European Symposium
on Fluency Disorders
Presentations
Montclair State University, United States of America
Dr. Michael P. Boyle is an Associate Professor in the Department of Communication Sciences and Disorders where he teaches graduate courses in fluency disorders, directs the fluency disorders laboratory, and serves as the Graduate Program Coordinator for the Speech-Language Pathology Master's program. His research focuses on social and psychological aspects of stuttering.
This presentation will discuss the critical elements of guilt, shame, embarrassment, and stigma related to being a person who stutters. Information will be presented on how these variables differ, theories on how they develop, how they can contribute to decrements in psychological well-being and communicative functioning in people who stutter, and what may be done to ameliorate their effects. In addition, it will be discussed how looking at stuttering through a stigma framework helps to contextualize the personal experiences of guilt, shame, and embarrassment around stuttering.
Academy for Motivation and Behavioral Change, The Netherlands
Eva Bos is an experienced trainer and graduate trainer-psychologist. After two bachelors in social psychology and clinical neuropsychology, she graduated with the master's degree in Training and Development where she specialized in providing and developing training in professional interviewing. In recent years, Eva has specialized in Motivational Interviewing and she has been a member of the MINT network since 2018. Eva in five words: touching, humorous, inspired, incisive and open and she also conveys these qualities in her trainings.
Motivational Interviewing is an evidenced-based methodology that gives you insight and tools to increase people's motivation and achieve more results in behavior change. The method is not only applicable in addiction treatment or care, but certainly also in business, education and government settings.Motivational Interviewing is a collaborative conversational style that elicits and reinforces a person's intrinsic motivation and willingness to change.Intrinsic motivation is an important predictor of future (long-term) behavior. The more intrinsic motivation, the better a person can change their behavior. Unfortunately, intrinsic motivation is not just someone saying they like something. It takes more than that!
University College Dublin, Ireland
Maria Stuart is Assistant Professor in American Literature at University College Dublin, and a person who stutters. Her research focuses on literary/cultural representations of dysfluency, with particular focus on rewriting the cultural narratives around dysfluency. In 2018 she organized an interdisciplinary conference on dysfluency at UCD and was PI for the subsequent research project: ‘Metaphoric Stammers and Embodied Speakers: connecting clinical, cultural and creative practice in the area of dysfluent speech' (2019-2022), funded by the Wellcome Trust. She is also part of The Stammering Collective: thestammeringcollective.org.
The emerging field of Dysfluency Studies is an interdisciplinary approach to stammering that is rooted in the humanities and social sciences but in dynamic conversation with clinical practice. This paper will draw on some of the most recent projects in the field (the Wellcome-funded ‘Metaphoric Stammers and Embodied Speakers: connecting clinical, cultural and creative practice in the area of dysfluent speech' and The Stammering Collective), to explore the different disciplines and voices (stammering and non-stammering) that animate this new area of research and practice. Despite differences in disciplines/perspectives, we have a shared investment in resisting the pathologisation of the stammer, its conceptualisation as a speech ‘disorder' in search of a cure. Instead, we explore emerging clinical and cultural narratives (across literature, film and the visual arts) that challenge concepts of ‘normal' speech in favour of vocal difference and diversity, counternarratives alert to the generative, expressive power of dysfluency.
Health Service Executive, Ireland, ECSF, EFS
Mary O'Dwyer, PhD, is a speech and language therapist who works with children and adults who stutter and their families. Her main interest is in supporting people to gain knowledge about stuttering and openness about being a person who stutters. Narrative practice is a main component in her work. She has researched and published on the topic.
Health Service Executive, Ireland, ECSF, EFS
Fiona Ryan, PhD, is a Specialist Speech and Language Therapist working collaboratively with children, adolescents and adults who stutter. A graduate of the ECSF, her research interests include exploring a narrative approach to therapy particularly children's creative expression and responses to resisting existing dominant narratives of stuttering.
Stuttering has many definitions and the experience of stuttering is unique to each individual. Stuttering per se does not need to be problematic yet many who stutter report that they have experienced it as just that. Narratives are how we make sense of, and give meaning to our experiences. They have been described as the organizing principle of all human action and of giving meaning to experience (Bruner, 1986; Mattingly & Garro, 2000). The stories or narratives which people who stutter tell about their stuttering vary as do the stories of significant people involved in the lives of children who stutter. The experience of stuttering is narrated by all involved and this presentation explores how these stories about stuttering can lead to it being experienced as a problem or an experience to be celebrated. Identity is ‘storied' and narrated: as new experiences occur, they are assimilated and integrated into the story of our self (McAdams, 1993; White & Epston, 1990). How we view and talk about ourselves and others in the stuttering community impacts on our identities. Some experiences we have may not fit with the dominant story of the self and may challenge our storied identities; such challenges create space for growth and reauthoring the narrative (White, 2007).
University of Iowa, United States of America
Dr. Naomi Rodgers is an assistant professor at the University of Iowa (USA). Her interdisciplinary program of research centers on the psychosocial factors associated with stuttering experiences and therapy. Coupled with her background as a stutterer and stuttering therapist, she draws inspiration from the fields of behavioral health, cognitive science, and counseling psychology.
Durable change in stuttering therapy requires clients to actively engage in new communication and coping behaviors. However, clients begin the change process with different levels of readiness to engage in those new behaviors. Clinicians who consider a client's readiness to change can maximize engagement in the change process, thereby improving long-term outcomes. In this talk, attendees will learn about the "Stages of Change" and methods for exploring a client's change readiness through assessments and motivational interviewing. This ongoing assessment involves understanding what clients want to change, their perceived ability to make those changes, and their personal reasons for wanting to make those changes while co-developing a change plan that aligns with the client's values. Evidence supports the use of cognitive activities for clients early in the change process, and behavioral activities for clients later in the change process. Specific therapeutic applications for adolescents and adults who stutter will be discussed.
Statped, National Service for Special Needs Education & Nord university, Faculty of Education and Arts, Norway, EFS
Hilda Sønsterud (PhD) is a speech-language therapist and a clinical researcher in Norway. She works as a Senior Advisor at Statped, as well as an Associate Professor II at Nord university. Hilda works with treatment and research related to stuttering and cluttering and provides clinical practice and supervision for SLT students and SLTs. She is a national representative in the International Cluttering Association (ICA).
Stuttering affects people in individual ways, and there are multiple factors which may influence a person's goals when seeking stuttering therapy. The rationale underlying the work of Sønsterud and colleagues (2019, 2020, 2022), is that adherence and effectiveness will be greater if the stuttering therapy accommodates personal variability in needs and preferences. Within this perspective, SLTs need to be sensitive to clients' motivation, needs, goals, values, and responses in therapy. Obviously, the individual's needs and goals may change over time, as could the readiness for therapy. This in turn accentuates the necessity for SLTs to be able to work even more flexibly.The working alliance between SLTs and persons who stutter matters. Positive therapy outcomes may result from a non-linear interplay of multiple factors. The concept of the working alliance has its roots in psychodynamic theory, and this concept represents a proactive collaboration of clients and therapists across therapy sessions (Flückiger et al., 2018). By improving our understanding of the clients' individualized and context-sensitive goals, wishes and responses to therapy, we can strengthen the collaborative process, as well as improving the therapy outcome.
Academy for Motivation and Behavioral Change, The Netherlands
Eva Bos is an experienced trainer and graduate trainer-psychologist. After two bachelors in social psychology and clinical neuropsychology, she graduated with the master's degree in Training and Development where she specialized in providing and developing training in professional interviewing. In recent years, Eva has specialized in Motivational Interviewing and she has been a member of the MINT network since 2018. Eva in five words: touching, humorous, inspired, incisive and open and she also conveys these qualities in her trainings.
Motivational Interviewing was developed in America from 1980 by Prof. W.R. Miller and Prof. S. Rollnick. As a new treatment method for problem drinkers, where change was hindered by a lack of motivation. Motivational Interviewing focused on eliciting and increasing intrinsic motivation. The attitude was also different: not authoritarian, but cooperative and supportive. With great results.
Motivational Interviewing is widely applicable. Since the 1990s, Motivational Interviewing has also been experimented with in other areas. Especially in situations where changing long-term habitual behavior and self-management were the goals, Motivational Interviewing proved to be effective. It is now widely used in health care due to the increasing importance of self-management.
Mainly because of its measurable results, Motivational Interviewing is rapidly gaining popularity in the Netherlands. The effectiveness of this method has been substantiated through various (inter)national scientific studies. Because of these results and the enthusiastic and positive experiences from the field, the method is rapidly being applied in more and more settings.
Basic attitude
MI starts from a basic attitude (spirit). Mastery of MI conversation techniques alone, does not in itself automatically lead to an MI conversation. The basic attitude is fundamental and consists of four elements:
I. Collaboration (partnership): The client and professional work together as partners. The professional brings content expertise, the client knowledge of himself, his circumstances and his previous attempts to change.
II. Eliciting: The change objective (focus), reasons for change, the change plan and hope are elicited from the client - not imposed.
III. Accept (acceptance): The client is accepted as he is, creating space in which he can become who he wants to be. His autonomy is respected and supported. When recognition is given that the client has the right not to change, space for change often arises.
IV. Compassion: The well-being of the other is consciously put first. When working from the basic attitude of MGV, a professional has more of a guiding role, rather than that of driver or silent co-driver.
Processes
MI consists of four sub-processes that can take place sequentially, repeatedly or simultaneously.
- Building and maintaining relationships
- Focusing - choosing direction
- Eliciting
- Plan
The processes are like steps; each process rests on the previous step. Thus, processes are never finished: they carry the next step(s). In an MI conversation, you are dancing up (and sometimes down) the steps:
- without a good working relationship you won't make much progress
- eliciting change language is only possible if there is a focus - an intended change
- planning only makes sense if motivation and trust are sufficient - often these will have to be elicited
Sometimes you have to go down the stairs again because a process requires renewed attention.
Health Service Executive, Ireland, ECSF, EFS
Mary O'Dwyer, PhD, is a speech and language therapist who works with children and adults who stutter and their families. Her main interest is in supporting people to gain knowledge about stuttering and openness about being a person who stutters. Narrative practice is a main component in her work. She has researched and published on the topic.
Health Service Executive, Ireland, ECSF, EFS
Fiona Ryan, PhD, is a Specialist Speech and Language Therapist working collaboratively with children, adolescents and adults who stutter. A graduate of the ECSF, her research interests include exploring a narrative approach to therapy particularly children's creative expression and responses to resisting existing dominant narratives of stuttering.
Narrative Practice (NP) was developed by White and Epston (1990; 1998) and is "a respectful, non-blaming approach...which centres people as the experts in their own lives" (Morgan, 2000). People seeking help and support are facilitated to re-author a problem-based story to a preferred narrative that better fits with their hopes, dreams and ambitions for living through focusing on their skills and strengths.
This workshop will introduce the principles of NP and applications of NP to working with people who stutter. Personal stories develop and change within the context of wider discourses about stuttering; some of which are based on normalising practices. The recognition and the deconstruction of dominant discourses which do not fit for an individual is a key component of narrative practice.
In this workshop, some of the "taken for granted" assumptions that underlie therapeutic practices will be identified. Key concepts within narrative practice will be explored including externalization, re-authoring, thin and thick descriptions, absent but implicit aspects of identity and the interaction between identity and action. Examples will be provided which are drawn from clinical practice and the workshop will invite participants to actively explore narrative processes.