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Cognitive restructuring, relapse (2) - Coggle Diagram
Cognitive restructuring, relapse (2)
Menzies Tx
Key belief
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Preschool-school age chn (3-10) have opportunity to control exposure experiences-anxiety happens at younger age
Parents have control over their chn: can be overprotective, too supportive so protecting them from exposure to situations. Refer on if too difficult to handle
Data states increased exposure, decreased social anxiety
Encourage parent to enroll child in clubs, play dates- to persist despite the anxiety.
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Relapse defn
Client can no longer self-manage their fluency, decisions are made around their stut.
Recurrence of stut symptoms that were perceived as personally unacceptable after time of impv. Does not imply finality, only temporary.
"My stuttering is back, it's back to the point I need your help. I need help to get my stuttering back under control. I've lost control, these are all the factors.."
Relapse research
Methodology
Study aimed to investigate, compare factors contributing to recovery, relapse in PWS
50% experienced recovery, 50% relapse
more than 50% for older chn, adults
less than 50% for those who acquired normal sounding fluency during Tx, remained fluent permanently
Results
Indv related-regular practice, inner LOC, self-monitored, self correction, increased motivation
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Behaviour, personality related factors-Sheehan identify self beyond a PWS
Relapse predictors
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Who is likely to succeed? Those w no stut on phone calls to strangers less than 2%SS, score of 9 or less on Erikson scale, LOC score reductions by more than 5%.
What causes a relapse?
Severity of stut before Tx: increased severity are more likely to relapse, more speech motor deficit leads to less positive outcome
Less successful Tx outcome: failure to control stuttering during Tx means it is difficult for them to maintain, high levels of speech-related fears post Tx. Increased fear of comm, have increased risk of relapse
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Trait anxiety, age of client, motivation, self-acceptance and disclosure
Relapse rates
Inevitable for 30-40% of adolescents and adults who stutter following successful fluency shaping Tx w/i 6m of Tx
Regression vs. relapse
Regression: slip in fluency that includes variations in stut across time and situations, variations in ability to monitor, use fluency skills, temporary setbacks
Relapse=pronounced, persistent return to pre-Tx lvls of stut, not viewed as sign of failure but time to identify issues, take action to correct them. Increase confidence, make changes more robust
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Robust outcomes
Where Tx incoprorates
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Cognitive restructuring: rational thinking, positive affirmations
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Holistic approach that manages the stut moment as skill deficit, mgm of person, associated feelings, constructs. BUT not all clients need everything in your toolbox
If less than desired, think!
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6 themes
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Self-Tx, behavioural change. Including self-disclosure and acceptance
Cognitive change: risk taking, reduction in fear failure, taking responsibility, positive attitude, learning more about themselves as speakers
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High lvls of motivation, determination
5 recurring themes
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Self-acceptance, reduce fear
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Helpful hints
Many do recover in time, just need self-commitment
Need support from networks, community
Believe that you are in control of your own behaviour, life outcomes, strong internal LOC
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Set SMART goals, reward and punish appropriately
Rmb that everyone is dysfluent to some degree, you don't need perfection
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