A clinical note on psychotherapy for stuttering

IOURNAL

OF FLUENCY

DISORDERS

2 (1977),

253-255

Clinical Note A Clinical Note on Psychotherapy for Stuttering 1. Michael Dalhousie

Webster

University,

Wolpe

(1966)

various

Halifax,

reviewed

or much Over

population

years,

reporting records

that

though

all

evaluated

language

period.

subjects

trolled

Institute

who

in

usage among scale

evaluation

frequency

scale was disorder

of patients

they

speech

treatment

moment

were

signal

even each

by one of

and at discharge.

It

because

no

used and there was no uniformity

of the speech

of

used by the speech

corrected,

Rehabilita-

study of the psychotherapeutic

the six psychotherapists

generated

seen at

of this study,

only,

of their

before

ordinal

counts of dysfluency

speech

were

at any given

for purposes

of the quality

of the

individual

1969 and 1972. On the average,

quality

scales of any sort were

review

and/or

as the Speech

psychotherapy

pathologists

a large clinical

(i.e., no concomitant

(then known

in

How-

for stuttering. group

This group

to make any systematic

independent

somewhat

conducted

received

Fortunately,

received

speech

varying

2 to 6 hours per week

in terms of the fluent

The improvement treatment

for

Brody

is a psychoneurosis.

of psychotherapy

problems.

in therapy

time

certified

outcomes

and

as “apparently

reveals no studies involving

in New York City between

was not possible quantifiable

described

is a report on a recently

and Hearing were

during

in 1941

(although

as the sole form of treatment

tion Institute) 85 persons

theorists

the efficacy

paper

for their fluency

the Speech

eight

many

of 648 stutterers

psychotherapy therapy)

were

have held that stuttering

of the literature

The present clinical

the effects of psychotherapy

by Knight

cases, 426 (37.7%)

approach)

ever, a review

as reported

improved.”

the

theoretical

Canada

studies showing

psychoneuroses

1962. Of 1,129 total cured

Nova Scotia,

signal

performing pathologists

the therapy. in their

level data. Unfortunately, during

moderately

no con-

speech were gathered.

improved,

slightly

postThe

improved,

and unimproved.

@ Elsevier North-Holland, Inc., 1977

253

L. Michael Webster

254

Analysis

revealed that 0 (0%) were corrected, 51 (8%) were moder-

ately improved, 318 (49%) unimproved.

were slightly

Stated differently,

no improvement

improved, and 279 (43%)

597 (92%)

or only slight improvement

tics after psychotherapy

were

of the patients showed either

as independently

in their fluency characterisjudged by certified

speech

pathologists. While

one certainly cannot infer from these data that psychotherapy

had no positive effect on the stutterers, less trepidation fluency

one can infer with considerably

that this form of therapy had little

characteristics

of these individuals.

effect on the gross

It was not possible to deter-

mine from the records if such factors as the quality of psychotherapy, se, or “patient

resistance”

ported above. However, psychotherapy

per

had undue, negative effects on the data re-

as mentioned earlier,

it has been reported that

is apparently quite effective in nearly 40%

of the cases.

Keeping this in mind, it seems reasonable enough to imagine that of the 648 patients treated, one would have involved a joining

expect at least a few hundred would

of those factors often associated with successful

therapy (e.g., proper administration

of treatment, adequate patient moti-

vation, etc.). The data of this report failed to even approximate this expectation. Thus,

while psychotherapy

the stutterers’

psychological

may have had some positive effects on

well-being,

the same treatment

seems to

have done I ittle to amel iorate the fluency problems of the vast majority of these individuals. Contrasting

these results with some of the currently

of behavior therapy for stuttering comparison eral. Wolpe

is interesting

reported effects

in view of Wolpe’s

of the effects of behavior therapy and psychotherapy reported that of 618 cases of various

(1966) in gen-

psychoneuroses,

havior therapy apparently resulted in cure or much improvement (82%)

be-

in 509

of the patients. These data compare favorably with those reported

using behavior therapy techniques ster (1975)

reported that 80%

with stutterers.

For example, R. Web-

of 200 patients achieved levels of 97%

fluency or greater using a behavior therapy technique based chiefly on an operant model. Similarly,

Schwartz

and L. Webster

(1976,

1977)

have

reported that 72% of their 28 subjects achieved fluency levels of 94% or greater when using a modified version Finally,

of the R. Webster

technique.

while it is acknowledged that such outcome comparison are

best made when patients are matched on a number of variables and when

Clinical

255

Note

there is also a matched comparisons

untreated

control

can be considered

effects of large sample

group,

meaningful

nevertheless,

in view

these gross

of the controlling

sizes.

References Schwartz,

D., and Webster,

shaping

program.

Association Schwartz,

L. M. The Efficacy

Paper

National

Convention,

D., and Webster,

Fluency

Shaping

presented

at the

through

Canadian

precision

Speech

and

fluency Hearing

1976.

L. M. A clinical

Program

of a protracted

adaptation

of the Hollins

de-intensification.

1. Fluency

Research

Report,

Precision Dis.,

1977,

2, 3-10. Webster,

R. L. Hollins

1975, Wolpe,

Communication

Institute

Vol.

2, No.

1,

p. 4.

J. The

comparative

clinical

status

of

conditioning

therapies

and

psychoanalysis.

In J. Wolpe,

A. Salter, and L. Reyna (Eds.), The Conditioning

Therapies.

York:

Rinehart

New

Holt,

and Winston,

1966.