How Can CBT Help People Who Stutter?

by Team Stamurai

When an individual knows what to say, but their speech is interrupted by involuntary repetitions, prolongations and blocks, they might have a childhood onset speech fluency disorder or stutter.

Early intervention of stuttering in childhood may improve a person's fluency and ease of speaking.

Most children who stutter do not receive timely therapy and they grow up into teens and adults with anxiety and fear of stuttering. In such cases, stutter has profound negative impacts on the mental health of the person.

What Does Cognitive Behavioral Therapy Address?

Negative psychological impacts of untreated stuttering (mild and severe) may lead to anxiety, self-doubt, fear, frustration, avoidance, anger, and a negative attitude towards speaking in public in adulthood.

A relapse after stuttering treatment may cause severe demotivation, anxiety disorder, and depression.

Negative emotions and attitudes may interfere with the individual’s ability to participate in daily activities. It may even diminish their overall quality of life.

Therefore, treating stuttering with speech therapy and exercises may not be enough to motivate a person towards fluency. A teen or adult who has been stuttering for years requires more than conventional speech therapy to accept stuttering or work towards better mental health.

Cognitive behavior therapy (CBT) targets the biopsychosocial crises experienced by those who stutter. It is a multi-disciplinary approach that focuses on the behavioral, cognitive, and emotional aspects of stuttering.

It is important to note that CBT is not a cure for stuttering. It is a form of talking therapy under the guidance of a professional and qualified psychological counselor or psychotherapist. It can help an individual deal with the effects of stuttering in their life.

What to Expect During the First Days of Cognitive Behavioral Therapy?

Receiving pertinent information about stuttering is part of CBT for the client and their family. The psychotherapist addresses the client’s avoidance behaviors and unhelpful thoughts.

The next step typically involves helping the client face their feared and avoided situations. The therapists chalk out behavioral experiments that enable the client to face these situations, such as speaking in public.

Based on their interactions with those involved in the experiment, the therapist may guide them to modify their stuttering-related behaviors. It facilitates a slow but steady modification of the client’s self-focused behavior over the sessions.

How Can CBT Help You?

The therapist analyzes the cognitive errors and their observer’s perspectives. Both of these are crucial for the modification of behaviors associated with stuttering.

While cognitive therapists refrain from labeling behaviors as “right” or “wrong”, they also encourage their clients to think –

  • What are the reasons behind the negative emotions that they are feeling during or after an interaction?
  • Is there another perspective? Will another way of looking at the interaction give their actions and emotions a new meaning?
  • Is there evidence that what they are feeling may not be entirely true?
  • Can there be another version of the truth that they can explore by themselves?

Often, people jump to conclusions and predict the worst outcomes based on past unpleasant interactions that bear resemblance to the current ones. CBT can help them reduce these cognitive errors by adopting a different point of view and equipping them with skills that may help them respond differently.

Anxiety, negative thinking, and withdrawal from social interactions result in a thinking trap. The vicious cycle can be broken by adopting this line of self-inquiry. With CBT, the clients can learn to challenge their fear of negative interactions. They may acquire the necessary skills that can help them deal with similar issues in the future.

The common components of CBT that may help in managing anxiety include attentional training, cognitive restructuring, and behavioral experiments.

  • Attentional training – Working on the skills that help the client focus on their actions, words, emotions, and surroundings at a given time.
  • Cognitive restructuring – Developing the skills necessary for recognizing the cognitive errors, analyzing them, and taking appropriate action accordingly.
  • Behavioral experiments – Learn strategies that help the individuals deal with situations that evoke negative feelings associated with stuttering.

The CBT approach may include one or more methods of cognitive interventions and a dysfunctional thought record scheme.

A dysfunctional thought record scheme works through self-monitoring. It focuses on the identification and analysis of the dysfunctional thoughts of the client. The therapist helps the client replace these dysfunctional or negative thoughts with positive, functional, and more realistic ones.

The goal of a dysfunctional thought record scheme is to help the client practice alternate patterns of behavior that may change their cognitive distortion.

Cognitive interventions include sessions for the identification and modification of cognitive distortions, examination of facts, listing the alternatives, and enlargement of one's perspectives.

Can Mindfulness Work With CBT During Stuttering Treatment?

Studies show that CBT works best when coupled with mindfulness techniques. Some of the more popular mindfulness approaches leveraged in stuttering management including mindfulness-based stress reduction (MBSR), acceptance and commitment therapy (ACT), and mindfulness-based cognitive therapy (MBCT).

Combining CBT with mindfulness techniques can help a person become more aware of their speech and develop a positive attitude towards communication and social interactions. In addition to reducing the negative emotions and attitudes associated with stuttering, these therapeutic strategies may help the clients improve their quality of life, self-esteem, and control over their emotions.

How Long Does CBT For Stuttering Take To Work?

The duration of CBT depends upon the severity of one’s symptoms. Typically, it may range from 3 months to 3 years.

The goal of therapy is to restore the client’s resilience and enable them to think with a new perspective. The therapist tries to empower the client to set new goals and achieve them too. Therefore, the duration of therapy depends greatly on the individual needs of the client.

The client may require frequent sessions during the beginning of CBT. The frequency of sessions may reduce as they begin to show significant improvement. The client may also require booster sessions during follow-ups to maintain their positive outcomes or talk about new issues.

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