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Selvapandiyan J, Das A, Singh GP. Research on psychotherapy in India: A systematic review. Indian J Psychiatry 2024; 66:123-134. [PMID: 38523761 PMCID: PMC10956596 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_682_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/11/2023] [Accepted: 01/02/2024] [Indexed: 03/26/2024] Open
Abstract
We systematically reviewed empirical studies of psychotherapy with Indian clients. We defined psychotherapy as an intervention aimed at treating mental disorders using "talk," which, in a professional medical setting, along with the therapeutic relationship, acquires medicinal value. Besides manual searches in three leading Indian psychiatry journals, we conducted digital searches in PubMed, Google Scholar, and Scopus databases. We found that the commonly practiced evidence-based psychotherapy in India follows the cognitive-behavioral model. Our findings suggest several replication studies which claimed to have used the well-established western models of cognitive behavioural paradigm but have mostly focused on basic behavioural techniques in their protocol. A few innovations were observed, and several essential errors were noted. Innovations include contextual modifications to address the difficulties and challenges faced in service delivery, while errors include deviations from protocol without adequate rationale.
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Affiliation(s)
- Jaiganesh Selvapandiyan
- Department of Psychiatry, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India
| | - Anindya Das
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Gurvinder Pal Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Bhatinda, Punjab, India
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Panzarino R, Vanryckeghem M, Bedwell JS, Wendt O. Relationships Between Psychological Distress and Affective, Behavioral, and Cognitive Experiences of Stuttering. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:262-278. [PMID: 37956694 DOI: 10.1044/2023_ajslp-22-00347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
PURPOSE People who stutter (PWS) are vulnerable to the development of various psychopathological symptoms, although prevalence data are mixed and less clarity exists about factors that potentially influence their occurrence. The current study sought to shed light on the prevalence of self-reported psychopathology in PWS and aimed to identify relationships between affective, behavioral, and cognitive (ABC) experiences of stuttering and psychological distress (PD). METHOD Forty-four PWS were administered the Behavior Assessment Battery (BAB) for Adults who Stutter and the Brief Symptom Inventory-18. The prevalence of clinically significant PD was calculated via BSI-18 global severity index t-score cutoffs. Regression analyses examined relationships between ABC variables of stuttering and PD. RESULTS Participants' BAB scores approximated normative values, while the PD score distribution was similar to that of a nonclinical sample. Nine percent of participants met thresholds for clinically significant PD. All ABC correlates of stuttering significantly and positively correlated with PD scores, capturing considerable amounts of shared variance. CONCLUSIONS Levels of PD in PWS approximate those of the general community, highlighting the existence of psychologically distressed subgroups of PWS. Speech situation-specific anxiety had the strongest relationship to PD, followed closely by one's report of situation-specific speech disruption. To a lesser but still significant extent, PWS' frequency to which they engage in various avoidance/escape behaviors, as well as their communication attitude, predicted levels of psychopathology. These data inform diagnostic and clinical decision making, drawing attention to factors that should be attended to in treatment.
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Affiliation(s)
| | - Martine Vanryckeghem
- School of Communication Sciences and Disorders, University of Central Florida, Orlando
| | | | - Oliver Wendt
- Department of Inclusive Education, University of Potsdam, Germany
- Center for Families and Department of Educational Studies, Purdue University, West Lafayette, IN
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
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Sarani Yaztappeh J, Lorestani E, Zaheri Y, Rezaei M, Mohammadi H, Kakabraee K, Rajabi M, Kianimoghadam AS, Fatollahzadeh S, Mohebi MD. A Study of Emotion Regulation Difficulties, Repetitive Negative Thinking, and Experiential Avoidance in Adults with Stuttering: A Comparative Study. IRANIAN JOURNAL OF PSYCHIATRY 2024; 19:79-88. [PMID: 38420285 PMCID: PMC10896752 DOI: 10.18502/ijps.v19i1.14341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 07/19/2023] [Indexed: 03/02/2024]
Abstract
Objective: Stuttering is a type of communication and fluency disorder that hurts mental and emotional health. It is also associated with a significant increase in both trait and social anxiety. Studies on stuttering in adults have indicated the nature and impact of this phenomenon. In addition, some psychological aspects of this phenomenon remain vague and need further investigation. Therefore, the present study aimed to compare emotion regulation difficulties, repetitive negative thinking, and experiential avoidance between people who stutter and healthy individuals. Method : In this study, 101 people who stutter (43 females and 58 males, with a mean age of 29.55 ± 187 years), as well as 110 healthy individuals (74 females and 36 males, with a mean age of 25.57 ± 489 years) as participants were chosen using the convenience sampling method among those who referred to the speech therapy clinics of Tehran, Iran. Research instruments including the repetitive negative thinking inventory, Difficulties in Emotion Regulation Scale, and Acceptance and Action Questionnaire (AAQ-I) were used for data collection. Data were analyzed using multivariate ANOVA test and Multiple Regression Analysis. Results: The mean age of the participants was 29.55 years in the people who stutter and 25.57 years in the healthy individuals (P < 0.01). The present results indicated that the mean score of experiential avoidance was higher in the people who stutter (M ± SD: 35.74 ± 9.24) compared to the healthy individuals (M ± SD: 8.89 ± 31.11). Additionally, the mean score of emotion regulation difficulties was higher in the people who stutter (M ± SD: 88.75 ± 20.59) compared to the healthy individuals (M ± SD: 64.14 ± 94.94) (P < 0.001). However, there was no significant difference in the mean score of repetitive negative thinking between the people who stutter (M ± SD: 98.45 ± 25.85) and healthy individuals (M ± SD: 93.71 ± 25.24) groups (P > 0.05). There was a significant correlation between experiential avoidance and emotion regulation difficulties in people who stutter (P < 0.01). Experiential avoidance and repetitive negative thinking can significantly predict emotion regulation difficulties in people who stutter (R = 0.65, P < 0.01). Conclusion: People who stutter obtained higher emotion regulation difficulties and experiential avoidance scores than those without stuttering and A significant correlation between experiential avoidance and emotion regulation difficulties was found. Future studies should consider the role of emotion regulation difficulties and experiential avoidance in people who stutter.
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Affiliation(s)
- Jafar Sarani Yaztappeh
- Department of Clinical Psychology, Taleghani Hospital Research Development Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Younes Zaheri
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Rezaei
- Zendegi Clinic, Specialized Center of Psychology and Psychotherapy, Kermanshah, Iran
| | - Hiwa Mohammadi
- Neuroscience Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Keivan Kakabraee
- Department of Psychology, Kermanshah Branch, Islamic Azad University, Kermanshah, Iran
| | - Moslem Rajabi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Amir Sam Kianimoghadam
- Department of Clinical Psychology, Taleghani Hospital Research Development Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saina Fatollahzadeh
- Department of Clinical Psychology, Taleghani Hospital Research Development Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Tiryaki N, Sertan Özdemir R, Karsan Ç, Boyle MP. Turkish adaptation of the self-stigma of stuttering scale (4S): Study of validity and reliability (4S-TR). JOURNAL OF FLUENCY DISORDERS 2023; 78:106020. [PMID: 37948902 DOI: 10.1016/j.jfludis.2023.106020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 09/25/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE This study aimed to adapt the Self-Stigma of Stuttering Scale (4S) into Turkish and evaluate its factor structure, reliability, and validity in Turkish culture. METHODS The original 4S scale was translated into Turkish (4S-TR) using a forward-backward translation technique and was administered to 350 adults who stutter (AWS). To discover latent variables evaluated on the scale, two-factor analyses were performed. Internal consistency and temporal stability were calculated to ensure reliability. Test-retest reliability correlation scores were calculated with multiple applications of the scale within about two weeks. To verify construct validity, participants also completed the Turkish versions of the Self-Esteem Rating Scale-Short Form (BSDÖ-KF) and the Satisfaction with Life Scale(YDÖ). RESULTS The explanatory factor analysis showed three factors explaining 74.76 % of the total variance. The findings were also validated by confirmatory factor analysis. High levels of internal consistency (r = .89) and test-retest reliability (r = .96) were obtained. In terms of construct validity, our findings revealed that self-stigma has a significant negative correlation with self-esteem (r = -.41) and life satisfaction (r = -.38) as was predicted. CONCLUSIONS The findings demonstrate preliminary evidence that the 4S-TR is a viable and valid instrument for self-stigma evaluation in three domains (stigma awareness, stereotype agreement, and self-concurrence). The 4S-TR can be applied for research and clinical purposes in Turkish.
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Affiliation(s)
- Nurten Tiryaki
- Department of Speech and Language Therapy, İstanbul Medipol University, Graduate School of Health Sciences, İstanbul, Turkey.
| | - R Sertan Özdemir
- Department of Speech and Language Therapy, İstanbul Medipol University, Graduate School of Health Sciences, İstanbul, Turkey.
| | - Çağdaş Karsan
- Department of Language and Speech Therapy, Biruni University, İstanbul, Turkey.
| | - Michael P Boyle
- Department of Communication Sciences and Disorders, Montclair State University, Bloomfield, NJ, USA.
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Tichenor SE, Palasik S, Yaruss JS. Understanding the Broader Impact of Stuttering: Suicidal Ideation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:2087-2110. [PMID: 37473446 PMCID: PMC10561962 DOI: 10.1044/2023_ajslp-23-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/01/2023] [Accepted: 04/21/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE Suicide and suicidal ideation are topics that have a long but limited history in stuttering research. Clinicians and clinical researchers have discussed personal and therapeutic experiences with clients who have attempted suicide, died by suicide, or struggled with suicidal thoughts. This study sought to (a) explore the occurrence of suicidal ideation in a sample of adults who stutter; (b) evaluate the relationship between adverse impact related to stuttering and suicidal ideation; and (c) document respondents' thoughts related to suicide, stuttering, and their intersection. METHOD One hundred forty adults who stutter completed the Suicide Behavior Questionnaire-Revised (SBQ-R). Of these, 70 participants completed the Perseverative Thinking Questionnaire (PTQ), and 67 completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES). Participants who indicated at least some tendency for suicidal thoughts on the SBQ-R (n = 95) were then asked a set of follow-up questions to explore their experiences of suicidal ideation related to stuttering. RESULTS Quantitative data indicated that the majority of adults who reported experiencing suicidal ideation associated these experiences with stuttering (61.2%, n = 59). Individuals with higher Total Scores on the PTQ and OASES were predicted to experience significantly higher rates of suicidal ideation and, in particular, a higher likelihood of having more frequent suicidal ideation in the past year. Qualitative analyses revealed that suicidal ideation intersects meaningfully with the experience of stuttering. CONCLUSIONS Data from this study highlight the importance of considering broader life consequences of stuttering that some adults may experience, including suicidal ideation. By being cognizant that clients may develop such thoughts, speech-language pathologists can play a valuable role in identifying and providing necessary support for at-risk individuals. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23699688.
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Affiliation(s)
- Seth E. Tichenor
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
| | - Scott Palasik
- School of Speech-Language Pathology and Audiology, University of Akron, OH
| | - J. Scott Yaruss
- Department of Communicative Science and Disorders, Michigan State University, East Lansing
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McDonagh HDL, Broderick P, Monaghan K. Eye movement as a simple, cost-effective tool for people who stutter: A case study. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2023; 70:e1-e13. [PMID: 37782243 PMCID: PMC10476227 DOI: 10.4102/sajcd.v70i1.968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Access to services remains the biggest barrier to helping the most vulnerable in the South African Stuttering Community. This novel stuttering therapy, harnessing an unconscious link between eye and tongue movement, may provide a new therapeutic approach, easily communicated and deliverable online. OBJECTIVES This study provides both objective and subjective assessments of the feasibility of this intervention. Assessment tools holistically address all components of stuttering in line with comprehensive treatment approaches: core behaviours, secondary behaviours, anticipation and reactions. METHOD On receipt of ethical approval, this single-subject case design recruited one adult (21-year-old) male with a developmental stutter (DS). The participant gave informed consent and completed four scheduled assessments: baseline, after 5-week training, 3 months post-intervention and 24 months post-completion. The study used objective assessment tools: Stuttering Severity Instrument-4 (SSI-4); Subjective-assessment tools: SSI-4 clinical use self-report tool (CUSR); Overall Assessment of Speaker's Experience of Stuttering (OASES-A); Premonitory Awareness in Stuttering (PAiS) and Self-Report Stuttering Severity* (SRSS) (*final assessment). RESULTS The participant's scores improved across all assessment measures, which may reflect a holistic improvement. The participant reported that the tool was very useful. There were no negative consequences. CONCLUSION This case report indicates that this innovative treatment may be feasible. No adverse effects were experienced, and the treatment only benefited the participant. The results justify the design of a pilot randomised feasibility clinical trial.Contribution: The results indicate that this is a needed breakthrough in stuttering therapy as the instructions can be easily translated into any language. It can also be delivered remotely reducing accessibility barriers.
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Affiliation(s)
- Hilary D-L McDonagh
- Department of Health and Nutritional Science, Faculty of Science, Atlantic Technological University, Sligo.
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Moïse-Richard A, Ménard L, Bouchard S, Leclercq AL. Real and virtual classrooms can trigger the same levels of stuttering severity ratings and anxiety in school-age children and adolescents who stutter. JOURNAL OF FLUENCY DISORDERS 2021; 68:105830. [PMID: 33662867 DOI: 10.1016/j.jfludis.2021.105830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 01/30/2021] [Accepted: 02/09/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE Many school-age children and adolescents who stutter experience the fear of public speaking. Treatment implications include the need to address this problem. However, it is not always possible to train repeatedly in front of a real audience. The present study aimed to assess the relevance of using a virtual classroom in clinical practice with school-age children and adolescents who stutter. METHODS Ten children and adolescents who stutter (aged 9-17 years old) had to speak in three different situations: in front of a real audience, in front of a virtual class and in an empty virtual apartment using a head-mounted display. We aimed to assess whether the self-rated levels of anxiety while speaking in front of a virtual audience reflect the levels of anxiety reported while speaking in front of a live audience, and if the stuttering level while speaking to a virtual class reflects the stuttering level while speaking in real conditions. RESULTS Results show that the real audience creates higher anticipatory anxiety than the virtual class. However, both the self-reported anxiety levels and the stuttering severity ratings when talking in front of a virtual class did not differ from those observed when talking to a real audience, and were significantly higher than when talking in an empty virtual apartment. CONCLUSION Our results support the feasibility and relevance of using a virtual classroom to expose school-age children and adolescents who stutter to a feared situation during cognitive behavioral therapy targeting the fear of public speaking.
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Affiliation(s)
- Anne Moïse-Richard
- Marie Enfant Rehabilitation Centre of Sainte-Justine University Hospital Centre, Montreal, Canada; University of Montreal, Canada
| | - Lucie Ménard
- Marie Enfant Rehabilitation Centre of Sainte-Justine University Hospital Centre, Montreal, Canada; Laboratoire de Phonétique, Université du Québec à Montréal, Canada
| | - Stéphane Bouchard
- Université du Québec en Outaouais et Centre Intégré de Santé et de Services Sociaux de l'Outaouais, Canada
| | - Anne-Lise Leclercq
- Research Unit on Childhood, Speech and Language Therapy Department, and Clinique Psychologique et Logopédique de l'Université de Liège, Belgium.
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Selvapandiyan J. Status of cognitive behaviour therapy in India: Pitfalls, limitations and future directions-A systematic review and critical analysis. Asian J Psychiatr 2019; 41:1-4. [PMID: 30826668 DOI: 10.1016/j.ajp.2019.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/16/2019] [Accepted: 02/22/2019] [Indexed: 10/27/2022]
Abstract
Cognitive behavior therapy (CBT) an evidence-based psychotherapy is practiced across the globe with a common cognitive and behavioral fidelity. The focus of this review is about the status of CBT in India based on the analysis of published research on CBT from India. Publication of papers related to CBT in the Indian population is scarce. Among the published researches, the observed practice defects could compromise the overall response from the globally proven CBT interventions. Hence, quality control measures should be put into practice to regulate the application of CBT in India.
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Scheurich JA, Beidel DC, Vanryckeghem M. Exposure therapy for social anxiety disorder in people who stutter: An exploratory multiple baseline design. JOURNAL OF FLUENCY DISORDERS 2019; 59:21-32. [PMID: 30578977 DOI: 10.1016/j.jfludis.2018.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/21/2018] [Accepted: 12/11/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND & OBJECTIVES Social anxiety disorder (SAD) is a debilitating condition, and approximately half of adults who stutter have SAD. Cognitive-behavioral therapy (CBT) has shown promise in decreasing social anxiety symptoms among adults who stutter, but exposure, arguably the essential component for successful CBT for SAD, has been understudied and underemphasized. Aims of this study were to develop an exposure therapy protocol designed specifically for people who stutter and have SAD and evaluate its potential efficacy in reducing social anxiety and stuttering severity using a multiple baseline design. METHODS Six participants received ten sessions of exposure therapy. Participants reported daily social anxiety, and social distress and stuttering severity were evaluated at major assessment points. RESULTS There were substantial reductions in social anxiety and considerable improvements in affective, behavioral, and cognitive experiences of stuttering. No consistent change was observed for stuttering frequency. Gains were mostly maintained after six-months. CONCLUSIONS Results suggest that the novel exposure approach may decrease social distress, but not necessarily influence speech fluency. These findings underscore the importance of the assessment and treatment of SAD among adults who stutter and suggest that the integration of care between clinical psychologists and speech-language pathologists may prove beneficial for this population.
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Affiliation(s)
- Jennifer A Scheurich
- Department of Psychology, University of Central Florida, 4111 Pictor Lane, Orlando, FL 32816-1390, United States.
| | - Deborah C Beidel
- Department of Psychology, University of Central Florida, 4111 Pictor Lane, Orlando, FL 32816-1390, United States
| | - Martine Vanryckeghem
- School of Communication Sciences and Disorders, University of Central Florida, 4111 Pictor Lane, Orlando, FL 32816-1390, United States
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Mongia M, Gupta AK, Vijay A, Sadhu R. Management of stuttering using cognitive behavior therapy and mindfulness meditation. Ind Psychiatry J 2019; 28:4-12. [PMID: 31879440 PMCID: PMC6929220 DOI: 10.4103/ipj.ipj_18_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 06/10/2019] [Accepted: 08/24/2019] [Indexed: 11/29/2022] Open
Abstract
Stuttering is a speech fluency disorder with varied etiological explanations. It is important to identify symptoms early so that adequate and timely intervention can be delivered with focus on management and recovery. Stuttering, besides affecting speech fluency, might have a number of negative psychosocial consequences for the sufferer that may lead to immense anxiety, besides other symptoms. Therefore, it is thus imperative to include multiple dimensions in the holistic treatment of stuttering. Cognitive behavior therapy and mindfulness equip the client with the skills to manage the problems that occur as a result of stuttering. Since the rate of relapse in this condition is high, the chosen therapeutic paradigm must involve booster sessions over a long term. Periodic, detailed assessment would update the therapist about the barriers in treatment and would help in devising appropriate methods to get rid of these hindrances.
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Affiliation(s)
- Monica Mongia
- Scientist II, National Drug Dependence Treatment Centre Ghaziabad, Uttar Pradesh, All India Institute of Medical Sciences, New Delhi, India
| | - Anindya Kumar Gupta
- Department of Psychiatry, Command Hospital Air Force, Bengaluru, Karnataka, India
| | - Aishwarya Vijay
- Department of Education, Jawaharlal Nehru University, New Delhi, India
| | - Raja Sadhu
- Consultant Psychiatrist, Queensland Health Services, Australia
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Affiliation(s)
- Sanjeev Kumar Gupta
- Department of Clinical Psychology, All India Institute of Speech and Hearing, Mysore, Karnataka, India. E-mail:
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Baxter S, Johnson M, Blank L, Cantrell A, Brumfitt S, Enderby P, Goyder E. Non-pharmacological treatments for stuttering in children and adults: a systematic review and evaluation of clinical effectiveness, and exploration of barriers to successful outcomes. Health Technol Assess 2016; 20:1-302, v-vi. [PMID: 26767317 DOI: 10.3310/hta20020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Despite many years of research, there is no certainty regarding the cause of stuttering. Although numerous interventions have been developed, a broad-based systematic review across all forms of intervention for adults and children was needed including views and perceptions of people who stutter. OBJECTIVE The aims of the study were to report the clinical effectiveness of interventions for people who stutter (or clutter), to examine evidence regarding the views of people who stutter and the views of professionals regarding interventions. DATA SOURCES A systematic review of quantitative and qualitative literature was carried out between August 2013 and April 2014. The following electronic databases were searched: (1) MEDLINE, (2) EMBASE, (3) The Cochrane Library (including The Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, Health Technology Assessment Database and NHS Economic Evaluations Database), (4) PsycINFO, (5) Science Citation Index, (6) Social Science Citation Index, (7) Cumulative Index to Nursing and Allied Health Literature, (8) ASSIA, (9) Linguistics and Language Behavior Abstracts, (10) Sociological Abstracts and (11) the EPPI Centre. Reference lists of included papers and other reviews were screened and also key journals in the subject area were hand-searched. REVIEW METHODS The searches aimed to identify (1) evidence of clinical effectiveness in populations of pre-school children, school-aged children, adolescents and adults, and (2) data relating to perceptions of barriers and facilitators to intervention clinical effectiveness among staff and people who stutter. A metasynthesis of the two linked elements via development of a conceptual model was also carried out to provide further interpretation of the review findings. RESULTS A systematic search of the literature identified a large number of potentially relevant studies. Of these, 111 studies examining the clinical effectiveness of interventions, 25 qualitative papers and one mixed-methods paper met the criteria for inclusion in this review. Review of the effectiveness literature indicated evidence of positive outcomes across all types of interventions. Virtually all evidence we identified reported at least some positive effect for some participants. However, there was evidence of considerable individual variation in outcome for study participants. The qualitative literature highlighted the need for programmes to be tailored to individual need with variation at the levels of the intervention, the individual and interpersonal/social elements. Metasynthesis of the data highlighted the complexity of elements that need to be considered in evaluation of long-term impacts following stuttering interventions. LIMITATIONS Around two-thirds of the studies were considered to be at higher risk of bias. The heterogeneous nature and variability in outcomes meant that we were unable to complete a meta-analysis. CONCLUSIONS Although much of the evidence we identified was from studies at risk of bias, it is suggested that most available interventions for stuttering may be of benefit to at least some people who stutter. There is a requirement for greater clarity regarding what the core outcomes following stuttering intervention should be and also enhanced understanding of the process whereby interventions effect change. Further analysis of those for whom interventions have not produced a significant benefit may provide additional insights into the complex intervention-outcomes pathway. STUDY REGISTRATION This study is registered as PROSPERO CRD42013004861.
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Affiliation(s)
- Susan Baxter
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Maxine Johnson
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Lindsay Blank
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Anna Cantrell
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Shelagh Brumfitt
- Department of Human Communication Sciences, University of Sheffield, Sheffield, UK
| | - Pamela Enderby
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Elizabeth Goyder
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Baxter S, Johnson M, Blank L, Cantrell A, Brumfitt S, Enderby P, Goyder E. The state of the art in non-pharmacological interventions for developmental stuttering. Part 1: a systematic review of effectiveness. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2015; 50:676-718. [PMID: 26123259 PMCID: PMC4755200 DOI: 10.1111/1460-6984.12171] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 02/13/2015] [Accepted: 02/16/2015] [Indexed: 05/13/2023]
Abstract
BACKGROUND The growing range of available treatment options for people who stutter presents a challenge for clinicians, service managers and commissioners, who need to have access to the best available treatment evidence to guide them in providing the most appropriate interventions. While a number of reviews of interventions for specific populations or a specific type of intervention have been carried out, a broad-based systematic review across all forms of intervention for adults and children was needed to provide evidence to underpin future guidelines, inform the implementation of effective treatments and identify future research priorities. AIMS To identify and synthesize the published research evidence on the clinical effectiveness of the broad range of non-pharmacological interventions for the management of developmental stuttering. METHODS & PROCEDURES A systematic review of the literature reporting interventions for developmental stuttering was carried out between August 2013 and April 2014. Searches were not limited by language or location, but were restricted by date to studies published from 1990 onwards. Methods for the identification of relevant studies included electronic database searching, reference list checking, citation searching and hand searching of key journals. Appraisal of study quality was performed using a tool based on established criteria for considering risk of bias. Due to heterogeneity in intervention content and outcomes, a narrative synthesis was completed. MAIN CONTRIBUTION The review included all available types of intervention and found that most may be of benefit to at least some people who stutter. There was evidence, however, of considerable individual variation in response to these interventions. The review indicated that effects could be maintained following all types of interventions (although this was weakest with regard to feedback and technology interventions). CONCLUSIONS This review highlights a need for greater consensus with regard to the key outcomes used to evaluate stuttering interventions, and also a need for enhanced understanding of the process whereby interventions effect change. Further analysis of the variation in effectiveness for different individuals or groups is needed in order to identify who may benefit most from which intervention.
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Affiliation(s)
- Susan Baxter
- School of Health
and Related ResearchUniversity of SheffieldSheffieldUK
| | - Maxine Johnson
- School of Health
and Related ResearchUniversity of SheffieldSheffieldUK
| | - Lindsay Blank
- School of Health
and Related ResearchUniversity of SheffieldSheffieldUK
| | - Anna Cantrell
- School of Health
and Related ResearchUniversity of SheffieldSheffieldUK
| | - Shelagh Brumfitt
- Department of
Human Communication SciencesUniversity of SheffieldSheffieldUK
| | - Pam Enderby
- School of Health
and Related ResearchUniversity of SheffieldSheffieldUK
| | - Elizabeth Goyder
- School of Health
and Related ResearchUniversity of SheffieldSheffieldUK
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14
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Scott P, Jaime H. The Clinical Applications of Acceptance and Commitment Therapy With Clients Who Stutter. ACTA ACUST UNITED AC 2013. [DOI: 10.1044/ffd23.2.54] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The field of fluency disorders has used Cognitive Behavioral Therapy (CBT) techniques to help clients who stutter manage their thoughts about stuttering by engaging in cognitive restructuring activities. In the late ‘90s, a new form of cognitive therapy called Acceptance and Commitment Therapy (ACT) emerged, stemming from classic CBT and Relational Frame Theory (RFT). Though there is only one documented study in which ACT is used with clients who stutter, there is tremendous clinical potential to assist clients who stutter of all ages using the six core principles of ACT (contact with the present moment, acceptance, thought defusion, self as a context, defining values, and committed actions). The core principles encourage clients who stutter to live a values‐based life by assisting them in defusing adverse thoughts related to stuttering and choosing committed action behaviors and goals in accordance with their individual values through mindfulness practices. Participating in activities related to the core principles of ACT can help clients who stutter to become more psychologically flexible when managing their perceptions related to stuttering. Using ACT can further lead clients toward acceptance of all thoughts while learning to observe themselves in the present moment and make values‐based choices for future behaviors.
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Affiliation(s)
- Palasik Scott
- School of Speech-Language Pathology and Audiology, The University of Akron Akron, OH
| | - Hannan Jaime
- Cincinnati Children’s Hospital Medical Center Cincinnati, OH
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15
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Oliveira CMCD, Pereira LJ. Gagueira desenvolvimental persistente: avaliação da fluência pré e pós-programa terapêutico. REVISTA CEFAC 2013. [DOI: 10.1590/s1516-18462013005000046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objetivo : comparar a fluência de crianças com gagueira quanto à porcentagem de sílabas gaguejadas, porcentagem de descontinuidade da fala, fluxo de sílabas e palavras por minuto e gravidade da gagueira, em situação de pré e pós-aplicação do programa de intervenção fonoaudiológica. Método : participaram 10 crianças, na faixa etária de 6.0 a 11.11 anos, sendo 9 do gênero masculino e 1 do gênero feminino, provenientes do Laboratório de Estudos da Fluência. Todos os participantes deste estudo foram submetidos aos seguintes procedimentos agrupados em três etapas: (a) avaliação da fluência inicial; (b) desenvolvimento do processo terapêutico, e; (c) reavaliação da fluência. Resultados : em relação à avaliação após o programa terapêutico, observou-se uma melhora relevante no perfil da fluência, pois a maioria das medidas analisadas (descontinuidade de fala, disfluências gagas, fluxo de sílabas por minuto e gravidade da gagueira) apresentou diferenças estatisticamente significantes. Os achados indicaram que houve uma redução quantitativa nas rupturas o que ocasionou um aumento no fluxo de sílabas por minuto, e também uma diminuição na gravidade da gagueira. Estes resultados confirmam a eficácia terapêutica do programa de terapia aplicado. Conclusão : os resultados encontrados podem auxiliar o fonoaudiólogo em sua prática clínica, tanto na terapia como na realização do diagnóstico e do controle da eficácia terapêutica.
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