Multidimensional Individualized Stuttering Therapy Outcomes At 24 Months Post Clinic: An Embodiment and Awareness Perspective.

Abstract

Purpose: Multidimensional Individualized Stuttering Therapy (MIST) is based on proactive collaborative work and shared decision making between client and clinician with the goal of identifying individual case-appropriate procedures and therapy elements in a manner that is meaningful and context-sensitive for each person. MIST combines value- and awareness-based elements from acceptance and commitment therapy (ACT) with stuttering and speech modification interventions. In keeping with the principles of ACT, we locate mindfulness as part of an embodied practice facilitated through a collaboration between the person who stutters and the speech-language therapist.

Method: The aim of this study was to see whether the positive results of MIST recorded at 12 months post-therapy remained stable at 24 months post-therapy and to consider the role of embodiment and awareness within MIST. Fifteen of 18 adults already enrolled in a treatment study (2015/FO12451) took part in a single-group repeated-measures design. They completed measures of stuttering severity, impact of stuttering, unhelpful thoughts and beliefs about stuttering, general anxiety symptoms, and fear of negative evaluation.

Results: There was a significant reduction of stuttering severity and negative impact of stuttering from pre-therapy to 24 months post-therapy. Unhelpful thoughts and beliefs about stuttering, symptoms of general anxiety, and fear of negative evaluation were reduced at 12 months post-therapy, and these values remained stable at 24 months post-therapy.

Conclusions: MIST was associated with positive outcomes at 24 months post-therapy, suggesting a possible connection between the person-centered approach and longer-term benefit. Findings are discussed within the context of mindfulness and embodied adjustment, and shared client-clinician decision making. The absence of a control group is a limiting factor regarding certainty of interpretation. Future research is therefore needed on collaborative and individualized approaches to stuttering therapy that include embodiment and awareness perspectives.