Personal Construct Psychology emphasises that people can change. Peggy Dalton, who helped pioneer PCP and its use in a range of communication problems as well as in stammering, summarises the approach and its development.

Three decades ago two important things happened: the Association for Stammerers was created (later to be re-named BSA) and George Kelly's Personal Construct Psychology (PCP) was introduced into the treatment of stammering. As I was mixed up in both these events it was thought that I might give an account, particularly, of the development of the PCP approach over this time.

"we needed something which affected not only speech behaviour but the person's core sense of self"

Fay Fransella, a clinical psychologist, now a professor, wrote a book called Personal Change and Reconstruction. It was based on a research project where she set out to test her hypothesis that fluency would increase with an increase in the meaningfulness of being fluent. In other words, while the emphasis in treatment at that time was on getting rid of stammering, she placed the emphasis on elaborating fluent speech and speech situations, the fluent self. As you well know, someone who stammers can describe in great detail what it is like to stammer, how it feels, physically and emotionally, what kind of situation or person will trigger dysfluency, and so on. He or she will have little to say about times of fluency. These seem not to be registered. They can even be denied. Her hypothesis was proved and those of us who worked with people who stammered and were dissatisfied with the existing approach were immediately very interested.

Up until then we were largely using 'techniques' which help people to be fluent: syllable-timed speech, prolonged speech and others. There were 'programmes' for initiating fluency gradually, such as GILCU. There were of course, many therapists who were also trying to deal with the psychological aspects of stammering: the anxiety, the sense of helplessness, even the anger that many people experience. We talked about 'changing attitudes'. And this work often did some good. But it wasn't strong enough and most people could not maintain improvement. There were, also, people who were happy to use syllable-timed speech or prolonged speech, although it didn't sound natural. But we really needed something more comprehensive, which affected not only speech behaviour but the person's core sense of self.

Personal construct therapy entails, first of all, exploring the person's notions of themselves and other people. Therapist and client together build up a picture of the client's most important theories about their world. Do they see speech as the be-all and end-all? Do they compare themselves unfavourably with others, forgetting their own strengths and abilities? Often they will be so convinced of failure that they avoid some situations altogether. In order to test out that belief, they are asked to experiment with handling things in a different way. For example, taking things slowly instead of charging in, hoping to get there before the stammer did! Or deliberately making and maintaining eye contact when speaking, instead of looking away. More often than not, they would find that people were listening with interest instead of looking embarrassed or disapproving as they had supposed. With a combination of exploration, experimentation and discussion, people's view of things can change until their attention ceases to be on fluency alone.

As time went on, more and more of us undertook PCP training and a Diploma Course was created. We incidentally found that PCP was an appropriate approach for many other speech and language difficulties. Since that time Kelly's ideas have spread (albeit slowly) and in today's stringent times we are just about holding our own. There is still the old divide between working from a psychological point of view and from a behavioural point of view. I've found it possible to use both approaches where the stammer is severe. What most pleases me is where people not only become more fluent but value themselves for other attributes.

Peggy Dalton remains deeply interested in stammering but now works with a range of other psychological difficulties, finding that the two lines of work compliment each other. She is involved in training courses for PCP, where the majority of students are speech therapists. She has written three books focused on communication problems and three on PCP.

There is more on PCP and stammering in a paper by Margaret Leahy for the 2002 International Stuttering Awareness Day Online Conference: www.mnsu.edu/comdis/isad5/papers/leahy.html

From the Autumn 2008 edition of Speaking Out, page 18.