Chapter 9: Psychosocial Dynamics & Counseling

Question 1

What are the 4 Intervention Issues?

Answer 1

Family Systems
Personality and Voice Image
Cultural Stereotypes
Self-concept and Voice

Question 2

Family Systems

Answer 2

a. the role the patient adopts/vocal behaviors
b. use of systematic model to obtain information-family or life stages, patient aspirations related to role, observing interactional patterns, communicating with family members, using counseling techniques, provide support and practice opportunities

Question 3

Personality and Voice Image

Answer 3

a. treatment plan tailored to the personal lifestyle and characteristics of patient
b. ascertain underlying vocal image
c. voice in therapy is a process- attend to client, active listeners, cognizant of cultural differences
d. consider personality and temperament of client
e. persons with similar combinations of preferences=build relationships
f. Introvert/extrovert
g. perceiving/ judging
h. thinking/feeling
i. 4 basic temperaments: artisan, guardian, idealist, rational
j. Psychological types: MBTI- sensation, intuition, feeling, thinking
k. Artisan seeks sensation, guardian seeks security, rational seeks knowledge, idealist seeking identity
l. Artisan yearns for social impact, guardians for belonging, rationals for achievement, idealists for meaningful relationships

Question 4

Cultural Stereotypes

Answer 4

low pitch (males): strength, control, authority, sexuality
high pitch (females): grace, charm, gentleness, nurturance
Males: report talk
Females: rapport talk
Low context speaker: tell listeners too much, talk down
High context speaker: assume listeners know details do don’t elaborate

Question 5

Self-concept and Voice

Answer 5

a. laryngeal sphincter may respond to severe emotional states through “fight” or “flight” postures
Fear/anxiety: LS opens widely to allow max air flow to run away - weak, breathy voice
Stand ground: LS may lock overadduction, constriction
b. General body tension or specific tension
c. Compensations
d. Pitch variability or lack of variability

Question 6

Intervention strategies

Answer 6

1. Problem clarification
2. Feelings clarification
3. Concept correction
4. Skills inventory
5. Mobilization of support and services

Question 7

Research on Psychodynamic Aspects of Voice Disorders

Answer 7

a. Trait Structure- contributes to Functional Dysphonia, Vocal Nodules, Spasmodic Dysphonia: personality as contributing factor
b. Psychogenic voice disorders (high incidence of women)
c. Voice disorders following traumatic stress: process of recalling and telling their narrative during treatment
d. Emotional outbursts and effects on voice -phonotrauma sometimes related to repeated behaviors that arise from excitability and emotional lability
e. Non-organic Dysphonia and the ANS- link between nonorganic habitual dysphonia and subjective experience of dysfunction of the ANS

Question 8

Psychodynamic Voice Treatment Approaches

Answer 8

Humanistic -empathy
Interpersonal -interpersonal interactions
Behavioral -operant conditioning/reinforcement
Cognitive -how thinking influences behavior
Existential -overall well-being