Gaining Resilience and Bouncing Back Through Acceptance and Commitment Therapy (ACT) Applied to Stuttering – Dan Hudock and Tiffani Kittilstved

About the Authors:

Dan Hudock (he him,his) Ph.D., CCC-SLP, PWS; an Associate Professor of Communication Sciences and Disorders at Idaho State University, the PhD in Rehabilitation and Communication Sciences Assistant Director, ASHA SIG 4, Fluency Disorders, Coordinating-Committee Member, and Northwest Center for Fluency Disorders Founding Director (, which offers an interprofessional intensive stuttering clinic with SLPs and Counselors using Acceptance and Commitment Therapy (ACT). My areas of research include holistically-based assessment and treatment for clients with fluency disorders, mindfulness for PWS and students in healthcare programs, interprofessional collaborations with Counselors, examining the intersectional and lived experiences of PWS across communities, bio / psychophysiological, behavioral, and self-reported responses to typical and atypical speech, and the neuroscience of stuttering through high-density EEG time-course methods of analysis. Through applying ACT to my personal and professional lives I’ve been able to increase my resilience and bounce back from a compounded lifetime of difficult experiences with stuttering. 

Tiffani Kittilstved, (she/her/hers) M.S., CCC-SLP is a Ph.D. student at Idaho State University as well as a private practice Speech-Language Pathologist based out of Seattle, Washington. Clinically, Tiffani specializes in evaluating and treating children and adults who stutter. These experiences, along with her own personal experiences as a person who stutters, have motivated her current research interests, which include covert stuttering; the application of trauma-informed counseling approaches into therapy; and the intersectionality of identities among people who stutter. Tiffani is a proponent of ACT and uses it with her clients who stutter regularly. She is also actively involved in the stuttering community, holding leadership positions within the National Stuttering Association and the International Stuttering Awareness Day Conference and organizing One-Day Conferences through Friends, an Association of Young People who Stutter. She is excited to be a part of the ISAD conference for the 4th year in a row.

Below is a video by Dan Hudock, Ph.D., CCC-SLP, PWS, and Tiffani Kittilstved, M.S., CCC-SLP, PWS, about stuttering and resilience and how applying the principles of Acceptance and Commitment Therapy (ACT) can help increase resilience and the ability to bounce back in people who stutter.

This video can be played at 0.75 speed for readers whose native language is not English. 


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Gaining Resilience and Bouncing Back Through Acceptance and Commitment Therapy (ACT) Applied to Stuttering – Dan Hudock and Tiffani Kittilstved — 16 Comments

  1. Hi Dan and Tiffani,

    I really enjoyed your video! I’m especially happy to hear you endorse self-compassion. That’s something we talk about quite a bit in my circle of friends who stutter. I am happy that ACT is increasingly informed by the literature around the practice of self-compassion. What a powerful combination!

    Rob Dellinger

    • Thanks Rob! Self-Compassion is such a crucial, and yet under-utilized, human skill that could help us all live better.


  2. What an amazing paper! You guys explained the ACT therapy in such a simple way. And it all hit home. My key strategies have been Mindfulness and NLP, to help me focus on what’s important and leave the rest behind. ACT seems to include both. I wish more clinicians practice ACT, instead of blindly focus on “making stuttering go away” and defining the client by the amount of stuttered syllables.

    Do you think ACT can help with children, even the smallest ones? And can ACT be provided to parents of children who stutter, as in some cases it can be the parents who have a bigger problem with their child’s stuttering than the child itself?

    Stay safe and keep teaching ACT! 🙂


    • Hi Anita,

      Thank you for your comments! Acceptance and Commitment Therapy (ACT) has been such a positive influence for me both personally and professionally. Thankfully there are more and more university instructors approaching stuttering therapy, and SLP student instruction, through holistic, person-centered, framing, which is now also increasingly being supported through the literature!

      Great questions. Yes, ACT can help both children who stutter and their parents etc. Since the late 2000’s there has been more and more research applying ACT to children for a number of different purposes. There are several helpful books on applying ACT to children, teens, families etc and similarly, there are many books and resources about applying mindfulness to children etc too. ACT is wonderful for a number of reasons, one of which is the open-access understanding. Meaning that anyone who uses and creates ACT resources is expected to make them freely available! If you search the internet you’ll find many resources.

      Recently, there have also been a few researchers / clinicians publishing on resilience in children who stutter and their families, of which many components strongly parallel with ACT principles.


  3. Thank you for implementing 3rd wave of therapies to stuttering therapy—did you notice ACT is following other therapies integrate mindfulness- So awesome –

    • Thanks for your post Michael! I love that many of the third wave of cognitive-behavioral therapies are emphasizing mindfulness, many of which also integrate components of self-compassion as well. It makes sense to have present moment awareness as a primary principle of ACT, and awareness in general.


  4. Hello Dan and Tiffani!

    I agree with the assertion that people who stutter (PWS) are inherently resilient. It rings very true. Choosing to do what may scare you is a very brave thing and requires fortitude against potential negativity. The tenets of resilience were wonderfully explained. Acceptance and Commitment Therapy (ACT) seems a very fitting method for treating stuttering. It addresses the internal mental and emotional structures of the PWS and works to strengthen their mental and emotional wellbeing, rather than try to force their speech into fluency.

    I particularly liked the segment on values talking about how an internal disparity between one’s personal values and their choices that go against those values can be okay when one is developing acceptance. There should not be shame in growth, and not being ready to share something that makes one feel vulnerable is not a failing. I further appreciate that the unease of this situation was acknowledged even as it was explained to be natural.

    Wonderful paper and presentation! Great work!
    -Catherine Usery

  5. Hi Dan and Tiffani,
    Thank you for sharing this video and article. It was really interesting to learn about mindfulness and identifying negative thought patterns in regard to stuttering. I tried the technique of focusing on your breath going through your nose and out through your mouth several times and I felt myself become calmer. Also, I agree that it is so important to differentiate negative thoughts and reactions you have experienced from your self-concept. I can see how these approaches could really benefit people who stutter. I like how you touched on the idea of PWS accepting where they are in their stuttering journey. I think that this notion is really important in facilitating changes that increase resilience.
    Lorena Zarotsky

    • Thanks for your comments Lorena! Glad to see that you noticed the change in yourself and can see how these aspects would benefit people who stutter.


  6. Hello Dan and Tiffani,
    Thank you for this amazing video and article! I had never heard of Acceptance and Commitment Therapy (ACT), and you made it really easy to understand. As a second year SLP grad student, I intend on using the techniques that you had mentioned in the future. I really like how you brought attention to that fact that everybody has challenges and stresses in their lives that make us resilient, but people who stutter are extremely resilient in that they have fears of speaking or calling somebody on the phone, but they preserve and continue being strong. I also liked how you mentioned mindfulness. I think it is important to be aware of how you are feeling and how you can cope with those feelings, such as using deep breathing techniques. With those feelings, self-compassion is important because the positive views can really impact resilience and their overall life. Thank you again, I learned a lot from your paper that I will take with me for the future.
    -Jessica Hoang

  7. Hi Dan and Tiffani,

    I really enjoyed this video! I love the perspective and approach of ACT. I am currently a graduate student taking fluency and I am eager to work in the field using approaches that will benefit the clients. I love the empowerment that is embedded in this presentation and I look forward to learning more and how to apply this in therapy!

    • Thank you for your kind words. I’m so glad that you found this useful for your future practice. Best of luck in your studies and learning to apply these ideas into your therapy!


  8. Hi Dan and Tiffani,
    I appreciated learning about this new approach of Acceptance and Commitment Therapy (ACT). I am a student studying to become a speech-language pathologist, and I had never heard of this method before, but I found several aspects valuable. I especially love the component of “self-as-context” where individuals can distinguish the difference between their thoughts and their being. I feel it is essential to acknowledge that not all PWS are not going to accept and embrace their stuttering at every moment. Therefore, it is important to accept any negative thoughts or feelings so that you are empowered to know the thoughts are not reality; they are not permanent. I also love the concept of identifying personal values so that PWS can determine how their life choices align with them. I feel that fluency therapy should always be tailored to the individual, as PWS are all so unique in their skills and values. Having clients write down or share their values could be a helpful strategy to utilize in therapy when I enter the field. Thank you for your insights!

    • Thank you for your thoughts and feedback! I agree with many of the important points you made here. Self-as-context and values are probably my two favorite ACT principles and I find them (as well as other principles too!) hugely helpful to use in therapy for PWS. I appreciate your recognition regarding how therapy should be individualized and I agree that using Values activities is a great way to do so (I definitely do this in my therapy and highly recommend it!). Thanks for your insight. I hope that you incorporate ACT into your work with future clients who stutter. Best of luck with your studies and profession!