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From: Gunars
Date: 13 Oct 2004
Time: 23:56:58 -0500
Remote Name: 24.16.236.248
Dear Kristie, Most people who stutter as adults or young adults have been totally demotivated by their experience in stuttering therapy. They are like naturally obese people who have tried a dozen diets and nothing helps them with their weight problem . In keeping the weight off a person has to a) limit how much they each and b) participate in regular exercise. Even then, the weight loss and maintenance is quite a problem. Some studies show that practically no person who goes on a weight loss regimen attains their ideal weight and manages to maintain it, if they were obese at one time. About 10 to 30% reach a stage where their weight is good enough. . In a balanced stuttering program we have to understand that people have to work on their emotions, beliefs, and practice exercises (voluntary pseudo-stuttering, cancellations, pullouts, pre-pullouts, easy onsets, and elongation of vowels). . In order to motivate a person to do all of these things the therapist has to a) have available concrete examples of people who have succeeded in the type of therapy they prescribe and b) understand how to motivate people. . In order to motivate people it is good to understand the stages of change (derived by Prochaska, J. O. & DiClemente in their Transtheoretical Therapy Model): 1) pre-contemplation, 2) contemplation, 3) preparation, 4) action, 5) maintenance, and 6) termination. However, it is good to read Miller, W.R. & Rollnick S. Motivational Interviewing: Preparing People for Change 2nd Ed. There the above model is discussed in context of motivation on page 200 - 216. . The above book is really the authoritative book on motivating a client. Unfortunately, I have not yet digested it all so I cannot give the best suggestions. . Shooting from my hip I suggest that you form a collaborative relationship with the client. This means that the client is the expert in his problem and you are the expert in the process of therapy. In this model you and the client are equal. You ask him: What are your goals for therapy? Why are you coming to it?. What would motivate you to change? Do you think you can change? (this is a real important question) Do you think you would gain anything by talking with less struggle or force? What do you think of people who stutter? How can we make the therapy more meaningful? . I am asking you: Have you been ever taught the collaborative model in therapy? Do you know anything about Solution Oriented Therapy? Do you know anything about constructivistic therapy? Can you see yourself as working side by side with him on the problem where you are his consultant only and he is the expert in his problem? Have you ever shown him in public what you expect him to do? . Let me think about it more, and I will add on the answer. . Gunars