When asked to review a book looking at one approach to stammering therapy current in Hungary, I was eager to find out what was happening in an Eastern European country. However, I was rather put off by the title which seemed to suggest a traditional and more medical approach to therapy. In addition to this, I found the notion of "treating stutterers" quite alienating. For me the term "stutters" is a label which denies individuality, the person who stammers, and seems to me to be more about working with a disorder rather than a person. I find this difficult to reconcile with the way that I prefer to work.

My initial reaction was reinforced on reading the book. What Vekassy sets out to do is present a new approach to therapy. He claims that increased understanding about stammering has led to the need for a more complex form of therapy which is holistic, and includes attention to the psychological aspects of stammering. The approach to therapy includes elements of several professions and approaches combining: "speech therapeutic and psychological procedures with the medical examination". The age range for whom this "treatment" is felt to be appropriate is from eight years upwards.

Whilst I had a sense of what Vekassy was trying to do in this book. I did not feel that it offered any new or original insights into stammering therapy. I found it extremely difficult reading and felt that this was to do both with the language and the content. Whilst it may have lost much in translation, the language was dense and quite distancing.

What created distance for me from the start was that the approach was firmly based within the medical model of therapy. This places the therapist in the position of the "expert", the person who has the knowledge, who knows best. His/her role is to chariot an "examination", thereby taking much of the responsibility for finding resolution to the problem. The client is left with little or no responsibility for bringing their own expertise and experience, as people who stammer, to therapy.

What Vekassy offers is a deficit model of stammering, and he talks of "communicational deficiency", "damage" and "malfunction". I found his examples of "general characteristics" of people who stammer to be particularly unhelpful, offering an extremely negative and stereotypical profile. The medical model was further endorsed by the inclusion of medication as a supplement to therapy. Although therapy embraced a range of ideas, ultimately it was prescriptive and presented a traditionalist approach packaged in a holistic framework.

I would be extremely hesitant to recommend this book. It was clearly an attempt to bridge the gap caused by Hungary's many years of isolation from other approaches to stammering therapy and is a result of them now gaining access to new ideas and approaches. However, in the end, what Vekassy presents is a traditionalist and particularly unclient-centred view to which I felt totally unable to relate.

Reviewed by Jan Logan, BSA Speech Therapy Adviser, in the Summer 1995 issue of 'Speaking Out'

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