Mindful Communication, Resilience, and Self-Care Tool Kit Dhruv Gupta and Michael Sugarman

About the Authors:

Dhruv Gupta has lived in seven countries and worked on hospitality, IT, and climate-crisis projects. He recently moved from Mumbai to Ossining, NY: “I aspire to cultivate resilient local community – an interdependent network of people who care for themselves, each other, and their local lands and species. I am currently teaching skills to foster self-care – yoga, whole plant-based cooking. I am learning how to teach skills that foster care for others – compassion, non-violent communication – and care for our local lands and species – biology, permaculture.

Michael Sugarman has been an activist in the stuttering and disability communities since the 1970’s. He was co-founder and former Executive Director of the National Stuttering Project and former chair of International Stuttering Association. Michael wrote for academic journals and promoted people first language and stuttering awareness in “It’s Ok to Stutter” (Journal of Fluency Disorders) and the Perniciousness of Labels (Transactional Analysis Journal). As a medical social worker, he recently updated his children’s book, The Adventures of Phil and Dotty. Michael currently co-facilitates a peer support group, and is co-writing an article on peer and professional facilitation of support groups, emphasizing mindfulness communication, self care skills and resilience.

Welcome peers and professionals to a comprehensive six week support group training program. Designed to train peer facilitators and professionals by allowing People who Stutter (PWS) to increase choices and awareness of their communication rather than perceiving stuttering as a powerful single force in control of them. In other words, it’s better to understand yourself before communication takes place rather than during and after. 

To recap, we’ve facilitated a peer support group for PWS to actively work on communication and behavioral/emotional self-care skills. We want to provide the stuttering community Peer and Speech Language Pathologist’s (SLP’s) Mindful communication and Resilience skills by using Avoidance Reduction Therapy, Acceptance Commitment Therapy, Mindfulness-based Cognitive Therapy and Dialectical Behavior Therapy. Suggest SLP’s to become familiar with Motivational Interviewing Skills, Stages of Change by Prochaska and DiClemente, Boundaries between professional and client and integrate communication tools. Each group session lasted 90 minutes and met once a week for six weeks. 

Week 1: Shame and Vulnerability

Below are activities that we request you start before our first meeting. 

  1. Make your bed every morning OR pick a task to do every morning that can become a positive self care skill such as watering the plants, yoga, etc. (you might already be doing a task.. stick with that)
  2. Pick a time in the day (6pm) and write in a journal/diary:
    • How am I feeling right now? For example: worried; bored; angry; content; overwhelmed; hopeful; confused; energized; or excited—
    • Write two responses to: “I’m grateful for…” It’s best if they are experiences/thoughts/feelings you had during the day.
  3. Practice mindful meditation for five minutes a day using any app like Calm, Headspace, Insight Timer
  4. Watch two Ted talks by Brené Brown on Shame and Vulnerability

1st week agenda: Mindful exercise: A Loving Kindness Meditation to Boost Compassion (repeat the same meditation for six weeks). Group Discussion on Shame and Vulnerability.

Week 2: Avoidance 

We suggest you continue to do the three self-care activities we started in Week 1: 

  1. Daily morning positive self care skills 
  2. Journal, once a day:
    • How am I feeling right now? 
    • I’m grateful for… (at least 2 thoughts)
  3. Meditate for at least five minutes a day 
  1. Review this article Emotion Regulation Skills: Opposite Action Worksheet, download, and try filling out the worksheet. 
  1. Opposite Action (Dialectical Behavior Therapy) and Avoidance Reduction Therapy share and discuss:
  • Make a list of people or situations where you communicate
  • Make a list of (from Vivian Siskin’s talk Let’s Talk About Struggle):
    • Things you do to escape or avoid disfluency and communication 
    • Things you don’t want to feel 
    • Things you don’t want others to think 
  • Monitor 
    • Write down what you’re thinking and feeling / what’s going on in your body when you’re disfluent (mind/body process). Write down your secondary behaviors. How did the communication end? Feel ok? Worse? Uncomfortable?

2nd week agenda: Mindful exercise. Group Discussion on Avoidance. 

Week 3: Radical Acceptance and Harm Reduction

We suggest you continue to do the self-care activities: 

  1. Daily morning positive self care skills 
  2. Journal, once a day:
    • How am I feeling right now? 
    • I’m grateful for… (at least 2 thoughts)
  1. Meditate for at least five minutes a day 
  2. Watch Tara Talks: Radical Acceptance is a Prerequisite for Change (1:56)
  3. Download and fill out: Changing your thinking: a thought replacement worksheet

3rd week agenda: Mindful exercise. Discuss negative automatic thoughts and rational thought replacement / reframe.

Week 4: Anxiety and stress 

We suggest continue self care skill activities:

  1. Daily morning positive self care skills
  2. Daily journal:
    • How am I feeling right now? 
    • I’m grateful for… (at least 2)
  3. Daily meditation/mindfulness (use apps suggested) – sitting, walking, listening, yoga
  4. Discuss these questions The Zen of Listening Mindful Communication by Rebecca Shafir, MA 
  • Feel frustrated or impatient when communicating?
  • Give the appearance of listening when you are not?
  • Become self conscious in one to one or small group conversations?
  • Listen to the speaker without judgement
  • Feel uncomfortable allowing silence between you and your conversation partner?
  • Preface your statements with unflattering remarks about yourself?
  1. Watch and share mindfulness-based method working with our afflective thoughts: Catch it, Check it and Change it exercise.
  2. Watch these Ted talks: 

Improv Activity (from The Indian Stammering Association): If in-person, form a circle. Ask a participant to ask you (the facilitator), “did you stutter?” Prepare a funny and confident retort to that question, like “Yeah, you wanna learn?” Demonstrate a few more times, and then take turns asking participants and participants asking each other. The atmosphere should be light-hearted and honest. This activity is building the participant’s resilience and assertiveness muscles. You, as the facilitator, can decide if the group is ready for this activity.

4th week agenda: Mindful exercise. Discuss the items above. Optional: Improv activity. 

Week 5: Mindful Communication & Resilience

Please continue the following: 

  1. Daily morning positive self care skills
  2. Daily journal:
    • How am I feeling now? 
    • I’m grateful for… 
  3. Daily meditation/mindfulness (use apps)- sitting, walking, listening, yoga
  4. Mindful Communication:

Read: 3 Important Lessons on Mindful Communication  by Lili Powell July 1, 2016 Mindful magazine

Watch: Wise Speech for Social Change (Donald Rothberg) & Mindful Speech – Tara Brach

  1. Resilience (from What is Emotion Regulation? + 6 Emotional Skills and Strategies?):
  • Self-awareness: Noticing what we feel and naming it is a great step toward emotional regulation. For example, when you feel bad, ask yourself – Am I feeling sad, hopeless, ashamed, or anxious?
  • Mindful awareness: In addition to gaining thought awareness, mindfulness lets us explore and identify all aspects of the external world, including our body. Simple mindful exercises such as breath control or sensory relaxation can calm the storm inside and guide our actions in the right way.
  • Cognitive reappraisal: Cognitive reappraisal includes altering the way we think. It is an essential component of psychotherapies like CBT, DBT, and Anger Management, and calls for greater acceptance and flexibility.
  • Adaptability: Emotional dysregulation lowers our adaptability to life changes. We become more prone to distractions and fail our coping mechanisms, which is why we often start resisting changes. A great exercise to build adaptability is objective evaluation.
  • Self-compassion: Setting aside some time for ourselves every day is a great way to build emotional regulation skills. Reminding ourselves of our talents and virtues, and letting our minds land on a flexible space can immensely change the way we feel and react to our emotions.
  • Emotional support: Psychologists believe that we all have the innate capacity to build a robust emotional repertoire and save our mental energy from getting invested in negativity. We can seek emotional support within ourselves by practicing mindful self-awareness or can seek help outside by engaging in positive communication with others.

Pick ONE TED Talk and watch: 5 Inspiring TedTalks To Help You Build More Resilience

5th week agenda: Mindful exercise. Discuss the items above.

Week 6: Compassion & Mindful Communication

  1. Continue doing something beneficial every morning (cultivating a positive self care skill)
  2. Journal daily: How am I feeling now? I’m grateful for… 
  3. Meditate for 5 minutes – sitting, walking, listening, yoga
  4. Self-Compassion
    Watch: Kristin Neff and Rick Hanson: The Benefits of Self-Compassion
    Read: Self-Compassion Practices to Deepen Your Resilience
  5. Read: Training the Wise Mind for greater self-confidence and discuss Rational, Emotional and Wise Mind

Wise Speech THINK…

T – is it True?

H – is it Helpful?

I – is it Inspiring?

N – is it Necessary?

K – is it Kind?

  1. Here is a bonus talk we talked about last week; exploring how we are all interconnected and interdependent: Buddhism and Biology & Existentialism, Buddhism & Biology based on the book Buddhist Biology by Dr. David Barash, psychology professor and evolutionary biologist.

6th week agenda: Mindful exercise. Discuss the items above.

It takes courage to confront our communication and create true self expression. By actively addressing issues which affect you, you can learn more about yourself and become aware to identify and explore aspects of a communication disability and learn ingredients to make changes.

 

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Comments

Mindful Communication, Resilience, and Self-Care Tool Kit Dhruv Gupta and Michael Sugarman — 56 Comments

  1. I have had the honor to participate in one of these groups with these two authors. This paper offers a wonderful guide to further explore these concepts.

    • Thank you for sharing your experiences with us —look forward to our 2 more sessions – warmly

  2. Excellent paper Dhruv and Michel,
    In order to keep my clients motivated I ask them to journal free hand much the same items you bring up and then weekly fill out the following Progress Assessment which contains four visible items (1 through 4) according to expanded Sheehan’s stuttering metaphor with the rest invisible. Do you think that utilizing such an assessment is in line with your mindfulness, resilience, and self-care aspects? You can find the assessment form in the “Talk with a Professional” and “Talk with a PWS” post sections.

    • Yes – Will check — TEAM -CBT by David Burns has therapists After every session to ask questions on the progress of therapy —so awesome —
      Thank you for all you and Heather are doing for Stuttering community —warmly

  3. I really enjoyed reading this weekly guide for mindful communication. As a graduate student who is learning so much about stuttering, I have become really interested in treatments strategies that also seek to address behavioral and emotional aspects of life, not just communication I am wondering, how have the participants responded to the sessions? Have you noticed that a lot of people are now more familiar with mindful activities or is it still relatively new? I really like that TED talks are incorporated in the weekly activities as it allows an opportunity to incorporate different perspectives.

    • So awesome you are interested in combining behavioral and emotional aspects in communication – by the end of the group PWS were using journal writing and mindful apps – Reported integrating self care skills into daily lives
      We are in 5th week for Professional -SLP and are enjoying the concept of integrating mindfulness into clinical practice and sharing information with their colleagues.
      It’s a very exciting times in being a therapist – Happy you see the benefits – called 3rd wave of therapies —I hope you decide to use some of the ideas for your therapy group

  4. Hi Dhruv and Michael,
    I really enjoyed reading this explanation of your program! It sounds like a comprehensive, productive, and empowering six weeks. I love that you’ve included activities like worksheets to keep members accountable for their emotions and their progress, because this feels like a measurable way for participants to see how they are improving their relationship to stuttering. I also love that you included general mindfulness and talks not related to stuttering but to gratitude and acceptance in general. I’m inspired to watch many of these videos myself after reading this paper!
    Best,
    Athena Kavounas

    • Thank you very much for your kind comments . Our hope you use any ideas to use in your facilitated support group- you can add another session to focus on what you want –
      Warmly and good luck in your adventures –

  5. Hello Dhruv and Michael,

    What an interesting paper. I would certainly like to participate in your group one of these days! I am curious about your description of incorporating elements of ACT and CBT (among other methods). The CBT aspects are apparent to me, such as, “Changing Your Thinking: A Thought Replacement Worksheet.” I’m wondering – which elements of your program are explicitly ACT-congruent? I am also wondering about using CBT methods of “thought stopping” and “challenging your thoughts” together with ACT-congruent methods; to me, they seem to be incompatible with one another. If I am understanding correctly, CBT works by helping you identify, challenge, and change unwanted and unpleasant thoughts, whereas ACT holds that unwanted and unpleasant thoughts (and other experiences) are simply a fact of life – something that it makes sense to acknowledge, and to drop the struggle around, if you wish to pursue a value-driven, meaningful life. ACT encourages you to accept thoughts, rather than trying to change them – seemingly the opposite of CBT. Please let me know how you approach meshing these two methods. Best to you both,

    Rob Dellinger

    • Thank you – there are two schools in CBT and Mindful based Cognitive Therapy- one Dr. Beck the one most SLP’s learn at SFA- they have changed to CT-R and integrate mindfulness into their clinical practice —And now ACT offers MindfullyACT-
      Use Dr. David Burns CBT author of Mood Therapy —we use gratitude now—he encouraged therapists to use mood diaries —-and now he has develop TEAM-CBT – later on that—
      Absolutely trying to integrate those ACT and MBCT – the CBT – Burns Feeling Good changing your thinking patterns negative to positive And combining ACT to accept those new behaviors – and throw in Dialectical Behavior Therapy with Opposite Action with Emotional Regulation – the format to the support group is DBT – which is the standard in Behavioral Health –
      Just to throw in another wrinkle Brené Brown’s with Emotional fluency/ Emotional Intelligence-
      The format to the group 1-3 sessions To develop Emotional Intelligence and 4-6 sessions Speech and communication – Mindful Speech And communication by using Tara Brach, DBT Zen of Listening , and self compassion Rick Hanson neuropsychologist and Neff – —You can use any ideas to enhance your clinical skills-
      You can contact Kirsten C. or read her comments above or Another school SLP I
      Posted is doing is doing mindful speech —

      It’s exciting and changing times – I was extremely lucky to been hired at Stanford – David Burns – and extremely lucky to been part of the CBT 2nd wave and retired 3rd wave – MBSR Kabat-Zinn -spent time at Stanford and Oakland/San Francisco

      Hope we can continue to share —-warmly

  6. Hi Dhruv and Michael,

    Thank you so much for sharing your program with us! As a second-year graduate student, I have found myself turning towards mindfulness activities to counteract the amount of stress and overwhelming feelings I have encountered. I did not even think about the positive benefits PWS could have from simple activities like these! In my stuttering class we have learned the importance of a safe place and unfortunately our mind is not always safe! Add in this pandemic, where a lot of people are forced to be isolated, and it becomes even worse! Your program helps these participants make a safe place for themselves. I like how you incorporated a physical aspect such as a walk or yoga! I do not think people realize the benefits exercise have on the mind! I cannot imagine the positive differences your participants got through this, props to you both!

    – Lauryn Mellberg

  7. Thank you for your comments – in your future clinical work use any ideas – self care skills, gratitude, mindfulness and a therapy – remember this is for group therapy sessions and be willing to try new ideas – Good luck

  8. Hi Dhruv and Michael,

    Thank you for sharing your paper about the comprehensive six week support group training. I believe that it is important to always be positive to yourself and participate in self-care activities that will help with mindfulness thinking. I appreciated you guys, including articles, videos, worksheets, and apps. I am going to use these resources, and I will also share them with others. I believe that self-care activities help every individual decrease negative emotions and encourage positive thinking. As a future clinician, mindfulness techniques will be beneficial for me to use in group therapy with my students.

    Thanks again!

    Kind regards,
    Victoria

    • Thank you for your comments —Self Care Skills includes mindfulness – hope you use any of the resources in group therapy —

      Namaste 🙏🏾

  9. Hello Dhruv and Michael,

    I love the ideas you both poured into your six-week intensive support group training. It also makes me curious what prompted your weekly subject choice order. I think it is great you included TED talks and functional worksheets to coordinate each medium to that week’s subject. As a graduate student of speech-language pathology, your focus on mindfulness makes me want to incorporate similar strategies in my sessions. Thank you so much for your submission!

    • Thank you for your comments – The first three group sessions focus on Emotional fluency or Emotional Intelligence and 4- 6 sessions are on mindful speech and communication —
      The format is used in Dialectical Behavior Therapy – where the focus begins with mindfulness and explores Distress Tolerance , Radical Acceptance and Emotional Regulation—Most SLP are aware of CBT and ACT —you can use the material to create your group therapy format—-
      1-3 session addresses shame, Vulnerability, Avoidance and radical Acceptance-
      Good luck and namaste

  10. Hello Dhruv and Michael,

    Thank you for sharing your program with us! This program is well thought out with many mindfulness activities, worksheets and TED talks implemented throughout. I did have a question about how you both came to the conclusion of this specific model? Is there a reason for the arrangement of what you are addressing each week? As a future SLP, the strategies used in this progress are ones that i definitely want to use in my future practice. I love that physical activities are also incorporated such as yoga or walking; physical activities are so important, not just for the body but for the mind also. Thank you both for all your hard work and dedication to this program!

    – Casey Edwards

    • Thank you for your comments – see response Above to similar question –
      Group sessions 1-3 addresses shame, vulnerability avoidance and radical acceptance —
      Emotional fluency or Emotional Intelligence
      Group sessions 4-6 addresses mindful speech and communication — and provides flexibility for SLP clinical skills
      Good luck and Namaste 🙏🏾

    • Thank you for your comments – We share the same philosophy of mindfulness , meditation and walking and yoga – look forward to hearing about you integrating these concepts –

      Namaste 🙏🏾

  11. Dear Dhruv and Michael,

    I am so thankful for this amazing self-care toolkit. I believe in the importance of positive self-love, and positive-mind affirmations DAILY! I loved that you incorporated this into the therapy everyday because we have to do thinks that reduce our anxieties, and increase our positivity. I specially liked how you incorporated a daily journal, the power of writing your ideas/thougths down is so important, even if you don’t go back to them, but it’s a way to release energy (both good and bad). My boyfriend took the time to read this through, as he is an individual who stutters and he was so happy to find something that doesn’t focus on fluency so much but rather self-care and mindfulness. Especially in these unprecedented times, where things are changing and we are always in social-political havoc it’s important to appreciate yourself and be mindful and present. Thanks so much again,for including articles, videos, worksheets. I know my boyfriend will be checkign them out and I will definately incorporate them in therapy.i truly believe in the power of mindfulness and being active to do that for yourself can really decrease those negative emotions that can arise in stressful times like these.

    Thanks,

    Michelle Alferez

    • Thank you for your comments —Yes I agree journal writing, mediation practices (self care practice) changes our mindset—
      Please use any of the ideas for facilitating Therapy support group-
      🙏🏾

  12. Hello Dhruv and Michael,
    Thank you so much for taking the time and sharing your six-week training program. I really enjoyed reading and even practicing some of these mindfulness activities daily to start off my mornings or throughout the day. I have really seen a change in the ways I perceive myself and those around me. I am a huge fan of Brene Brown and think it is awesome the program talks about shame within the first week. I did not realize that I could incorporate simple activities throughout therapy to help with teaching mindfulness, resilience, and self-care with any person and age group. I firmly believe in the positive impact that these have in an individual’s life and I cannot wait to utilize some of these with my future students and clients. Thank you again for sharing your knowledge and resources with us!

    • Thank you for your comment about Brené Brown. – please take and use any of mindful exercises and mindful speech and communication –

      Namaste 🙏🏾

  13. Thank you for taking the time to research and inform us on your six-week group training. It sounds like a productive and positive experience. Self-care activities can be helpful for everyone. In particular, I appreciated how you included worksheets, applications and other activities to be used by the people undergoing the training but also to be shared with others. These are the kinds of activities that bring people together and increase optimism and acceptance. Overall, I feel inspired after reading about this and I look forward to using these tools during treatment.

    Thank you again!

    • Thank you for your kind comments – using mindful and self care skills in your treatment plans.
      Good luck
      🙏🏾

  14. Hello Dhruv and Michael,

    This program sounds like such a great idea! I love the idea of using mindfulness activities and self-reflection to help build confidence and resilience in people who stutter. Self-help is such an important skill, and we are our biggest advocators. I love that this program tackles those negative perceptions head-on and encourages the participant to focus on the positives in their life. I also like the incorporation of group sessions that provides a safe community of people who share similar experiences. Thank you so much for sharing this program! I would love to use these strategies with future clients when I am practicing in the field.

    Sincerely,

    Caitlin

    • Thank you for your comments and plans to integrate these skills in your clinical practice —Good luck

      Namaste 🙏🏾

  15. Dear Dhruv and Michael,

    I really appreciated being able to learn about this unique approach with your support group training program. The concept of using mindfulness to truly come into touch with yourself as a means to then understand your communication abilities is so powerful. As a student studying to become a speech-language pathologist, you have provided me with various helpful resources in the form of worksheets and videos to potentially use in the future. I found the improv activity in week 4 especially intriguing, as I had never heard of a technique like this before. I feel as if it would be a great way to create an enjoyable and low pressure environment to be assertive with their communication. It’s also an enriching experience to hear about a technique used in a different part of the world, and how you are integrating it here in the states. Thank you for sharing!

    Quinn Gardner

    • Thank you for your comments- hope you can use these mindfulness, self care and topics as part of your clinical practice- Good luck in your studies-
      Namaste 🙏🏾

  16. Hello Dhruv and Michael,
    This sounds like a great program! I really like how you encourage the participants to think about their own feelings towards their stuttering. I believe that it gives them control over their own journey, which will lead to positive thinking and acceptance. I practice daily writing in my journal every day, and I think it really beneficial for self-awareness, mindfulness, and Cognitive Behavioral Therapy. As a grad student, I know most people think about the core behaviors of stuttering first, but it is really nice how you mention the strategies of dealing with the underlying feelings and thoughts that can impact stuttering. I will definitely keep in mind your tips and strategies when I start working in the future. Thank you again, this is an amazing paper.
    -Jessica Hoang

    • Thank you and good luck in integrating mindfulness, meditation, self care skills and therapies into your clinical practice – Good luck in completing school –
      Namaste 🙏🏾

  17. Dear Dhruv and Michael,
    I absolutely love your description of your training program which includes aspects of Avoidance Reduction Therapy, Acceptance Commitment Therapy, Mindfulness-based Cognitive Therapy, and Dialectical Behavior Therapy. I was a psychology major back in undergraduate school, and I always learned about various social-emotional diagnoses that these techniques may help. However, I never learned how they may help those who stutter. I am currently in my last year of graduate school to become an SLP. I am currently working with two middle schoolers who stutter and the amount of exercises you presented will definitely help me lesson plan for those two students in the future. In addition, I love how in each week you encourage those to do something beneficial every morning as well as journal for what they are thankful for. These are activities that I do every day since I began graduate school and have extremely helped my emotional wellbeing and mindset. In addition, your view on mindful communication and showing self-compassion, I believe are incredibly important TO emphasize and encourage when helping those who stutter. I truly enjoyed all of these tips and will definitely be carrying them into my own practice as a future SLP.

    Kind Regards,

    Bailey Deason

    • Thank you and good luck in completing your graduate and plan to integrate third wave 🌊 therapies and mindfulness into your clinical skill set —
      Namaste 🙏🏾

  18. Druv and Michael,

    Thank you both so much for sharing this wonderful program. I recently listened to a Stuttertalk on Acceptance Commitment Therapy, and I have personal experience with CBT, so being able to see how they worked in tandem was very interesting. I also loved the acronym you described with THINK. Growing up, my sister and cousin tended to butt heads and we used similar questions to help them consider what was in/appropriate to say to each other, but seeing this applied in terms of speech pathology, and specifically stuttering, was something I hadn’t considered.

    Best,
    Kennedy

    • Thank you for reading 🙏🏾 Yes, hope it can be useful in your future life & work. All the best!

  19. Hi everyone! Michael and I will be having a one hour Q&A about this paper on Wednesday, October 21 between 5-6 pm ET. Feel free to join to listen, ask questions, share comments, and enjoy the hour together! We will meet on Google Meets via this link: https://meet.google.com/avz-ggas-vxn

  20. Hi Dhruv and Michael,
    I am so amazed by this support group training program you both developed! I enjoyed reading about the different themes for each week while incorporating objectives from the previous week into the current week. Moreover, I really like how the first week focused on developing self-care skills for the PWS to find a way to take care of themselves and help jumpstart them into starting a simple routine that will slowly help promote positive emotions into their days. Another part of the program that I thought was incredible was in Week 4 and its activity from The Indian Stammering Association where participants prepare a funny or confident response to someone who asks them if they stuttered. I can imagine how fun this activity would be in a group that is more familiar with one another by the 4th week! Furthermore, I can see how this activity bolsters are more light-hearted atmosphere while empowering each PWS in having fun with how they can build their confidence while also watching their other peers grow to combat these types of negative remarks. As a graduate student in speech language pathology, creating a comfortable environment and promoting positive attitudes about a client’s own stutter has been heavily emphasized in my fluency class. Now, a new concept has been added into my repertoire of addressing stutter, and that is mindfulness and self-care. Thank you both so much for sharing details about your program; I will definitely remember and bring these effective techniques into my career as a future SLP!

    • Thank you for your comments—Gaining confidence in a positive atmosphere can only benefit participants- as well it’s important to know as a facilitator when to try interactive improv games –
      Namaste and good luck in your career

  21. Hello Michael and Dhruv,

    Thank you very much for this valuable resource. Explaining the concepts, like I sometimes to do, is one thing, but you are giving us concrete tools to use. Thank you.

    Hanan

    • Thank you – I used my experience with facilitating Dialectical Behavior Therapy and Mindful based Cognitive Behavior Therapy clinical support groups –
      Hope we catch up in person – Still planning to go to Israel

      Namaste

  22. Good afternoon!

    Thank you so much for such a valuable resource. I enjoyed reading about the different concepts and tools to use. Just today I had a discussion with a person who stutters who posited that clinicians should be called to help with these concepts, reducing stress and avoidance and focus on mindfulness rather than placing so much focus on fluency strategies. These concepts seem right on par with what you have discussed here, it was great to see these strategies in line with what a person who stutters prefers during therapy. Thank you for sharing!

    • Thank you for your comments – I feel you part of the future SLP integrating fluency strategies and Mindfulness and 3rd wave 🌊 therapies—use any ideas —
      Namaste and good luck

  23. Hello Dhruv and Michael,

    I am a currently a graduate student and I cannot thank you enough for this incredible resource. I thoroughly enjoyed reading about your approaches to treatment. I am currently in my Fluency class and I have learned so much about the role of cognitive and emotional therapy/shaping in working with PWS. This group training program really hones in on self-reflection, self-worth and acceptance. Creating a positive, trusting and safe environment is of upmost importance when working with PWS. I appreciate that your program is self-motivated. Too often therapy is focused on instilling change unto others, though I think this program forces the PWS to be the agent in their journey. Although this is set out to be a six week program, I think it’s also important to consider that many people may need more time. Habits take time, changing your mindset takes time. Everyone’s journey looks different. It think it’s important to validate people at any and every point of their journey. I will definitely be extending what I have learned here to my clinical practice as a future SLP. Thank you so much!

    • Thank you for your comments – the focus of this paper is on clinical support group- you’ll have the opportunity under scope of care to do both individual sessions and clinical group sessions –
      Use any of the ideas to enhance your clinical skills
      🙏🏾

  24. Thank you so much for sharing your support group training program. This is a wonderful guide that I can take with me as a graduate student who will be going into the field of speech-language pathology. I love how each week targets a meaningful topic that supports stuttering in a mindful and positive way. As a person who participates in mindfulness every day, I agree that this is a great way to help people who stutter stop and reflect on their feelings. By gaining, the resilience tools in this program, they will learn to bring out the positives every day and create less stress and anxiety around their stuttering. It is great that a very clear list of activities is listed to be done before the meeting to help facilitate the most effective discussion. It gives the members something to talk about and share with the group. The Ted talks and worksheets are a great addition to the activities, which can be adapted to be given to individuals for inspiration and thought-provoking one on one discussions when group therapy is not available.
    Thank you again for sharing your program!

    • Thank you — scope of care – you can use ideas for individual and group therapy-

      Good luck in your career –

      Namaste

  25. Thank you for sharing this approach with us! As a speech-language pathology graduate student, I have found that incorporating self-care and mindfulness into therapy has lead to clients and students being more confident. I have very little experience with people who stutter, but I will definitely be using these strategies with any future clients who stutter. It seems like an effective way to reduce the anxiety associated with communication, and hopefully to instill more optimistic views about oneself. In related classes, it has been largely emphasized that success when working with PWS is heavily impacted by their relationship with their stutters. By creating a more positive environment with these strategies, positive self-talk and higher confidence will hopefully follow.

    • Thank you for sharing your comments – you can use these ideas in your individual and support group therapy sessions –

      Good luck as a SLP-

      🙏🏾

  26. Hello,

    I really enjoyed learning about this approach. I started to see how each week was another step that led to the next week and how it all fit together at the end. Many PWS view their stuttering as this powerful thing that controls them, so I like how this approach increases their choices and awareness of their communication. It’s important to focus on creating the awareness and understanding before communication rather than during and after. I think the mindfulness approach is so effective in really drawing people in to examine their own feelings and stressors. We so often just go mindlessly through our days, so the activities you had them complete each day are very useful. I think it’s something everyone should apply to their daily routine whether they stutter or not. The mindful awareness of the first week is a perfect segway into the self-awareness focus of the second week. The questions they answered regarding their escape & avoidance behaviors, negative feelings, and fears surrounding stuttering were structured in a way that drew attention to and made them think about their thoughts, which then allowed them to monitor how it made them feel and the effect it was having on their communication and life. I like how awareness was created first before introducing the idea of acceptance. Now that they’ve identified their feelings and emotions, then they can begin to reframe, reshape, and replace their negative thoughts using cognitive reappraisal. I really like the phrase you used, “Catch it, check it, and change it.” I perceived this “change” as the adaptability and resilience stage. The last two weeks were a perfect wrap-up that pulled everything together. I think the most important part of dealing with a stutter is finding self-compassion and emotional support. It sounds like hardest part is releasing the shame, becoming vulnerable, and accepting yourself. As a future SLP, I can definitely see myself implementing this with clients. It takes a lot of courage to work through some of the activities in this program, but I think it is a very wholesome approach that addresses each step of accepting your stutter.

    Thank you for sharing this program with us!

    Best, Nicole

    • Thank you for your comments – remember this is part of scope of care you can provide – if you are able to do group and individual therapy — can and will benefit your client-
      Good luck in pursuing your career –

      Namaste

  27. Hello Michael and Dhruv,

    Thank you for sharing this great approach! As a graduate student, this approach is something I will definitely be incorporating into my daily life and practice. Mindful communication and self-care are both so essential and I really appreciate that the both of you were able to create such a great way for all of us to bring these approaches into our lives. I also loved that you included links to great resources for us to use such as 5 different inspiring TedTalks To Help Build More Resilience. I am currently taking a fluency course in graduate school and we have been learning a lot about the importance of addressing the patients’ feelings and attitudes and working through any negative emotions or experiences they have because of their stutter. Understanding and recognizing how you are feeling and being self-aware is so important for treatment and the techniques you gave in your approach are a great help with this such as a daily journal in which you address how you are feeling, mind and body exercises such as writing down what you’re thinking and feeling and what’s going on in your body when you’re disfluent, and discussions based on different experts’ approaches and beliefs, TED talks, listening to the speaker without judgement, etc.

    Sincerely,
    Ariana Arakelian

    • Thank you for your comments – hope you use any ideas in individual or group therapy –

      Good luck in your career-

      Namaste

  28. Hello Dhruv and Michael! I thoroughly enjoyed reading your article. I think a program that is focused on addressing the more emotional aspects of stuttering, that is often overlooked, is an important and meaningful contribution to support people who stutter. I really liked that the program emphasizes a reflective and compassionate approach to processing the deep-seated negative emotions that are often associated with stuttering. I also liked that the program layed out concrete examples of mindfulness and cognitive behavioral exercises. I will be sure to apply some of the cognitive exercises to my practice as a future clinician.

    • Thank you for your kind comments- use any of the ideas into clinical practice –

      Namaste

  29. Mindfulness, together with NLP, has been the tools that not only help me dealing with stuttering, the situations that stuttering put me into, and people’s reactions. It also helped me a lot with other challenges in life. The SOAL part is what I use all day, every day. From taking important decisions and coping with tough situations, to standing in a queue and clean the toilet. 😉 Mindfulness is my best medicine.

    Stay safe and keep educating

    Anita Blom