We would like to alert you to some exciting changes taking place at City Lit next year. In May 2005, speech therapy will be moving into City Lit's brand new building in the heart of Covent Garden, London. People who stammer will be attending their therapy courses alongside students in drama, music, languages and many other interesting courses which come together to make City Lit such a vibrant and exciting place to learn.

New course

In January 2005 we will be running our new intensive course - Stammering therapy: an integrated approach - for the first time. This new course offers an additional tool (vocal fold management technique) which sits alongside other ways of handling moments of stammering (block modification). Our hope is that using vocal fold management (combined with other strategies) will enable people to have a greater level of fluency than might be possible with a straightforward block modification approach. Not forgetting the central importance of offering people an opportunity to explore their feelings and beliefs about stammering, the course will continue to address the psychological aspects of stammering.

We are running this course twice next year and approach this change with excitement and optimism. We will keep readers informed about the outcome of this approach. We are particularly interested in hearing the client's perspective on therapy and hope that people attending the course will contribute to the evaluation by sharing their experiences with us.

Why a new course?

Over the years we have made developments to our Block Modification therapy programme and introduced a range of topic-based workshops in order to better meet the needs of people who stammer. Our therapy approach has continued to be based on block modification (C. Van Riper, 1973) and avoidance reduction therapy (J. Sheehan, 1975) which sit firmly within the 'stammer more fluently' approach to stammering therapy. This is where the client is encouraged to reduce their avoidance of stammering and to find ways to stammer more easily and smoothly. This contrasts with the 'speak more fluently' approach where the client is taught a technique to replace stammered speech with fluent speech.

At the American Speech and Hearing Association conference in 2001 and the Oxford Dysfluency Conference in 2002 we were particularly impressed with the work of Catherine Montgomery (the director of the American Institute for Stuttering in New York). Her programme is based on an integrated model of stammering therapy and draws on both 'stutter more fluently' and 'speak more fluently' approaches, combining desensitisation with stammering management and fluency shaping techniques¹. While in the past these two approaches have seemed mutually exclusive, Catherine is successfully combining them with positive results.

To learn more about this approach Carolyn Cheasman and Rachel Everard visited the USA in 2003 to observe Catherine working. Carolyn and Rachel were inspired by their experience and returned from the USA feeling optimistic about bringing together what we had previously felt to be distinct and opposing approaches.

The decision to make this change has not been easy and we have done much talking, thinking, reading and reflecting on our experience as therapists and our beliefs about stammering. Rachel and Carolyn have shared personal experiences of stammering and therapy which has been invaluable. We remain committed to the ideas of Van Riper and Sheehan.

For more information: City Lit page or the City Lit website at www.citylit.ac.uk/stammeringtherapy

References:
Sheehan, J., (1975) Conflict theory and avoidance-reduction therapy. In J. Eisenson (Ed.), Stuttering, a second symposium. New York: Harper & Row
Van Riper, C., (1973) The treatment of stuttering (2nd ed.). Englewood Cliffs, NJ: Prentice-Hall
1. See Jan Logan's article: An integrated treatment model for effective stuttering management. In Speaking Out, Winter 2002

From the Winter 2004 edition of Speaking Out

See also:
Fluency techniques and the skills to use them in one course - Winter 2006, clients and the City Lit team talk about results so far.
Catherine Montgomery, integrated therapy - summary of conference call in May 2005.