Monday Modalities

People who stutter often develop emotional responses to their dysfluencies that become more debilitating than the actual speech disorder.
As a mental health clinican, the most effective model that I have found to treat a patient’s emotional dysreguation is Dialectical Behavior Therapy.  Dialectical Behavior Therapy (DBT), developed by Marsha Linehan, Ph.D. in 1993, is a wide ranging cognitive behavioral treatment that has helped people to manage overwhelming emotions.  Over the past 20 years the treatment model has been found effective with many different populations.   DBT teaches four skills; Mindfulness, Distress Tolerance, Emotional Regulation and Interpersonal Effectiveness.
In my professional opinion, this treatment model would be very effective for people who stutter.  In my private practice I have started treating people who stutter.  I am excited to explore how DBT skills can help a person who stutters have a more fulfilling life.
QUESTIONS FOR PEOPLE WHO STUTTER and SLPs:   Is their an emotional response to stuttering?  If so, how should it be treated?  What role do you see mental health professionals playing for treating people who stutter?
Nora O’Connor

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Monday Modalities — 5 Comments

  1. Thank you so much for this perspective. I think there is a huge need in the field of mental health for clinicians who understand the impact that a speech disorder has on a person, their mental health and their family. Many times SLPs take on a dual role as a clinician as well as a counselor. To specifically answer your questions, the emotional response to stuttering is HUGE. It needs to be treated by a clinician who has compassion and an understand of why the emotional response is present. They need to realize that simply fixing the stutter is not going to be the easy fix they might think. Without addressing the thoughts and feelings related to the stuttering a clinician is doing their client a disservice and not providing the best treatment to allow for life long fluency. Mental health professionals have an opportunity to work in conjunction with SLPs to help people who stutter. This treatment method appears to be in alignment with what an SLP would work on. I think it will be important for the mental health professionals working with people who stutter to have a basic understanding of the etiology and theories of stuttering. Is this a program you would implement with only adults? Have you ever worked with children who stutter? Thank you for your time.

  2. I agree with the idea of using DBT. The part that I find useful as a psychotherapist is building tools to manage the Distress Tolerance and Emotional Regulation. When I was first in therapy for my own process maintaining emotional regulation in managing the tolerance and vulnerability was a long process. As a therapist it allows me methods to bring into the room for increased ease and relief.

    Elizabeth Kapstein
    New York, NY

  3. Hi Nora,
    Thanks for this piece, and your many other contributions so far to this year’s ISAD conference. I’m intrigued with the DBT that you mention. I have never heard of it, and I have been in therapy for almost 6 years, working on my own growth and emotional regulation.

    The therapist I see is a clinical psychologist and he has experience working with people who stutter. I think a multi-disciplinary approach is key to success with people who stutter. I consider myself lucky that the therapist I see understands stuttering.

    I have an interest in mindfulness, but have never really attended to it enough to really understand it and fully practice it. I am going to ask my therapist about DBT. Thanks for the insights.


  4. Great responses, Pam, Elizabeth and Deborah.

    Deborah – I taught these skills to people who stutter at an intensive speech program this past June. The youngest participant at the Successful Stuttering Management program at Eastern Washington University was 15 years old. The responded well to the additional counseling / skill building treatment as they learned stuttering modification.

    I worked with a 9 year old who stutters this past summer. She responded well to skills taught.

    Elizabeth – I would have so loved to have had a therapist who knew how to teach skills and not just listening to me talk in therapy. DBT skills have changed my life. I taught myself as I was teaching my clients !

    Pam – contact me directly and I can provide you information on DBT.