Clinical Trials and Cognitive Therapy

By Susan Block, Ph.D.
Winter 2009

alt text Social anxiety (i.e. anxiety arising in social encounters) cannot be overlooked in the management of chronic stuttering. The evidence for a relationship between anxiety and stuttering is considerable. Adults who stutter have reported high levels of trait, state, and social anxiety on standard measurement instruments (Hancock & Craig, 1998; Kraaimaat, Janssen, & Vandambaggen, 1991). Those who stutter appear to experience higher than normal levels of anxiety, independent of speech. A recent, large-scale population study of Australians (Craig, Hancock, Tran, & Craig, 2003) found trait anxiety levels to be higher in stuttering participants than in controls.

This paper presents the results of a study in Australia in which the authors examined social anxiety and stuttering. The study examined the rate of social phobia among 32 adults who stutter, the effects of speech restructuring treatment on social anxiety, and then the effects on anxiety and stuttering of a cognitive-behavior therapy (CBT) package for social anxiety.

Thirty-two adults with chronic stuttering were randomly allocated to receive either speech restructuring (Prolonged Speech) following a CBT package for social anxiety or speech restructuring alone. Data were obtained on a variety of speech and psychological measures at pre-treatment, post-CBT, post'speech restructuring, and 12 months follow-up.

Sixty percent of the cohort were diagnosed with social phobia. Speech restructuring treatment alone had no impact on the social phobia of the cohort at 12 months follow-up. At follow-up, participants who had received CBT showed no social phobia and greater improvements than control participants on a range of psychological measures of anxiety and avoidance. However, the CBT package made no difference to the speech outcomes of those with social phobia.

Consequently, it was concluded that the CBT treatment was associated with significant and sustained improvements in psychological functioning but did not improve fluency.

This article is from the Journal of Speech, Language, and Hearing Research Vol. 51 1451-1464 December 2008. It is based on research by Ross G. Menzies, Sue O'Brian, Mark Onslow and Ann Packman of the Australian Stuttering Research Centre, The University of Sydney, Australia; Tamsen St Clare of The University of Sydney and Westmead Hospital, Sydney, Australia; and Susan Block of La Trobe University, Melbourne, Australia.

Craig, A., Hancock, K., Tran, Y., & Craig, M. (2003). Anxiety levels in people who stutter: A randomized population study. Journal of Speech, Language, and Hearing Research, 46, 1197'1206.

Hancock, K., & Craig, A. (1998). Predictors of stuttering relapse one year following treatment for children aged 9 to 14 years. Journal of Fluency Disorders, 23, 31'48.

Kraaimaat, F. W., Janssen, P., & Vandambaggen, R. (1991). Social anxiety and stuttering. Perceptual and Motor Skills, 72, 766.

CELEBRITY FOCUS

Kenyon Martin

Kenyon Martin, the basketball sensation who was named to the NBA’s All Star Team in 2004, joins other famous people who stutter in a new brochure. The brochure - which unfolds into a small poster - is available free of charge from The Stuttering Foundation.

The poster is intended to give children and adults who stutter inspiration as they grapple with their speech disorder.

Ken Venturi

As much of the nation watches the U.S. Open Golf Championship, it is impossible not to think about our late friend Ken Venturi. Ken overcame many challenges to win the Open at Congressional in 1964 and go on to become the voice of golf for more than three decades.

However, Ken faced no bigger obstacle than stuttering. Ken Venturi was a champion to those who stutter, going out of his way to share his personal experience when consulted by a colleague, friend, or child who stutters.

King George

In November 2010, worldwide movie audiences were presented with a most interesting and unusual movie release with The King’s Speech, starring Colin Firth as King George VI and Helena Bonham Carter as his wife Elizabeth.

Unfortunately, history may have forgotten the courageous and inspiring story of Prince Albert who stuttered badly and never dreamed that he would ever be king when his older brother, King Edward VIII, abruptly abdicated the throne in 1936 to marry Wallis Simpson, an American divorcee.

Darren Sproles

Darren Sproles, a former player for The Philadelphia Eagles, the New Orleans Saints and the San Diego Chargers, made history in 2007 when he became the first player in NFL history to return a kickoff and a punt for his first two NFL touchdowns in the same game. In 2021, he was selected to be inducted into the College Football Hall of Fame.

Alan Rabinowitz

Alan Rabinowitz, Ph.D., who passed away in 2018, was an explorer, wildlife conservationist, and author. He established the Hukawng Valley Tiger Reserve in northern Myanmar, which is about the size of the state of Vermont.

His love for animals began when he was very young.