A Client-Centered Decision-Making Model Based on Phonology as Human Behavior (PHB)

Abstract This paper describes a model for clinical decision-making based on the theory of Phonology as Human Behavior (PHB). This model can be used to guide decisions about commencing therapy as well as decisions about prioritizing therapy goals. The model stresses the role of communication in determining the definition of therapeutic benefit. The therapeutic process is seen as a scale, where communicative gain and effort expended are to be balanced. The client is seen as the ultimate judge of the value of the communication improvement gained from intervention as compared with the effort to be expended. The effort which is related to the actual change in behavior is analyzed for difficulty in the context of PHB. Applications of the model to disorders of phonology/articulation, voice, fluency, grammar, lexicon, and pragmatics are illustrated with brief case descriptions.