely includes willingness, discomfort, motivation, determination, and perseverance. Changing from the known to unknown is very difficult.

Scott’s closing: Life is a series of choices. What choices we make is up to us. The thoughts that we choose are up to us. The actions that we choose are really up to us. For me, being present in the moment, being willing to see my thoughts as just words while stepping outside of myself and connecting my values with everyday life has been the most rewarding journey of my life.  This process has kept me alive, both mentally and physically. It has been a way of life, a constant line of growth. Now you don’t have to use every principle in ACT, you can use just one or more than one. It’s up to you. Again, the choice is yours. Make choices for you, so that you can live a values-based life and empower you to be you!

Dan’s closing: Seeing the potential benefit through increased cognitively flexibility that we’ve obtained via ACT may help us lean into discomfort and start living our lives the way we want to.

1,146 total views, 1 views today

Comments

Self-Empowerment of Acceptance and Commitment Therapy for People Who Stutter (Scott Palasik, Dan Hudock) — 36 Comments

  1. Hello Scott and Dan,

    It was great to hear how ACT has empowered you both in your journey, as it has me in mine. Like you, I walk the line between PWS and clinician. In my personal experience, there is not much vitality in a life occupied by avoiding talking and stuttering. A values-driven life is a rich life, disfluencies and all! Warm regards,

    Rob

    • Rob,
      Hey! It is always great to hear from you! You bring up a great point about avoiding talking (making the choice to avoid) and living a values-driven life. Our values (no matter what that are) are individualized and make our life what it can be.

      Thanks so much for reaching out! I miss NC!!!!
      With compassion and kindness,
      Scott

      • Scott, I sure hope you (and Jaime) will be able to visit us again in NC before too long!!
        Rob

        • Rob,

          Thanks for your post! It’s great to hear that you have found value of ACT in both your personal and professional lives. As an SLP we often experience compassion fatigue, so self-care is such an important part of quality of life in personal and professional senses! On a side-note, not sure if you are going to ASHA or not this year, but I have a 2hr invited talk with two others about speciality clinical offerings an my topic is our intensive clinic that uses ACT. I’ll also be doing a one-hour presentation about the one-year outcomes from the clinic.

          Cheers,
          Dan

        • Rob,
          Thanks for the invite! We would love to come back to NC! Perhaps we will look into the state conference! When is that?
          Always great to hear from you!
          With compassion and kindness,
          Scott

  2. Dan & Scott:
    Thank you for sharing your stories and the value of ACT in living a value-guided life. Even though I do not stutter, I have benefited from being present (through meditation) and from becoming a more reflective person using meta cognitive strategies. I have found that even though I try to practice daily, it is an ongoing process (and sometimes struggle) with varied degrees of benefit. I am committed to continuing to do so, but have recognized that I need to keep at it. There doesn’t seem to be a destination, but has helped tremendously along the journey (of life).
    I don’t mean to get too deep here, but do either of you have similar experiences (results vary from day to day), and if so, how do you get back on track when you veer from the road?
    Thanks, Charlie

    • Charlie,

      Thanks for your post. It’s great to hear that you use mindfulness practices. I try to meditate several times a week and often attempt to include mindfulness in daily activities and conversations. I have found it greatly beneficial in both my personal and professional lives (as I briefly touched on in my response above). You bring up a very important point, we all veer from the road in many aspects of our lives. When I realize that I have I try to be non-judgmental and may implement mindfulness in my next task (whatever that may be). If possible, I also try to just take a few mindful breaths after the realization and focus on the internal reward and benefit that I receive from that practice. As you know, finding time in Academia or life is very difficult, so incorporating such practices into my daily routine has worked for me.

      Hope this helps!
      Dan

      • Charlie,
        As always it is an honor and privilege to hear from you and have a conversation. I always seem to leave our chats with so much to think about. Thank you.

        Thanks for sharing your experiences with the daily struggles related to results of practicing meditation or self-reframing and how it may vary. Your question of how do we get back on track is important, especially when we perceive to lose our way, or “veer from the road” (which I love the visual of this Charlie, well done!).

        I heard something profound the other day, “the point to life is to live.” You might be saying, “Duh Scott!” I had to think about this myself. We sometimes forget that we are doing what we are supposed to do (in a very basic sense). We are living. When I get thrown off my track and my car is hugging the edges of the road I’m traveling, I tend to go back to the basics. I go back to my breath. I go back to the person I want to be. I go back to what matters in my life and where I want to place my energy. For example, if I have had students cheat in classes I teach. At first I would get so angry (not a value of mine, taking me off my path of what matters to me, which I now recognize). Now, I see this as something the students have chosen, not me, and that my efforts and energy can be put toward students who want to learn and grow. I feel bad for the students who choose cheating over working for a grade, and, that is what they choose. That is just one example of trying to come back on track after letting a behavior (in this case anger) lead me away from my value of caring.

        As for stuttering. When my mind veers off the road and negative thoughts about my speech pop up, I try to do the same thing I did above. I remember what matters to me (getting my point across with an effective and assertive and kind voice). I remember that I can’t change what other think of me, and that what others think of me is their choice. I can be the person I am and live by what matters to me. In essence, coming to terms with letting go of control (still challenging). This is all done while coming back to my breath (the basics).

        These are just some thoughts. What a great question, Charlie! You are amazing and I appreciate you in my life and in this world!

        With compassion and kindness,
        Scott

  3. Hello Scott and Dan,

    Thank you so much for sharing. I am a graduate student studying to be an SLP and stuttering is very near to my heart, as I have a close friend and a brother who both stutter. I agree that perhaps the most important job we have as SLPs treating people who stutter is our focus on ACT. I also appreciate hearing your personal experiences with stuttering. Though I have two people very close to me who stutter, I don’t feel like I can ever actually understand the feelings that come along with being a person who stutters. I’ve always felt that the stutter was this taboo subject that was only okay to talk about if they brought it up themselves. Is there any advice you have for me in assisting my brother and friend, and my clients who stutter?

    Thanks again!

    Colleen Hogan

    • Colleen,

      HI! It is so nice to meet you. Where are you a grad student (if you don’t mind me asking. You don’t have to share, I was just curious). Thank you for sharing your connection to stuttering with your brother and friend. You are in the right field if you are already caring about people around you. Caring is the fist quality to being a good therapist. Another quality is honesty. An important less I learned during my time getting therapy in undergrad was not to tell a client “you will be fine.” That is not being honest. I had a clinician tell me, “You will be fine,” right after I shared something negative about my stuttering. I remember feeling, “This is not fine. Stuttering sucks!” My point is, as a therapist and friend you can be honest . If you want to ask your brother and friend questions about their stuttering then ask them if you can ask the some questions. With clients we can do that same. I always ask, “Can we talk about this?” Or, “I’ve notice that.. Can I ask you how you feel about that….” This might show you care about them and that you want to learn more about them. I know when I was growing up and even as a young adult, I felt alone because no one seemed to want to talk about it.

      The other side is some people might not want to talk about stuttering. This is okay, because it is not in their comfort zone yet. But with increased comfort come increased willingness. With increased willingness when doing anything, comes increased confidence and so much more.
      Thanks again !!!
      With compassion and kindness,
      Scott

      • Scott,

        Thank you so much! This is great advice and I will be sure to use it in my professional and personal life. I don’t mind you asking at all, I am a student at Illinois State University. I appreciate your help and wish you all the best.

        Thanks,

        Colleen

        • Colleen,

          HI! Best of luck at Illinois State University! Enjoy learning, and keep asking questions! On a side, I lived and worked in and around Chicago for 7 years as an SLP. I dig Illinois!

          Thanks again for being you!
          With compassion and kindness,
          Scott

  4. Scott and Dan,
    Thank you for helping to frame stuttering into this important perspective. You are helping people who stutter to recognize that how you think about, and respond to your stuttering is ultimately a choice.
    And I’d like to add that your decision to film yourselves underscores your commitment…
    Best,
    Charley

    • Charley,

      Hi! Thank you for your feedback, it is very humbling to hear. I will let Dan chime in here, but I think I can speak for both of us when I say it is important to us to lead by example (addressing your comment about our commitment). Like you (taking the time to write to us and visit this online conference) we all can advocate for ourselves and for those who might not know how to advocate. By passing on what we have learned and experience, in other words by having a conversation, we all can learn. So if you will permit me to ask you a question so we can learn a bit about you (and you don’t have to answer, I just wanted to allow you to share too), What is your connection to stutter? Any connection is important, for it is connections that can determine and influence how we react and interact with the world around us.

      it is very nice to meet you Charley!!
      With compassion and kindness,
      Scott

      • Hi Scott,
        I assumed that my whole name would appear as the sender. My name is Charley Adams, and I am on faculty at the University of South Carolina, in Columbia, SC. I lead an NSA chapter, and have taught the fluency course here since 2001. I’ve known Dan for many years, so it’s great to meet you now too. If you are going to ASHA, it would be great to chat some more –
        Cheers,
        Charley

        • Charley,

          HI! I think we have crossed paths before, and it is a pleasure to chat with you again. Yes, I will be at ASHA, so I’d love to talk more.

          One of my colleagues at Akron went to USC for his PhD and Masters in Speech Pathology (Dr. K Todd Houston,he does auditory verbal therapy with cochlear implant kids and adults, great guy!).

          I too lead an NSA chapter in Bowling Green for 4 years and now we just recently (well last Fall) started an adult support in Akron Ohio called “The Stuttering Voice.”

          Thanks for all you do Charley: teaching the fluency, course advocating for PWS, and leading a support group. Thanks!

          With compassion and kindness,
          Scott

          PS. You said you’ve known Dan for a long time? That is wonderful. He is a great guy! I’m lucky to know him too.

  5. As an SLP graduate student, I feel confident to say that we as a field have just begun to scratch the surface with regards to ACT. The model is applicable to a variety of communication disorders, yet it may be most beneficial for PWS. I hope to see more classes and training specific to counseling for SLP’s, as this has the potential to provide lasting and meaningful benefits. If the client can learn to accept stuttering, they may see that people don’t think less of them, and ultimately gain greater self-confidence. Fluency shaping strategies aren’t relevant or useful when a client has severe anxiety about speaking situations. Addressing these feelings before attempting to target fluency shaping strategies seems to be a logical choice. Given the abysmal long-term success rates that traditional fluency therapy has, ACT needs to be further researched and explored.

    • Dear Jeremy (or did Andrea write the above?, Well dear to you both!!),

      Thank you for sharing your thoughts. Can we ask, where are you from?

      You bring up an interesting perspective about gaining increased self-confidence before achieving relative (relative to the PWS) success with fluency shaping or stuttering modification strategies. I was just thinking about this idea when Dan and I were getting this video together, and how my journey of finding success and fun speaking really didn’t take shape until I began to discover I CAN adjust how I view myself and my speech and that I didn’t have to be governed or defined by one characteristic of me (stuttering). A student asked me last year if I could teach an entire class using fluency enhancing techniques. I had never tried this before, but I decided, “Why not try?” I found that out of 3 hours, I used them for about 2 hours and found my relative success (success that consisted of me leaving that speaking situation with my head held high and accomplished my goal of saying all I wanted to, and having fun). If I had tried to use any techniques with any relative success just a few years ago, I would have last a few minutes, gotten frustrated, and quit (I know this because I tried). However now that I have gained confidence and acceptance of myself and my stuttering (through many experiences) I can now feel more free to use any tool I wish, when I wish, and not have to use them either. Now my success using these tools is again relative to me, and I don’t have to hold onto success either. I can acknowledge some ease in communication, which I was aiming for and wanted. Thus allowing my mind to practice cognitive flexibility, which is a truly liberating feeling for me. Again, these are just my experiences. Each person has their own experiences, and all are valuable and valid.

      Anyway, thank you so much for sharing your thoughts.
      With compassion and kindness,
      Scott

  6. Hi Dan and Scott,

    This post was really fantastic to read! I work as an SLPA at a fluency clinic, where we focus nearly 100% on fluency enhancing techniques. This year I have been learning more about ACT and the affects it can possibly have for PWS. The more I learn about it, its importance grows in my mind for how it can have a positive affect in the lives of PWS, meaning that it is something we really need to include as part of therapy.

    This post was particularly interesting for me because it helped me to understand the point of view of PWS. For example, Dan’s thoughts on how stuttering defined him as a person for a long time made me really think about how many of my clients might feel and what effect that can have on their lives. Considering that many of them are school-age children, I feel that perhaps utilizing ACT in therapy could be very beneficial as they grow up and form views of themselves and the world.

    Thank you for the great post!

    Katie

    • Katie,

      HI! Welcome, and thank you for your post! We are always excited to hear from people who take the time and energy to write us. So thank you!

      We (Dan and I and so many others) who practice and teach ACT enjoy this approach as not just a “Therapy treatment” but a way to interact with PWS and families. We use this as a foundation (and for most of us, ACT is a way of life) to treating people with kindness, compassion, nonjudgmental, examining values and being present with people. The great thing about living in the time we are in is that there are many kinds of therapy approaches that are addressing thoughts and attitudes, some of which are talked about at this conference. Some are REBT, ACT, CBT, Solution Focus, and Mindfulness to name a few. There are so many options now to help PWS navigate negative and challenging thoughts, and all of them have such value.

      That being said, keep learning and asking questions.

      Thanks for your post!!!
      With compassion and kindness,
      Scott

  7. Hi Scott and Dan – thanks for sharing more about ACT. A friend suggested I look into it a couple of years ago and I did some reading. I think it is definitely a way to help navigate persistent negative thoughts. I like to say (and tell myself) that I am fully accepting of my stuttering but every once in a while, and usually most unexpectedly, shame creeps in and makes me feel like crap. When I have these moments of stuttering shame, I often experience physical signs too – my chest tightens, I blush or flush and sometimes I experience my heart pounding. This happens most often when I am giving presentations to teenagers, which I do a lot of, because its a primary part of my job. When a teenager reacts negatively to my stuttering, like laughing and pointing to a friend, I feel those shame moments. I’m interested in continuing to learn about acceptance and self empowerment on my journey and this piece has been very helpful. Thanks so much.

    Pam

    • Dear Pam,

      HI! As always, your ability to share and be vulnerable is amazing and appreciated by those who read your words. You bring up many wonderful points, the first being how our thoughts can create physical changes in our body. We know from many years of research and our own human experiences that when we create negative or stressful thoughts about anything (for PWS it might be getting teased, a certain speaking situation, feared words or sounds to name a few) our body can tense up and we feel it in our necks, chest (like you mentioned), our face might get hot and red, our body may sag (an indication of shame), our heads might droop, we may loose eye contact, and more. All physical reactions to the thoughts we generated. These thoughts have been developed and repeated over time and reinforced by us whenever they come up. In a way, stuttering may be kin to PTSD. With PTSD, people relive one or a few emotionally traumatic events over and over in their minds and the thoughts are reinforced by not only their perceptions and attitudes toward that event, but in part by the physical reactions they experience when thinking about that event. People who stutter not only relive their own relative traumatic events, in their minds, but sometimes everyday whenever they speak. This is further reinforcing the memory, perception, attitudes, and physical responses to stuttering on a daily basis.

      ACT is an evidence-based practice with PTSD, so you can see who it might be a nice fit for PWS. The neat thing I like about ACT (and there are so many wonderful psychological approaches out there that are all becoming very similar: treat the whole person, which is so lovely) is that instead of pushing away negative thoughts (which is judging them as “Bad”), ACT has people acknowledge the thoughts and try to move toward not judging them. We all have things we might not like about ourselves, and it might be more beneficial to recognize those things and thoughts we have and look at them in a neutral manner, thus giving them less power. Acceptance is not necessarily liking something, it just means there are parts of that things that we may not connect with, and (important word here) we can walk with that things. For example, I accept that I won’t play in the NBA and that I don’t have the skills to play basketball at that level. I don’t like that idea, and, I can walk with the fact that I won’t play in the NBA without judging it as “good” or “bad” but rather just a part of my make up. I can improve my basketball skills by practicing, and learning new ways to shoot more effectively, and, I don’t need to focus on the NBA. I can focus on me becoming the best version of basketball player for me. Where that version takes me is unknown, much like life itself.

      One thing that helps me is when I get caught up in my own shameful thoughts and negative perceptions (and I start to cling to them) I return to my breath and ask, “Is this thought being kind to me? I value kindness, yet this thought is not kind.” This helps me connect what matters (my values) with my thoughts and thus my physical behaviors and reactions.

      Anyway, thanks for sharing pieces of yourself, Pam. The more we share, the more WE learn.
      With compassion and kindness,
      Scott

      • Hey Scott- thanks so much for the very thoughtful response. And for acknowledging my willingness to be vulnerable and share pieces of my story with readers. I appreciate that.

        Your further explanation on ACT was great food for thought for me. I certainly see how stuttering is akin to PTSD. It made me think of when I was seeing a wonderful psychologist for some stuff. Of course stuttering came up many times, as its part of me and I was working on openness and desensitization. When we parted, (before I wanted to,) he recommended that I consider seeing someone that had experience with PTSD. He understood stuttering as he co-taught a graduate counseling course with a professor from the communication sciences disorders department. In fact, we had many “sacred space” conversations about stuttering and I learned more about my stuttering from him than I did when I was going to speech therapy. I never followed up to see another counselor who had experience with PTSD.

        If I ever decide again to pursue speech therapy, it would definitely be something along the lines of ACT. I think I would benefit from exploring that at this time in my life.

        Thanks again,

        Pam

        • Pam,

          HI! Again, thank you for sharing your experiences. These are valuable for people to read. Not only what you have experienced, but also that as individuals our struggles are not easy fixed (like we are cars). For anyone, struggles come with work and come with the idea that we will evolve and learn throughout life. Thank you for showing that point.

          Keep being you, Pam! The world is a better place when you do so!
          With compassion and kindness,
          Scott

  8. Hi Scott and Dan,

    I’m a graduate student at East Tennessee State University. I was just wondering where you guys first learned about ACT and what would be the best way site/article/book for me to learn more about it?

    Thanks,
    Jacqueline

    • Jacqueline,

      HI! Welcome to the ISAD conference! Is this your first ISAD? Also, congrats on being a graduate student at East Tennessee!!! That is exciting! What is your favorite part about being a grad student? I like to ask people questions, that way we get to know each other, and have a conversations (conversations are valuable because that is how we learn on a daily basis).

      If you want to write me on my school email, I can send you an article that Jaime Michise (Hannan) and I wrote in 2013 on ACT and Stuttering. Plus we are putting the finishing touches on an article that will be published in the spring that I can send in time too. Further, there were a few other articles that were published on ACT and stuttering that I can send you (these are wonderful). This is how you can start with getting to see what the field has published on stuttering and ACT. You can also begin reading about ACT with books like “ACT Made Simple” or Kelly Wilson’s book “Mindfulness for Two.” There are MANY great ACT books out there. Most are really good, clinical, and fun.

      My school email is: spalasik@uakron.edu.
      You can also check out and like Jaime and my facebook page: ACTforStuttering

      Good question. Please feel free to contact Dan or I online or off line with any questions, thoughts, or ways you might implement ACT into YOUR life or a client’s life.

      Enjoy ISAD!!!

      With compassion and kindness,
      Scott

  9. Hi Scott and Dan,

    Thank you for sharing. We are SLP graduate students at the University of South Carolina. It was great to read your thoughts on ACT. I think it is great that you talked about how important self-acceptance is in these videos. Mental and psychological health is such an important issue, especially in people who perceive themselves as being “different.” It is also an issue that is not readily visible in every person who struggles with mental health, so it is often swept under the rug. It is so important that we help our clients to accept themselves how they are, and I am thankful that someone is willing to talk about the struggles that they have walked through. Thanks again for sharing!

    Sincerely,
    Kaleigh, Sara, and Megan

    • Kaleigh, Sara, and Megan,

      Welcome to the ISAD! Congrats on being graduate students at USC!!! A friend of mine got his PhD there. Small worlds, we are all connected some how.

      You ladies bring up a great point about “not readily visible in every person who struggles with mental health.” Because I feel that by sharing stories we can all learn, I will share with you ladies that when I was 18-20 I had suicidal ideation (thoughts) and attempted suicide based on my perceptions of how my speech impacted my life (who just reading that line brings sadness and appreciation to my heart, perhaps a strange mixture, but what it tends to trigger. Sadness for the adolescent I was who struggled, appreciation that I survived, not all people do). Now, I can look back and see those thoughts and that person in a much different light, but not many people saw the visible struggles I had because I stopped talking and became that “shy” person who stutters even more. With ACT (and so many of the other lovely psychotherapy and counseling approaches) our discipline is becoming conscious of the mind and that we ALL struggle with something. Suffering is suffering, pain is pain. It all brings similiar reactions, however the triggers and stimuli are unique to each of us.

      The more we can recognize ALL of our thoughts and reduce self judgments of them (decrease clinging to thoughts) the more we can focus on what matters (values we hold) and live a life we want to live.

      Keep asking questions and keep learning! The more we learn, the more questions we ask (without judgment), the more we can pass on and evolve!

      With compassion and kindness,
      Scott

  10. Hi Scott and Dan,
    My name is Jordan. I am a second year graduate student studying Communication Sciences and Disorders (Speech Language Pathology). This was a great post! I loved the way you both incorporated values, choices, and your feelings towards stuttering then verses now. It is encouraging to read how you overcame your negatives thoughts you had about stuttering and are now thinking about it in a more positive way. How can I as a future clinician encourage my clients, even though I don’t completely understand what they are going through? Is there anything anyone did for you that really encouraged you through the process of accepting your stuttering?

    Thank you!
    Jordan

    • Jordan,

      HI! You are a second year grad student?! That is awesome. That means you are seeing the light at the end of the tunnel where you can get a job!!! Yeah! (I get excited about students getting jobs and evolving).

      You don’t have to be a person who stutters to know how it feels to struggle. The first thing I tell any student about counseling (and not just using ACT, but just basic counseling) is learning to listen. Listening involves being present, which can be more challenging than we think. Distractions keep us from being present (mental and environmental distractions). We can also ask questions, summarize what people say, in order to better understand and show people we are engaged and “actively” present with them. Many values of “caring”, “compassion” and ” appreciation” (to name a few) can be vital to being present and listening to others, thus helping you understand what they are experiencing. Finally, and this important, you probably know how if feels to struggle with someone. We all do, with something. You might even have struggled with communication before (doing public speeches, talking to authorities, etc). Struggling is struggling. Suffering is suffering. Pain is pain. The reactions to these things (mental and physical) may look very similar no matter what the stimuli. It is important to validate thoughts as they come, and try to let go (not push away, pushing away can be seen as a violent gesture) of thoughts that don’t serve our values. This is a process, and a practice effect that takes time.

      Does this make sense? You asking questions shows that you care, which is so valuable when serving others. Keep asking questions. Keep caring!

      Thanks connecting with us and asking questions. Enjoy the ISAD conference!!!
      With compassion and kindness,
      Scott

      • Yes! I can finally see the light at the end of the tunnel! It has been a long road, but I am very proud and excited of who I have become both as a person and a new clinician. This is wonderful advice and yes it does make sense. I can’t wait to use it now and in the future. Thank you for the quick reply and for being honest.

  11. Dr. Hudock & Dr. Palasik,
    After participating in Dr. Hudock’s Intensive Interprofessional clinic this summer I quickly understood the success and brilliance behind this ACT approach. Something that Dr. Hudock mentioned in this article was that when ordering a meal he found it a success if he ordered what he wanted despite stuttering. One of the biggest things I took away from this summer clinic camp was just that, if you still choose to use your voice despite the vulnerability that stuttering brings it is a success! I am excited to see the longterm effects that I know will come from the research associated with this clinic. I feel very fortunate that I am going into the SLP world with this experience. Rather than feeling undereducated and lacking experience on assessment and intervention for clients who present with fluency disorders (which is what has been expressed to me by many SLPs I have been placed with) I am instead eager to put this knowledge and specifically this approach to work. I truly believe that the covert aspects of stuttering are even more important than the overt aspects and saw this day in and day out for two weeks while at this camp. I also found that this ACT approach was applicable and valuable in my own life even as a person who does not stutter. As well as the concept of mindfulness I found very valuable too. It was something I really needed as a person who does not handle stress well and chose to take on graduate school! I found that meditation and mindful breathing exercises really can make a huge difference.
    Thanks for your continuous research and learning in this particular aspect of our field I am excited to see the research that will continue to come from this and how it will change therapy for many people who stutter.
    Best Regards,
    Brooke McBride

  12. I felt that this article was very interesting as your personal experiences really shined through your writing. Reading about how you used ACT to overcome negative thoughts and view yourself in a more positive way was inspirational. Choosing to act based on positive core beliefs is an excellent trait to practice, for PWS and others. Thank you for sharing your experience.

  13. Hello Dan and Scott,

    Thank you for sharing your stories. ACT is an excellent way to empower yourself to live a life you are proud of. Developing a flexible mind is so important in life. What stood out to me in this paper was where Dan describes self as context. Identifying yourself as something you do such as a PWS or an occupation is usually the first thing people do. However, what you do is not who you are as a person. It is important for PWS to know that their stuttering does not define who they are as a person, but it is just apart of them.

  14. Hello Dr.’s Palasik and Hudock,
    Thanks for your thoughtful and open discussions of how the principles behind ACT have influenced and shaped your lives and your perceptions of stuttering. I am currently a graduate Speech-Language Pathology student, and I’m in the process of writing a literature review regarding ACT for PWS, so the outlining of the principles behind ACT for PWS will overall serve to aid my understanding of ACT.

    The principles that resonated with me most, I think, were the principles of acceptance and willingness, living in the present, self as context, defining values and committed actions. Defining values as a principle, specifically, would never have occurred to me as a principle with regard to ACT. I was fascinated by your description of how defining values can allow a person to identify his/herself as self-actualized, picture their self-actualized depiction, and in the moment, see what steps may need to be taken to allow for them to become the actualization of their ultimate self. The removal of instances where self-defeating thoughts occur or easy choices are made can certainly, for almost all people, set a person onto their own path to personal success. This, of course, ties in well with committing to actions – decisive actions that will move a person forward, toward their goal.

    Thank you again for your perspectives and your work!
    Emily Schrader, Edinboro University of PA

  15. Dear Scott and Dan,

    My name is Lauren Kuehl and I am an SLP graduate student at the University of Wisconsin-Stevens Point. I was in my fluency disorders class when my professor introduced the ISAD conference website to us and I jumped a little in my seat when I saw you had posted a presentation! To explain, Scott and one of his colleagues named Jaime came to the University of Wisconsin-Milwaukee this past March where I did my undergraduate degree and conducted a workshop on Acceptance and Commitment Therapy (ACT) geared towards adults and children! I am so excited that you continue to share your insight on ACT because it is applicable to any client we may see as an SLP, and is even helpful towards discovering who we are as clinicians, along with ourselves as a person outside of the therapy room. I love your overall idea of empowerment because I truly believe that is the essence to all change. I have used the Power Can therapy activity with children and discovered what they think of when they hear the word power. I have also utilized the Values Cube which is a great reflection activity for all of us to do to think about who we are as a person and what do well.

    Thank you for continuing to share this wonderful program!
    Lauren Kuehl

    P.S. I hope you are doing well Scott!