My Approach to Stammering Therapy The Long Version!

For the shorter version, please click here.

My approach to stammering therapy has evolved significantly since I trained as a speech and language therapist in 2009. Growing up with a father who stammers gave me early insight into both the challenges and strengths of people who stammer. Within the last decade, my influences have largely come from listening to people who stammer describe their therapy experiences. This, alongside attending specialist training, workshops and stammering supervision has shaped how I work today.

Whether you are an adult who stammers looking for support, a parent seeking therapy for your child, or a therapist looking into stammering supervision, I hope this page helps you understand how I work and whether my approach feels right for you.

What I Believe About Stammering

Stammering is a neurological difference, not a disorder that needs fixing. There is no cure for stammering and there is no single technique or strategy that guarantees fluent speech. I have realised that many of the challenges people who stammer experience are shaped not only by the stammer itself, but by social expectations and how others respond to a speech difference.

When working with children who stammer, I focus on supporting them and their families early on, so parents can access clear, evidence-based information and feel confident in how they respond. Early support isn’t about eliminating stammering; it’s about building confidence, reducing any anxiety and helping children feel good about themselves as communicators, whether they continue to stammer or not.

I practice within an acceptance-based, neurodiversity-affirming framework grounded in the social model of disability. This means I am interested not only in how stammering feels physically, but also in how communication differences are treated in society.

My Philosophy

The goal of therapy isn’t to make you (or your child) fluent. My philosophy is about supporting communication and wellbeing holistically. Therapy with me helps you to:

• Communicate with confidence and authenticity, however your speech sounds
• Reduce any heavy feelings around stammering, such as fear or shame
• Develop strong self-advocacy skills
• Navigate a world that doesn’t always accommodate difference, whilst also working to change it
• Feel comfortable and empowered when communicating

For parents: My goal is to help you support your child, understand stammering, respond in confidence-building ways and advocate for your child at school and beyond.

What Therapy Might Look Like

I pride myself in offering therapy that is tailored to exactly what you need. There isn’t a one size fits all approach. Everything we do is discussed and agreed together, so you always know what we are working on and why. Here are some areas we may focus on:

1. Education and Understanding

• Learning about stammering as a neurological difference
• Understanding the medical and social models of disability
• Exploring how society shapes feelings about “normal” speech
• Recognising where therapy goals really come from

2. Reducing Fear and Shame

• Desensitisation work to reduce any fear or anxiety around stammering
• Voluntary stammering exercises
• Open stammering in progressively challenging situations
• Processing difficult experiences and heavy emotions
  
  

3. Building Self-Advocacy

• Learning to explain stammering confidently to others
• Practicing requesting accommodations (e.g., extra time in presentations, not being interrupted)
• Developing responses to reactions from others
• Building skills to challenge discrimination
  
  

4. Reducing Physical Tension and Effortful Speech

• Cancellations: Pausing after a stammer and saying the word again with less tension
• Pre-block modification: Easing into words when you sense a block coming
• Post-block modification: Releasing tension during moments of stammering

These are stammering modification tools. They work with your stammer to make speaking feel easier and more comfortable. They are not about eliminating or hiding stammering. I will always discuss the pros and cons of any tools or techniques before we consider working on them.

5. Communication Skills

• Building confidence across different situations (e.g., speaking in class, job interviews, phone calls, social situations)
• Working on participation goals that matter to you
• Exploring what helps communication feel easier and more authentic
  
  

6. Psychological Support

• Processing experiences of bullying or discrimination
• Working through communication-related anxiety
• Building confidence and self-esteem
• For children and families: Supporting the whole family system and addressing any worries or questions
  
  

What I Don’t Focus On

I don’t offer traditional fluency shaping techniques (such as easy onset, light articulatory contact or continuous phonation) as a routine part of therapy.

Why? Because I’ve learned that:

• They often contradict the message that stammering is okay
• They can make communication feel harder, not easier
• They are often difficult to sustain long-term
• They can reinforce the idea that stammering needs to be hidden
• For children, they can create the impression that something is “wrong” and needs fixing

In very specific circumstances, we may decide to use certain strategies as tools for particular situations, however this is always within a broader framework of acceptance, never as the main goal.

What Success Looks Like

In my practice, success isn’t measured by fluency percentages or counting stammers.

Success looks like:

• Speaking more in situations that matter to you or your child
• Feeling less anxious about communication
• Advocating confidently for yourself or your child
• Participating more fully in life
• Feeling okay (and perhaps even good) about how you speak
• Thriving socially and academically, feeling confident as a communicator
• Feeling equipped to support yourself or your child and advocate effectively

A Word About “Wanting Fluency”

Many people come to therapy saying “I want to be fluent.” I can understand why. Through gentle exploration, I often discover what people really want is to:

• Feel confident
• Be heard and understood
• Participate without fear
• Connect with others
• Not to feel judged

These are brilliant goals, and we can work towards all of them without making fluency the target. Research shows that focusing on acceptance and confidence, rather than fluency, leads to better long-term outcomes in communication satisfaction, wellbeing and quality of life.

Why This Approach?

I work hard to stay up to date with the latest evidence base. My approach brings together current research, the voices of people who stammer, my experiences as a therapist and what I’ve learned from my father’s journey. Through this, I’ve learned that:

• Acceptance can protect long-term wellbeing
• Confidence and authentic, meaningful communication matter more than fluency
• People who feel okay about their stammer often have better life outcomes
• The problem isn’t always the stammer, it is often how society responds to it
• Early support that focuses on confidence and acceptance can help children thrive

My Commitment to You

I’m committed to:

• Listening deeply to your experiences and goals
• Providing transparent, evidence-informed information
• Creating a space where stammering is genuinely okay
• Working collaboratively on what matters most to you
• Continuing to learn and evolve my practice
• Advocating for systemic change, not just individual adaptation

Who I Work With

I work with:

• Adults who stammer seeking support at any stage of their journey
• Children and young people who stammer (from early years through adolescence)
• Parents and families who want to understand and support their child who stammers
• Schools and educational settings seeking guidance on supporting students who stammer

If you are interested in working with me or have any questions at all, please contact me here.

P.S Things are always changing, and I continue to learn and adapt my practice as new research and ideas emerge. Below are some of the key studies and resources that have shaped how I work. This isn’t an exhaustive list, but I hope it offers a helpful starting point if you would  like to explore further.

Further Reading and Research

Alatawi, M. (2025) ‘Between therapy and reality: A lived-experience analysis of person-centred stuttering therapy’, Journal of Communication Disorders, 99, 106282. doi:10.1016/j.jcomdis.2025.106282.

Beilby, J.M. (2012) ‘Acceptance and Commitment Therapy for adults who stutter’, Journal of Communication Disorders, 45(6), pp. 427–437. doi:10.1016/j.jcomdis.2012.09.002.

Byrd, C.T., Coalson, G.A., Wiele, B. and Irani, F. (2024) ‘CARE Model of Treatment for stuttering: Theory, research, and clinical applications’, Frontiers in Psychology, 15, 1488328. doi:10.3389/fpsyg.2024.1488328.

Carter, A., Breen, L., Yaruss, J. and Beilby, J. (2017) ‘Self-efficacy and quality of life in adults who stutter’, Journal of Fluency Disorders, 54, pp. 14–23. doi:10.1016/j.jfludis.2017.09.004.

Coalson, G.A. and Byrd, C.T. (2025) ‘Social validation of post-treatment outcomes of adults who stutter who participated in CARE Model treatment: replication and extension’, Frontiers in Rehabilitation Sciences, 5, 1541059.

Constantino, C., Campbell, P. and Simpson, S. (2022) ‘Stuttering and the social model’, Journal of Communication Disorders, 96, 106200. doi:10.1016/j.jcomdis.2022.106200.

Everard, R.A. and Howell, P. (2018) ‘We Have a Voice: Exploring participants’ experiences of stuttering modification therapy’, American Journal of Speech-Language Pathology, 27(2), pp. 837–852.

Gerlach, H. and Constantino, C. (2022) ‘Interrupting ableism in stuttering therapy and research: Practical suggestions’, Perspectives of the ASHA Special Interest Groups, 7(6), pp. 1507–1515.

Irani, F. (2025) ‘Reimagining stuttering therapy and outcomes through an identity-affirming approach: A lived-experience analysis’, International Journal of Speech-Language Pathology, 27(1), pp. 115–128.

Kraaimaat, F. and Brutten, G.J. (2001) ‘Self-acceptance of stuttering: A preliminary study’, Journal of Communication Disorders, 49(5), pp. 37–48. doi:10.1016/j.jcomdis.2016.07.001.

Redefining Stammering (2022) Stammering and the Social Model. Available at: https://www.redefiningstammering.co.uk/wp-content/uploads/2022/02/Stuttering-and-the-social-model.pdf.

Sisskin, V. (2022) ‘Disfluency-affirming therapy for young people who stutter: Unpacking ableism in the therapy room’, Language, Speech, and Hearing Services in Schools, 54(1), pp. 114–119. doi: 10.1044/2022_LSHSS-22-00015.

Sisskin, V. (2018) ‘Avoidance reduction therapy for stuttering (ARTS®)’, in Amster, B.J. and Klein, E.R. (eds.) More than fluency: The social, emotional and cognitive dimensions of stuttering. San Diego: Plural.

Tichenor, S.E. and Yaruss, J.S. (2019) ‘Stuttering as Defined by Adults Who Stutter’, Journal of Speech, Language, and Hearing Research, 62(12), pp. 4356-4369. doi: 10.1044/2019_JSLHR-19-00137.