Advice for aspiring SLPs

Hi! My name is Jess Shotwell and I am a second year graduate student in the speech-language pathology program at Idaho State University. I was hoping to hear from the perspective of PWS what their advice for new clinicians might be when working with PWS. I would love to hear any feedback about how we can best support individuals who stutter, and potentially hear about therapeutic experiences (both positive and negative) that you have had. In your opinion, what makes or breaks a therapeutic alliance? I look forward to hearing your thoughts!

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Advice for aspiring SLPs — 2 Comments

  1. Over a period of decades, I had stuttering therapy from approximately 35 different clinicians! About 80% did not help me at all. But there were seven who did, including three who helped me substantially.
    I experienced a large variety of therapeutic approaches, and for me, the most helpful was fluency shaping with carefully defined fluency targets – with relaxed diaphragmatic breathing being the most helpful technique of all.

    But regardless of particular therapeutic approach, I experienced many different clinician styles. I’ll answer the question based on clinician styles, which can apply across the board in any therapeutic approaches.
    I have some general advice to increase the bond with people who stutter, gain their trust, and to be a highly effective clinician respected by those who stutter.

    – Know what is possible and feasible, and do not overburden a person who stutters. Progress can be made in small steps, and it is unlikely that a great deal of progress can be attained quickly. Appropriately praise progress, but progress may not be a rising sharp line.
    – Relapses are NORMAL in the treatment of people who stutter. They are to be regarded as natural and expected. (I have studied speech-language pathology myself, and I’m aware that many other speech/language disorders can be treated without expecting occasional major relapses in the client. Stuttering is different.)
    It is very normal in therapy for stuttering for clients to have a zigzag line of progress – two steps up, one step back, two steps up, one step back, etc.
    When relapses occur – as they almost inevitably will – it is VERY important NOT to blame the client in any way. The relapse did not happen because the client was not following a clinician’s instructions carefully enough. The relapse did not happen because he or she did not practice enough, or was not trying hard enough, or was not committed or dedicated enough to the effort. It is SO essential to understand that occasional relapses are a natural part of the road to progress in stuttering therapy. Clinicians need to empathize and understand the nature of relapses, and skillfully and sensitively help clients to get back on track. Blaming clients for relapses is a quick way to erode trust in the clinician-client relationship. In my experience – and in the experiences of many others who stutter who I have personally known – being blamed by a clinician for a relapse results in very negative views of that clinician. And people who stutter would then often tell others who stutter to avoid that particular clinician. So this is really important!
    – It’s important to be patient. A client who stutters may not meet all the goals that a clinician sets, as quickly as a clinician might expect and hope. Patience is needed. It is not the client’s fault if these expectations are not achieved in the time frame hoped for.
    – Clients need praise for what they achieve. They need to be encouraged with sensitivity and understanding. If larger goals appear out of reach for the time being, be satisfied with smaller goals. Talk with a client, and fully understand his or her needs, and what his or her therapeutic goals and expectations are. It’s important not to convey disappointment. Always maintain a positive and cheerful tone. It’s important to spontaneously modify planned therapeutic approaches to meet the challenges and circumstances at hand.

    I hope this has been helpful.

  2. Question: “What makes or breaks a therapeutic alliance?”

    Answer: The mindset of the individuals coming into the therapy relationship.

    The person who stutters needs to realize that the therapist will not be the savior who will swoop down and magically make stuttering disappear.

    And likewise, the therapist needs to know and understand that he/she will not be the savior who will swoop down and magically make stuttering disappear.