Stuttering: Cognitive Restructuring Approach

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Introduction “Stuttering has been described as a motor speech disorder that interrupts the timing and/or coordination between the respiratory, laryngeal and vocal tract subsystems of speech…. [including] repetitions, prolongations, and cessations of sounds interwoven with elements that exists below the surface“ (Beilby, 2010, p. 133). One of the elements that can exist below the surface is anxiety. Anxiety, defined by Iverach, Menzies, O 'Brian, Packman, & Onslow, (2011) is a complex psychological construct composed of verbal cognitive behavioral and physiological components. The experience of anxiety can include thoughts and expectancies of negative events, escape or avoidance behaviors, and physical sensations such as muscles tension and…show more content…
Therefore, there is a need to utilize a more comprehensive approach in stuttering treatment, including both traditional aspects such as fluency shaping, in addition to cognitive restructuring approaches. One cognitive restructuring approach is cognitive behavioral therapy. Cognitive behavioral therapy (CBT) is a psychological and anxiety reducing treatment approach, which mainly centers on coaching the individual who stutters to monitor his or her speech in addition to viewing their stutter as a component of their speech rather than their identity. (Blomgren, 2010). The main components of CBT include “exposure, cognitive restructuring, behavioral experiments, and attentional training” (Menzies, O’Brian, Onslow, & Packman, 2009, p. 189). Exposure is a longstanding hallmark for many behavioral therapy programs which aim is to target anxiety. During exposure, the individual is exposed to a situation that would typically cause an overwhelming amount of anxiety; the individual is then taught to remain in the uncomfortable, other than reverting to typical strategies of avoidance situation until anxiety begins to decrease. In CBT programs used specifically for stuttering treatment, exposure is used to practice fluency in anxiety-ridden situations in a…show more content…
In this system articles are rated based on eight standards, including a clear purpose statement, objective literature review, suitable methodology, repeatability of intervention, reliability measure, sufficient sample size, clear results, generalizability of findings. Scores of 1, 2, and 3 were given in eight areas leading to a total possible score of 24. A score of 1 indicated insufficient information; a score of 2 meant adequate information, and a score of 3 equaled thorough, clear, and concise information. Articles were also rated by level of evidence (table 2). 1A equaled a meta-analysis of multiple well designed controlled studies, 1 equaled well designed randomized controlled trials, 2 equaled well designed non-randomized controlled trial (quasi-experimental), 3 equaled non experimental designs, and 4 equaled expert opinion

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