Becoming an Effective Clinician for People Who Stutter: You Can Do It!

The purpose of this issue of Seminars in Speech and Language has been to help speech-language pathologists improve their ability to help people who stutter. One feature of this update that readers will certainly notice is that it has not been a comprehensive presentation of all possible approaches to treating stuttering. The knowledge base in stuttering treatment is vast, and presenting a full summary of the literature in a single issue of journal would be impossible.

Of course, it is important for clinicians to have a good understanding of the background literature in the field. As seen in Bernstein Ratner's article, there has been a tremendous amount of research on stuttering in recent years, some of which has substantially altered earlier understanding of the disorder. Current findings about the genetic and neurological underpinnings of stuttering have significant consequences for treatment, as do findings about the broader consequences of stuttering for people's quality of life and the effectiveness of various treatment approaches. Still, much work remains to be done, and new discoveries and refinements appear in the research literature regularly.

Regarding treatment, this issue has not attempted to teach clinicians “everything they need to know.” Instead, the purpose has been to provide an overview of several key features of a selection of treatments, including the parent-child interaction approaches for preschoolers and their families (Millard and Cook), a broad-based set of strategies based on a comprehensive view of stuttering in school-aged children (Yaruss), and both cognitive and speech-motor restructuring strategies for adults (Blomgren). There are certainly many other treatment approaches available, and readers are encouraged to use these overviews as examples of ways they can enhance their clinical skills and to consult the literature for information about other relevant techniques.

Even if a thorough review of techniques had been presented, this would still not provide readers with a complete understanding of how to treat people who stutter, for as Bernstein Ratner noted, we do not yet have sufficient information to be able to determine which treatments might be best for which individuals. Therefore, even when they are equipped with a solid knowledge of various treatment approaches, clinicians must still have the ability to become attuned to their clients. As Manning emphasized, developing a therapeutic alliance with clients is critical to serving the unique needs of each individual or family, and this forms the foundation for helping clients achieve meaningful and significant changes in their lives. Quesal explained that one of the most important ways clinicians can develop this alliance is to cultivate a strong sense of empathy for people who stutter. The more clinicians understand the experience of people who stutter—including the reactions of listeners and others, as described by Healey—the better able they will be to provide the expert help that people who stutter need (Millard and Cook). Thus, the overall take-home message of this issue must be that the specific techniques used by clinicians are not necessarily as important as the broader understanding that clinicians can develop about stuttering—and about the specific individual or family with whom they are working at the time.