Anthony DiLollo

A personal construct psychology view of relapse: indications for a narrative therapy component to stuttering treatment.

UNLABELLED Relapse following treatment for stuttering is a common problem for many clients. It has often been suggested that one factor contributing to relapse is the clients difficulty in adjusting to a new role as a fluent speaker. In this tutorial article, we first present a personal construct view of relapse, which suggests that this difficulty may be addressed by increasing the meaningfulness of the fluent speaker role for the speaker. Section 3 proposes that post-treatment success for persons who stutter may be facilitated by the use of a narrative approach to counseling in which the meaningfulness of the fluent speaker role is elaborated. In this approach, clients are guided through a process of deconstructing their stuttering-dominated personal narrative, followed by the reconstruction of an alternative narrative that is more compatible with being a fluent speaker. EDUCATIONAL OBJECTIVES The reader will (1) learn about a personal construct psychology perspective on resistance and relapse in stuttering therapy, (2) be able to describe a narrative approach to counseling for people who stutter that is directed toward the long-term maintenance of fluent speech and the steps of deconstruction of the dominant stuttering narrative and reconstruction of a new, more fluent personal narrative, and (3) be able to prepare a series of narrative interview questions with which to engage clients in conversations that may facilitate the deconstruction and reconstruction processes.

Client perceptions of effective and ineffective therapeutic alliances during treatment for stuttering

UNLABELLED The treatment components that contribute to and account for successful therapeutic outcomes for people who stutter are not well understood and are debated by many. The purpose of this phenomenological study was to describe in detail the underlying factors that contribute to a successful or unsuccessful therapeutic interaction between clients and their clinicians. Twenty-eight participants, 19 men and 9 women, who had received from 6 months to more than 12 years of therapy for stuttering were studied. The participants were asked to consider their experience with one or more speech-language pathologists with whom they had received fluency therapy and to describe the characteristics that made that individual effective or ineffective in promoting successful change in their ability to communicate. Analysis of these data resulted in 15 primary categories. Finally, the essential structure of an effective and ineffective therapeutic interaction was described. Results highlighted the importance for effective therapy of understanding the stuttering experience, forming a positive client-clinician, alliance, and being knowledgeable about stuttering and its treatment. EDUCATIONAL OBJECTIVES The reader will be able to: (1) describe, from the perspective of a select group of adults who stutter, the themes associated with an effective therapeutic interaction, (2) describe, from the perspective of a select group of adults who stutter, the themes associated with an ineffective therapeutic interaction, and (3) describe the ways in which an effective or ineffective therapeutic interaction could impact a person who stutters.

Cognitive Complexity as a Function of Speaker Role for Adult Persons Who Stutter

Fransella (1972) was the first to suggest that a personal construct psychology approach to therapy with persons who stutter may be useful. She implicated reduced meaningfulness of the fluent speaker role as a primary maintenance factor of stuttering, even following initially successful behavioral treatment of the problem. Limited research has been performed, however, to confirm Fransellas hypothesis. This study investigated the “meaningfulness” of stutterer and fluent speaker roles for 29 persons who stutter through a text-based measure of the complexity of their construct systems associated with each role. As hypothesized, results indicated that persons who stuttered have a less differentiated or cognitively complex system of constructs for construing themselves in a fluent as opposed to stutterer role. These results support Fransellas hypothesis and suggest that constructivist interventions for enhancing the complexity of the construct systems of persons who stutter with respect to their fluent speaker role should be integrated into traditional treatments for stuttering.

Social networks and links to isolation and loneliness among elderly HCBS clients.

Objectives: The purpose of this study was to explore the network types of HCBS clients based on the structural characteristics of their social networks. We also examined how the network types were associated with social isolation, relationship quality and loneliness. Method: Forty personal interviews were carried out with HCBS clients to assess the structure of their social networks as indicated by frequency of contact with children, friends, family and participation in religious and community organizations. Hierarchical cluster analysis was conducted to identify network types. Results: Four network types were found including: family (n = 16), diverse (n = 8), restricted (n = 8) and religious (n = 7). Family members comprised almost half of participants’ social networks, and friends comprised less than one-third. Clients embedded in family, diverse and religious networks had significantly more positive relationships than clients embedded in restricted networks. Clients embedded in restricted networks had significantly higher social isolation scores and were lonelier than clients in diverse and family networks. Discussion: The findings suggest that HCBS clients’ isolation and loneliness are linked to the types of social networks in which they are embedded. The findings also suggest that clients embedded in restricted networks are at high risk for negative outcomes.

Exploring the Potential of Computers to Enrich Home and Community-Based Services Clients' Social Networks

Older persons receiving services in community settings, rather than Nursing Homes, are at risk of social isolation. Computer mediated communication offers technological resources that recipients of Home and Community-Based Services (HCBS) might use to reduce their social isolation. The present study involved personal interviews with 40 HCBS clients regarding their interest in communicating with members of their social networks and using computers. At the time of the interview, 30 of the 40 participants did not use computers and reported cost, lack of training, physical limitations, lack of interest and access, and fraud as the reasons for not using computers. After watching a videotape illustrating an easy-to-use computer interface that allows older persons to communicate with families and friends, 90% reported that it would be helpful for people like them. Participants said such a computer would be helpful because it would make communication with friends and family easy, it could accommodate visual and manual disabilities, and would be interesting. Eighty-five percent said they would use a system like the one they were shown if it were available to them.

Psychosocial Implications of Foreign Accent Syndrome: Two Case Examples

Research on foreign accent syndrome (FAS), a rare form of speech disorder that typically follows some form of neurological insult, has concentrated almost exclusively on its neurogenic origins and motoric features, to the virtual neglect of its psychosocial implications for the patients who experience it. In this article we draw on the concepts and methods of personal construct theory to analyze two cases of FAS, demonstrating the significant and sometimes sweeping reconstruction of these persons’ sense of identity in the social world.

Survivor: A Narrative Therapy Approach for Use with Sex Trafficked Women and Girls

ABSTRACT Awareness and widespread interest regarding sex trafficking has increased significantly over the last decade. However, research demonstrates little success from well-intended human trafficking “rescue” efforts. In order to increase the capacity for feminist therapists to more effectively serve women and girls who have been subjugated to sex trafficking, a narrative therapy approach is presented as a method for helping survivors reconstruct personal narratives that reflect resilience, recovery, and prosperity.

Conversation of Augmented and Typical Speakers—Speaking Roles Versus Conversation Turns

Abstract This study investigated a difference in conversations between individuals who use augmentative and alternative communication (AAC) and typically speaking partners by using contrasting methods of counting conversation turns and counting attributed speaking roles (i.e., animator, author, and principal) (Goffman, 1981). Three individuals who use speech-generating AAC devices and 27 typically speaking conversation partners were recruited. Each AAC user had conversations with nine typically speaking partners. The findings showed that counting numbers of attributed speaking roles showed a significantly greater symmetry of conversations than counting numbers of conversation turns. The value of the measurement of speaking roles was highlighted and discussed.

Assessing personal constructs of adolescents with autism spectrum disorder: a person-centered measure of social cognition

Many protocols assessing social communication skills of adolescents with autism spectrum disorder (ASD) are based on behavioral observations. It has been suggested, however, that social cognition encompasses processes underlying observable behaviors. Such processes include personal constructs, which can be assessed using repertory grids. Personal constructs of five adolescents with ASD with average or above average intelligence and receptive and expressive language skills were explored using repertory grids in this study. With visual structure and verbal scaffolding, all participants successfully engaged in the repertory grid process. Data suggest participants had well organized, complex construct systems, a significant understanding of social roles, and were interested in social interactions. Repertory grids may provide additional person-centered information for assessing social communication skills in ASD.