Until recently, I had a basic knowledge of stuttering from undergraduate coursework, but I knew nothing about fluency treatment or why a clinician might choose one particular treatment option over another.
Going into clinicals, this made me extremely anxious and I labored over whether or not I’d be able to properly select and implement effective therapies for my adult client with a stutter. Yet, as the semester progressed, prepping for sessions, discussing client goals with my supervisor, and meeting with my client became more natural.
Here’s how I got to that point … and how you can too!
Your Clinical Supervisor and Fellow Students Are Resources—Use Them!
Over time, I realized how fortunate I was to have access to my clinical supervisor’s breadth of experience, not just related to fluency disorders, but also her approach to counseling clients. While observing her, I noted how she was able to get at the heart of the issue through careful listening and thoughtful responses.
Her skillful model of difficult counseling moments and techniques gave me confidence as I found my own voice in each session. I went from passively listening to my client, to taking a more active role and reflecting upon the experiences my client shared in therapy.
My fellow classmates and I also role-played counseling strategies with one another throughout the semester. My supervisor observed and provided encouraging, helpful feedback. She gave us case studies of situations related to current and former clients to discuss, and allowed us to ask questions and explore possible strategies in a supportive and functional way. In her critiques, she provided both affirmation and actionable suggestions for ways to respond to our clients more effectively. Armed with these suggestions, I felt less anxious and allowed myself to relax and enjoy my client’s willingness to share his perspective.
Pursue Independent Study
If available, take an independent study course. These courses can vary in their focus, duration, and design, but each allows a unique opportunity for you to focus your instruction on one subject. I was lucky enough to take an independent study course with my clinical director, which helped me further expand my knowledge of both fluency and counseling.
During sessions, my client would often talk about the challenges he had regarding his fluency. It could become emotional at times, which was hard to navigate. I had difficulty knowing what to say or how to respond to his feelings and attitudes about stuttering. I felt clumsy—a bit like someone learning a new dance step, unsure of whether to lead or follow. When I did recognize the right time to jump in on-beat, I had a hard time phrasing what I wanted to say—if at all.
Throughout my independent study, my clinical director and I talked about how I could best approach these difficult conversations with my client. She shared her own experiences which was helpful for me to draw from, as well as specific feedback from observing my sessions.
Review Research Articles
It was also imperative for me to review evidence-based resources related to fluency therapy. Based on my clinical director’s recommendation, I began with:
- Counseling in Communication Disorders: A Wellness Perspective (2007), by Dr. Audrey Holland
- Mediations for Stuttering Reduction: Lessons from African American and Mexican-American Children (2007), by Nola Radford and Jesus Tanguma
- A Phenomenological Understanding of Successful Stuttering Management (2005), by Laura Plexico, Walter Manning, and Anthony Dilollo
Each of these resources expanded my knowledge of fluency disorders and treatment, as well as helped me self-critique my own work.
When I took what I learned from these resources and combined it with feedback from my supervisor and clinical director, my whole attitude toward therapy began to shift. Counseling wasn’t just something I facilitated; participating in conversation with my client became a part of the therapy itself and it started to feel more natural.
Learn From Your Clients
During the first session with my client, it became clear to me that because of his personal experience, his knowledge of fluency outstripped mine. I needed to be open to learning from him.
As I let go of the idea of leading each session, I felt less burdened and more ready to listen and engage with the stories my client shared. A diligent student in his own speech, he opened my eyes to socio-emotional responses that I hadn’t experienced myself but began to process and understand through his perspective.
Throughout the semester, our conversations began to take on more depth as we both settled into our respective roles. He expertly provided salient examples of situations that were challenging for him and remained open to my ideas for new ways to approach those situations. When I learned to follow my client’s lead, I became a more effective counselor.
Give Yourself Time
At the end of the day, a combination of research, guidance from others, practice, and time are what’s needed to calm your feelings of anxiety in sessions. All of these factors will make a significant difference in your clinical experience. I hope my experience and personal tips help you become a more confident future clinician!