Cognitive restructuring and cluttering

Question 0

What is the goal for a person’s shift in thinking?

Answer 0

Individual has to be able to move on from seeing themselves as ‘a stutterer’ to… ‘someone who stutters sometimes but is able to capably control fluency when they so desire.

Moving from a position of powerlessness and no control to a position of power and control.

Question 1

What is cognitive restructuring?

Answer 1

Cognitive Restructuring (CR) is the process of learning to refute cognitive distortions or ‘faulty thinking’ with the goal of replacing one’s irrational, counterfactual beliefs with more accurate and beneficial ones.

Cognitive Restructuring advises changing irrational beliefs and substitute with more rational ones

Question 2

What are the two parts to cognitive restructuring?

Answer 2

Two part process by which individuals

1.  Become aware of the thinking patterns that lead to feelings of stress or ineffectual behaviour
2.  Change these thoughts to produce more positive ones

Question 3

How do our thoughts shape our behaviours?

Answer 3

Every time a person has a ‘thought’, a mental script is created or reinforced, and that script (i.e., the thought) sets off series of biochemical reactions and physical responses that are positive, negative or neutral, and these shape the resultant behaviour.

Question 4

What are some coping skill techniques?

Answer 4

Substituting positive self-statements
Relabeling one’s anxiety
Inducing relaxation
Thought-stopping
Making statements that asses the reality of a situation
Dispute an irrational belief

Question 5

What are the three Ps for creating positive affirmations?

Answer 5

Framing dialogue in the POSITIVE
 Framing dialogue in the PRESENT
Framing dialogue in the first PERSON

Question 6

What is the Menzies Treatment?

Answer 6

Key behavioural treatment for anxiety
 Confronting anxiety provoking situations rather than avoiding  Difficult to implement in adulthood thus used more routinely in children
 Some parents present as overprotective, too supportive so protecting them from exposure situations
 Encourage parent to enrol child in soccer, regular play dates on their own – need to persist despite the levels of anxiety

 Set up the task as an experiment – test out the thought then ++ reflection after the event
 Write down responses of what they think will happen – hold them accountable
 Ask them to tell you what happened during the experiment then bring them back to the prediction
 ++repetitions of positive reinforcement
 Trusting that inner voice is a bad idea and that is the foundation of treating anxiety

Question 7

What is important in cluttering treatment?

Answer 7

Tailored to client’s unique difficulties
 Minimal data available suggesting standard procedures for treatment
 Number of strategies have been effective in the treatment for cluttering
 Aim to include speech, language and other skills that may impact communication skills
 Need to remember that stuttering reduction is also important and should be prioritised if a dominant feature
 Can incorporate fluency shaping strategies

Question 8

What is one of the most important issues in cluttering treatment?

Answer 8

Slowing rate.
This can be effective in dealing with a range of cluttering symptoms.
Do this using:
Paced reading tasks
DAF
Pre recorded material to match pace etc.
Operant rate control programs/bio feedback.

Question 9

What are treatment options?

Answer 9

Smooth Speech & Prolonged Speech have proven efficacy for PWC and not only are effective at slowing speech rate & reducing dysfluencies, there is an improvement in self-monitoring, clarity & language planning abilities

Question 10

What other strategies are important?

Answer 10

Heightened monitoring.
Using clear articulation.
Acceptable, organised language
Interacting with listeners
Speaking naturally
Decreasing excessive dysfluencies
General relaxation, meditation, breathing control.