Stuttering and the Cognitive Behavior Therapy – Neurology Example

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"Stuttering and the Cognitive Behavior Therapy" is a brilliant example of a paper on neurology. A 2008 study by Menzies, O’ Brian, Packman, St. Clare and Block investigated the usefulness of cognitive behavior therapy (CBT) in the treatment of stuttering.   In the literature review aspect of their research, the authors offer a  great deal of evidence that supports the role of social anxiety, even to the point of phobia, in contributing to stuttering during the speech.   Previous research is included which shows that interventions that have been developed to combat anxiety  have proven successful in  attempts  to reduce  stuttering, but  lack a consistently successful method of implementation.     In response to these needs, the authors of this study have developed an experiment to replicate findings of the relationship between stuttering and social phobias  (expecting a strong relationship)  and evaluating two types of therapy  as possible treatments for both conditions: speech restructuring (does not address anxiety  in theory)  alone,   and  in combination with  a CBT derived treatment that considers the influence of social phobias.   The researchers predicted that  restructuring therapy alone would not reduce social anxiety, and thus would be less successful at treating stuttering than when combined with a CBT approach that is tailored to reduce this type of phobia.   Methods  Participants for this study were 32 adults (over 16 years of age) from Sydney, Australia who stutter on more than 2% of their pronounced syllables.   However, only 30 subjects (25  male, 5 female) completed the experiment and were included in the data analysis.   Participants were randomly assigned to either  the  experimental  group (received both types of therapy) or the control group (restructuring therapy only)  with fifteen subjects in each group.   The experimental condition was to receive ten weeks of CBT followed by ten weeks of restructuring therapy.

The control group received no treatment for the first ten weeks followed by ten weeks of restructuring.

The main outcome measure was changed in a stutter syllable percentage following treatment(s).   Psychological measures were obtained through clinical assessment and a variety of questionnaires.   The data were analyzed using t-tests, analysis of variance (ANOVA), and multiple comparisons.   Results,   Discussions, and Conclusion  The findings found that 60% of the subjects had an identifiable social phobia in addition to a significant stutter, agreeing with the first prediction of the authors.   This number is  even  larger than  those found in  previous studies that  still  identified a  relatively  high probability of  presenting  with the two conditions.   Other results also agree with the authors’ predictions as speech restructuring alone was found to be unsuccessful at treating social phobias, while restructuring in combination with CBT was effective in performing this task.     However, contrary to the expectations of the researchers,   the results indicate that CBT had no significant effect on stuttering.

They suggest that the results may be due to the reduction in social anxiety to weaken the subjects’ resolve in correcting stuttering  (though they admit that this speculative approach is very optimistic), or that social phobia is a correlate  of the developmental process  that  is also correlated with stuttering and  is not directly involved in the stuttering process.   In conclusion, they propose that additional confounds should be accounted for in future research.   This research offers insight into the treatment of social phobias using combination therapies, but potential confounds along with a small and unvaried (mostly female) sample are issues that stand out in this study.  

References

Menzies, R. G., O’Brian, Onslow, M., Packman, A., St. Clare, T., & Block, S. (2008). An experimental clinical trial of a cognitive-behavior therapy package for chronic stuttering. Journal of Speech, Language, and Hearing Research, 51(6), 1451.
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