How to be a stuttering therapist: a few thoughts
Stuttering therapy has improved my life. I am fortunate that my stuttering journey has been blessed by a number of excellent stuttering therapists who have guided me to a better place with my own speech. However, not all of my experiences of stuttering therapy have been positive; some I even perceive to have been harmful! I want to share some personal reflections and advice on good and bad therapy practises from my own experiences from the other side of the therapy room (or zoom call these days!).
Hold up the right role models
My memory of childhood speech therapy is patchy at best but what I do remember is quite a few conversations that centred on famous people who stutter. These well-meaning conversation typically went something like this: “People who stutter can succeed in life and become celebrities, Patrick. Just look at Samuel Jackson, Bruce Willis and Mr. Bean.” There’s a problem with these examples, though: you never hear any of them stutter. They all very much place stuttering in the past tense in their own narratives; typically, as something they have ‘overcome’. The message this sent to my young brain by these examples was that I too had to overcome my stutter in order to succeed.
More helpful role models for children who stutter are adults who stutter for real in real life, like the comedians Drew Lynch or Nina G, or the author David Mitchell. Here in the UK, Action for Stammering Children has a built great repository of videos by ‘Stambassadors’, people who stutter in range of jobs showing that you can be anything you want to be with your stutter (without having ‘overcome’ it).
Pick the role models you give to children as therapists carefully as they may convey unseen narratives around stuttering.
Don’t be prescriptive
Stuttering therapy is not one size fits all; different things work for different individuals. Early on in my journey, I went to a ‘costal breathing’ based course. Some people who stutter find the technique helpful. I, however, did not. I found it tiresome and I actually preferred to stutter. The course instructor though was clear that costal breathing was the way to help stuttering. They described not using the technique as ‘winging it’; words that have remained with me to this day. The course also encouraged people to stand-up and declare themselves ‘A proud recovering stutterer’.
My social model mindset has difficulties these days with any technique that aims to improve fluency but some people who stutter do report benefit from them. You may decide to offer them as part of your therapy. If you do, please do not frame it so people who stutter see them as the ‘right’ or ‘correct way’ to approach stuttering.
Each technique is one in of a myriad of options in a field in which there is no clear best evidence-based way to approach stuttering (Baxter at al., 2016).
Listen: give time & space
I once went to a therapy session with stuttering as far as possible from my mind. I had sat some important medical exams and suspected (incorrectly, it turned out) I had failed them. I had a forty minute session booked; I came out two hours later.
We hadn’t spoken much at all about my stuttering; instead, my therapist had offered support, comfort and a listening ear at an anxiety provoking time for me. I’m very grateful to this day for that session that boosted my spirits and settled my nerves.
Occasionally, a stutterer will turn up to therapy in a mindset in which they are not able to engage in therapy around their stutter; the session is not lost. You can still listen to the person in front of you and help them a little on their life journey.
Be ready to reflect and grow
My last therapist was the most experienced. She probably had more accumulated knowledge and experience of stuttering than any of the ones before her. A few years after therapy, I went back to the centre to present on the social model and talk about Stammering Pride and Prejudice. She was in the audience and one of the most active participants of the session. Still learning, still reflecting, still growing even after all those years experience.
I guess, you never know it all in therapy: keep learning! Buy Stammering Pride and Prejudice :-)
Baxter S, Johnson M, Blank L, Cantrell A, Brumfitt S, Enderby P, Goyder E. Non-pharmacological treatments for stuttering in children and adults: a systematic review and evaluation of clinical effectiveness, and exploration of barriers to successful outcomes. Health Technol Assess. 2016 Jan;20(2):1-302, v-vi. doi: 10.3310/hta20020. PMID: 26767317; PMCID: PMC4781644. https://pubmed.ncbi.nlm.nih.gov/26767317/