The workshop elevated my confidence in my stuttering therapy with adults, and has given me new and concrete tools which enriched my view and approach, even technically. Insisting on describing a situation through Cognitive Behavior Therapy (CBT) cycles has made a real difference. Also, since then I have been doing Parent Child Interaction therapy, which I have never done thoroughly. I enjoy the process and it has been showing results.
Since the workshop, I offer Parent Child Interaction therapy to families of preschoolers and use CBT and SFBT principles and procedures in individual and group therapy with those who stutter. Also I have had my practicum students read about PCI, CBT, and SFBT and learn to apply these strategies with the clients they work with under my direction.
We have added CBT to our intensive clinics, added some best hopes elements to our extended and intensive therapy, practice Solution Focused Brief Therapy (SFBT) strategies during staff development and in our supervision sessions with students, and have started to use PCI components in our therapy for children.
I’ve been integrating a lot of things I learned from last summer's workshop in practice and in my everyday life. My workplace has become more 'solutions' focused and there has been a greater emphasis placed on clients being the expert.
I facilitated a workshop with my colleagues and put on my Solution Focused Brief Therapy hat with the questions I asked and it really helped point out to my colleagues how useful SFBT is (rather than the clinician being the expert and telling the clients what is important, the client can be the expert and set up noticing tasks jointly). As a result of the increased awareness of the usefulness of SFBT, my workplace has contracted an external Solution Focused Brief Therapist to run a workshop for us and other Speech Language Pathologists to spread the word.
I have used the Cognitive Behavior Therapy model to describe how stuttering can have a vicious cycle to my school aged/teen clients with great results. This has really helped them tune into their thoughts, feelings, physiological responses and behaviors which contribute to the manifestation of the stuttering ‘problem.’
The most important lesson I learned and use all of the time is to provide an opportunity for the client to openly discuss the issues pertinent to themselves with respect to communication. I have had 3 adults on my caseload this year, all of whom have been in therapy before. All have felt that they “just didn’t work hard enough or practice enough” when they were in therapy before. Not one of these gentlemen has used disclosure or had any CBT. I know you understand the relief I see on their faces when we use CBT and solution-focused work.
I had an epiphany one day recently while taking one of my daughters to her endocrinologist for a diabetes appointment. With diabetes, much like stuttering, the numbers are never going to be 100% where you want them to be. I have observed my child's doctors being fixated on the numbers and forgetting about the angst the patient feels because some of the numbers were out of “desired range.” I began to think about our fluency clients and how they too, feel similarly. We recently saw a doctor who doesn’t look first at the numbers but knows instinctively that his guidance was needed and took the time to get to know my child. I can't tell you how amazing this was for my daughter’s sense of well being. At this point, I really don't like taking counts in front of a client. I am more concerned with whether or not they were able to say, for example, their first name at a meeting (stuttered or not) rather than saying “Mr. Paul B....” inappropriately to avoid stuttering. That is a much more important measure of success.
Upon returning from the workshop, I started a client session with a SFBT focus to help review and frame what had been going well while I was away. Initially, he reported that it was a roller-coaster over the last few weeks but somehow he managed to remain upbeat and to talk more. He played for me a recording of him reciting the speech from the end of The King’s Speech. He spoke with fluency, control and confidence. As we explored the effect this self initiated task had on him, it was a catalyst for him to feel better about himself and to reinforce that he is in control!
I did a short presentation with my colleagues at the private practice. My excitement proved infectious as they were all very interested to learn more.
I start therapy tomorrow with a 9 year old who appears to be a great candidate for some CBT. I am going to start with helping him put names to feelings and emotions. I plan to read the kids’ letters on the SFA website to start. I know SFA has a great DVD and there are some books in our handouts. I may have him plot his stutter onto an iceberg as it might help him conceptualize what surface behaviors are and what’s beneath the surface (negative thoughts and emotions.)
The use of CBT and SBFT has been very positive in the sense that I have better tools to counsel parents not only applied to stuttering cases but in general for all kinds of speech and language cases. I also gave a presentation and led a discussion about CBT applied to school-age children in one of my Cluster Meetings with other SLPs. My fellow SLPs who attended were very interested in the topic. Regarding SFBT, I found it really fun and constructive to use it with my intern student from Emerson College, more on the supervision arena...The Ten minutes talk was very helpful.
-From the Summer 2012 Newsletter