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From: Bob Quesal
Date: 20 Oct 2011
Time: 16:42:54 -0500
Remote Name: 143.43.167.118
Hi Debbie: Thanks for your very kind comments. I think you have asked the million-dollar question: "What is it about a therapy that makes it work for some but not for all?" That is probably a topic for another ISAD paper, but I'd suggest a few things that come to mind. 1) I don't believe that everyone stutters for the same reason and for that reason, people respond differently to different treatments. 2) As the work of Wampold and others has shown, it is not the treatment but the therapeutic alliance that seems to make the difference. The therapy, client, and clinician all have to "click" for things to work optimally. 3) Along the same lines, some treatments just "feel better" (pretty scientific term there) to some people. In my experience, if a treatment has a certain appeal to an individual, s/he will embrace it more seriously and is more likely to do what is necessary to do things differently. I suppose this ties in with the Stages of Change work done by Walt Manning, Trisha Zebrowski and others, who have shown that people have to be ready to change before they can do so. I have said for a long time (actually, I am at the point in my career where I have said most things for a long time) that it is very important that we match clients and treatments. We still have a ways to go to do that with a lot of success. But it is still a noble quest. Thanks again for your comments.