KarinWexler
Karin B. Wexler

Treatment Model

Client-Centric Fluency Evaluation and Stuttering Therapy

 

Dr. Karin Wexler’s Treatment Model

To learn how Dr. Wexler views stuttering, how she evaluates someone for known or suspected stuttering, and how she does therapy for it, click on the blue bar above.  These easy-to-read articles may help you get perspective on what you are concerned about. You may get clarity in whether or not it really is an issue. If you decide that it really should be addressed, you may be relieved to learn how we might deal with it. You may find that you would like to try to prevent it from becoming chronic.

In Client-Centric Fluency Evaluation and Stuttering Therapy, Dr. Karin Wexler’s treatment model, she strives to adhere to the following principles:

 
 

The therapy emanates from the client

Maximized input from the client and from family/significant others is sought in the evaluation and in all aspects of treatment design and therapy process. To conceptualize the client’s problem and to treat the client, Dr. Wexler tries to employ the following:

  • Empirical evidence (findings on the specific client, as well as research on normal and disordered anatomy, physiology, and psychology) and other literature;

  • Established theories and methods;

  • Clinical experience (that of other clinicians as well as her own);

  • The experience of persons who stutter and those close to them; and

  • Her own creativity.

Bodies of literature she draws on include those of speech and language pathology, anatomy and physiology, psychology, other fields involving communication, learning, problem solving, and the stuttering self-help/mutual aid movement.

 

Goals

Goals are developed with the client, for the client. The therapy approach, methods, and techniques are also chosen or created in a partnership with the client or the parents.

In terms of speech-mechanics, there is a general goal - to speak easily, in a relaxed and natural way, as an effective and confident communicator, without disfluency interfering with the communication process. This is whether or to what extent the approach jointly chosen involves fluency shaping, stuttering modification, or both. 

 
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The client is treated holistically, with attention to all aspects of the stuttering problem

Evaluation methods, goals, treatment methods, and progress measures are to reflect all facets of the stuttering problem "in the real world".  The person a whole is considered, not only fluency/disfluency.

 

Therapy is success-oriented, minimizing risk of failure and expansion of the problem

Parents and others learn strategies to prevent possible development (exacerbation) of stuttering with increased age and awareness of negative listener reactions.  They learn how to minimize risks of causing reactive behaviors, thought pattern reactions, or emotional reactions.  Goals need to be realistic to maximize success and minimize risk of failure.  Maximum effectiveness and safety are sought in therapy methods.  A fluency goal might be “easy speech” (i.e., easy-flowing, relaxed, natural-sounding speech that does not affect the flow of communication) rather than perfect fluency (since research and clinical experience show that there is no stuttering therapy that can claim 100% fluency for everyone in all situations for life).

 

Interpersonal processes are used that may facilitate changes in behavior, in thought patterns, and in emotions. 

Dr. Wexler seeks to engage in a strong therapeutic relationship with the client and his/her family (or significant others); value and accept them; build a high degree of trust and safety; encourage expression of emotion and unspoken thought; show accurate empathy through empathic attunement; facilitate open communication, including through active listening; question her own assumptions; and be genuine.  Counseling skills are used as needed to deal with the stuttering problem.  Evidenced-based information is sought from relevant fields, including the science of positive psychology.

 

Treatment is HIGHLY self-related and in line with personal dreams

Treatment is highly self-related and in line with the client's personal dreams.   For speech practice, vocabulary and topics from the client’s daily life are prioritized — personal, educational/academic, and/or professional.

 

Therapy is aimed from the beginning at gains to be made in the real world and maintaining them long term

Focus on progress outside of the therapy room is regarded as more important than focus on progress within the room.  Clients work towards goals in their lives, immediately, and for their envisioned futures.