Consulting clients about stuttering therapy: a qualitative study - Margaret Leahy
Jan Logan reports from the 6th Oxford Dysfluency Conference, 2002

I was eager to attend Margaret Leahy's presentation as I am particularly interested in personal narratives of people who stammer and was keen to hear the client's perspective on therapy.

Margaret initially outlined the importance of seeking clients' views on therapy, identifying relevant factors underpinning client involvement:

Increased user involvement in decision-making
The need for professional accountability
Focus on value for money
The rise of the disability movement and self-advocacy
Increased trend towards working in partnerships

She considers collaboration with clients important for therapists to develop their professional knowledge. In doing so we recognise the client as an expert. Areas included in the study were:

Past impact

Here, the importance for clients of having the opportunity to talk about past experiences of stammering was highlighted.

Impact on education

Experience of teasing or bullying at school was explored. Again it was important for clients to share experiences and the depth at which these were expressed was significant. However, it was clearly not a 'victim' response but about people wanting to share something of 'where I have been'.

Positive experiences

All clients identified some benefits of stammering. These included, increased self-awareness and sensitivity, strength, a shift in values (for example, putting stammering in perspective) and friendships developed as a result of stammering.

What is successful therapy?

While for most clients their initial goals were to eliminate stammering, these changed over time to being more in control of stammering and more comfortable with their self and their stammer.

Therapy efficacy

Reports were more mixed here. Some experience of failure was reported. Other reports (in particular people recently completing an intensive course and those in individual therapy) were of achieving goals.

Client factors for success

Outcomes were reported to be reliant on the clients' contribution, their openness, willpower, honesty, motivation, and acceptance of dysfluency

Therapist factors

Equality in the relationship was central with the therapist's role of a facilitator/enabler with the ability to guide, not push. They need a thorough knowledge of stammering, a positive attitude, patience, sensitivity, and kind-heartedness.

I learnt a great deal from this presentation and believe clients' contributions, such as those outlined above, make an invaluable contribution to our understanding of stammering and therapy.

Margaret Leahy is based at Trinity College, Dublin.

From the Winter 2002 edition of Speaking Out