Showing Acceptance without minimizing the experience of PWS)

Hi Again!

I have a question about conveying acceptance to those who stutter. As someone who doesn’t stutter, how do I tell clients and friends that “stuttering is ok.” I don’t want to give the impression that they should feel this way (increasing shame), or reduce their experiences as people who stutter. As in, by saying this I’m minimizing the impact stuttering has had on them. I’ve said this clients, and as an afterthought I realized, maybe they don’t think it’s ok? I like to try and convey this, and even say it because I know it can be freeing. But, what about when it’s not? I enjoy discussing stuttering and feelings, etc. This is my favorite thing about stuttering and I have no difficulty bringing it up- but I want to make sure I’m being sensitive and taking into account the entire perspective. Any thoughts?

Alison LaJuett, B.A.

Graduate Student Clinician- University of Akron

134 total views, 2 views today


Comments

Showing Acceptance without minimizing the experience of PWS) — 7 Comments

  1. Acceptance is something I have struggled with myself with my own stuttering, and there seems to be much attention paid to this idea recently in our field. I’d seek out some of the recent materials made available on incorporating acceptance into stuttering therapy. In fact, there is an entire approach known as ACT (Acceptance and Commitment Therapy). I heard much about this last month at the Oxford Dysfluency Conference.

    Essentially, acceptance is the opposite of resistance. It doesn’t mean that you are quitting and surrendering to the issue forever. But, you are committed to giving up the struggle and fight, which often exacerbates problems such as stuttering. So, you might wish to explain it to your clients in terms of acceptance and acknowledging stuttering as a means as changing it, without continuing to resist or “fight” stuttering.

    This might seem counter intuitive to some, as it did to me at first. But, there are numerous therapy techniques that help to facilitate acceptance, and this is simply a partial list: self-disclosure of stuttering, voluntary stuttering, freezing, giving a class presentation on stuttering, participating in a stuttering support group, etc. Good luck!

    • Paul,
      Thank you for replying. I apologize for my late reply! I see that you have listed some activities I would consider “desensitization.” I had never quite connected these to acceptance, but can see how one would become more comfortable with moments of stuttering and “accept” them as part of their self. Thank you for the perspective. I understand that acceptance is quite like a rollercoaster, ups and downs, highs and lows. That’s why I think we can’t put too much stock in our thoughts, as they are always changing!! I was trained some on ACT over a couple semesters, and its very values based. Which I think makes so much sense when working with PWS, because stuttering can become your identity, and the very thing that makes you YOU becomes lost. I do like to employ it when it’s appropriate for my clients. Still a grad student… so… not many clients 🙂 Again, thank you for the thoughtful response.

      Alison

  2. Hello Allison, and I’m glad you’re thinking about acceptance. While it is true that if a client can accept stuttering, the handicap of stuttering will likely be lessened, know that a client may not be ready to accept stuttering. Also know that acceptance is on a continuum–there may be times and instances that a client says what he or she wants to say while stuttering, and not care what anyone thinks about stuttering. But there may also be times when a client hates his or her stuttering, or decides not to speak because of stuttering. All are OK. If you can accept the feelings of the client toward stuttering, you will go a long way to help the client.

    Also know where you are in terms of acceptance. How do you feel when you hear someone who is doing a lot of blocking, facial grimacing, or even mild stuttering? A big job of people who work with those who stutter is learning as much about stuttering first hand, through meeting people who stutter, joining support groups, such as the National Stuttering Association, listening to podcasts from people who stutter, such as StuterTalk. If we are afraid or unaccepting of stuttering, we will not be very effective treating people who stutter.

    Kind regards,
    Jean

    • Hi Jean!

      Thank you for taking the time to reply! I appreciate your comments about clinician attitudes and comfort about stuttering. This shouts ‘actions speak louder than words’ for me. If I appear comfortable, I’m setting the tone. I think it’s important to ask yourself these questions, and have a greater awareness of your body language when you are working with people whose speech may be atypical to your ear. I know when I first got interested in stuttering, I had to desensitize myself to stuttering. So, I listened to people stutter on YouTube, StutterTalk etc, and trained myself to lose the natural reaction, gain patience, AND most importantly, listen to the message!! I also like your comment about acceptance being on a continuum. This knowledge allows clinicians to feel less like failures (because I think in SLP we think we have to fix), and more like we’re along for the ride and it’s normal. This knowledge can or may lessen clinician apprehension when treating stuttering, as they understand many aspects will fluctuate (speech, attitudes, desire for treatment). Again, thank you the thought-provoking response.

      Alison

  3. Hi Allison,

    As you stated, one size does not fit all when it comes to supporting a person who stutters.

    A recent article in the Journal of Fluency Disorders addresses your question of how to be supportive. The article’s reference is: St. Louis, K. O., Irani, F., Gabel, R. M., Hughes, S., Langevin, M., Rodriguez, M., Scott, K. S., & Weidner, M. E. (2017). Evidence-based guidelines for being supportive of people who stutter in North America. Journal of Fluency Disorders, 53, 1-13. Basically, about 150 adult stutterers responded to a questionnaire, known as the PASS-Adult, that asked about how they preferred to be supported by the nonstuttering majority. The numerical results for each item are worth reading, but we summarized our findings as follows:

    “When first interacting with a person who stutters in North America, be engaging, patient, accepting, friendly, and as comfortable as
    possible, all the while being a good listener. After getting to know the person, learn more about stuttering and be flexible about modifying
    your interactions according the person’s personal preferences for being supported, realizing that sometimes a particular action, such as
    trying to guess and fill in a word being stuttered, though generally not advised, is sometimes desired. After considerable interaction, you
    may gently inquire if you should ask questions about the stuttering, offer advice or referrals, or otherwise comment on the stuttering, but be
    ready to respect the stuttering person’s wishes.”(p. 10)

    I know this does not give clear DOs and DON’Ts, but that is part of the point of the article. Being maximmally supportive implies being a good observer and listener as well as being flexible.

    Best of luck to you.

    Ken

  4. Agree with Paul and Ken. One additional point I would like to add… If a person is choosing to work on fluency shaping skills while also working on acceptance, consider the layout of your session. Avoid saying to your client “It’s okay to stutter” and then spend 29 of your 30 minutes on fluency shaping tasks. It will void the message of acceptance. Address acceptance simultaneously with fluency shaping (again, if that is wish of your client).

    Tricia

  5. That is an excellent point made by Tricia. I went to a famous fluency shaping program many years ago (as a client), and they stated on the first day that they felt stuttering was okay, as long as you realize that you might not get the job, get the date, etc. So, basically, stuttering is not bad, but you might experience consequences if you don’t fix it (I’m paraphrasing). Although I must admit that this argument might be valid to some extent (for some PWS), it might send “mixed messages” to the client regarding some the clinician really feels about stuttering.

    True, there might be consequences for some PWS…that is life some times, unfortunately. However, if the client is overly concerned about the potential ramifications of his or her stuttering, will they ever be able to fully accept it? Also, as Tricia alluded to, there’s no rule saying that clinicians cannot incorporate other approaches into a fluency shaping-based protocol, or vice versa.

    Although in the past, some fluency shaping and stuttering modification proponents were akin to the Hatfields and the McCoys, that is (thankfully) changing. Many clinicians now appreciate the benefits of both approaches and are adopting a more eclectic treatment approach. For example, a recent fluency shaping program I participated in included an online cognitive behavioral therapy (CBT) program as an adjunct to the speech therapy provided.

    Cheers,
    Paul

Leave a Reply