Adult Stammering Options Explained

Our guide to the different options in adult stammering support and what they all involve.

Looking for help with stammering? There are lots of approaches which we've listed on our One-to-one Adult Speech & Language Therapy and Adult Stammering Courses pages. 

It can be difficult to know which one to go for. Should you choose speech & language therapy? What about one of the non-therapy courses like 'costal breathing'? 

Here we explain the main approaches and what they aim to do.

On this page:

Managing expectations
Speech & language therapy
Non-therapy courses (including 'costal breathing')
Conclusion

Managing expectations

Choosing an approach that's right for you might depend on your goals. Do you want to increase your fluency? Or do you want to gain confidence in speaking, stammer or not?

Before going on, it's important to note that there is no 'quick fix' for stammering. None of the options below can cure or stop stammering. For more information see Is There A Stammering Cure? 

Changing speech or attitudes takes a lot of hard work, often over a long time. 

There isn't 'one' solution which fits everyone. For many it's a journey which might include trying different approaches along the way. 

If you would like to talk about the options, chat with us. Call our free helpline on 0808 802 0002, start a webchat or email help@stamma.org 

Speech & language therapy

The first thing that might come to mind is to see what support you can get on the NHS. 

Qualified therapists can support people who stammer in lots of ways. These may include:

• Helping you understand more about stammering and how it works.
• Identifying areas where stammering, or how you feel about it, is having an impact.
• Helping you deal with difficult thoughts and feelings around stammering.
• Giving you activities, tools and support to reduce the impact of stammering on your life.
• Helping you prepare for an upcoming event you might be worried about, eg a presentation or interview.
• Giving support, advice and information to others, if helpful. For example to employers, colleagues, friends and family. The aim is to create a positive environment which understands and accepts stammering.
• Working on speech patterns that can help you say what you want to say more easily.

Your speech & language therapist (SLT) will work closely with you to agree the goals of any therapy. They'll then tailor the support they offer to you based on your needs. 

Different therapy approaches

Here's a bit more detail about different approaches SLTs might discuss with you. You may find that a combination of different elements is useful for you.

1.    Looking at stammering in a wider context

Part of the challenge of living with a stammer is what you might do to avoid or minimise stammering. You might fear negative reactions or being disadvantaged at work or when socialising. Some newer approaches by therapists address this. 

SLTs might help you explore society's attitudes to stammering and how they affect you. Possibilities then open up for considering ways to challenge these attitudes. You'll look at stammering from a new perspective and discuss how to live better with your stammer. 

2.    Fluency shaping or 'speak more fluently' approaches

You might want to work on managing your stammer. Fluency shaping techniques aim to introduce you to a 'new way' of speaking. It's a way that aims to reduce moments of stammering and speak more fluently.

You may start by speaking in a very prolonged, slow, exaggerated way. As you become more confident using the strategies, the speed is gradually increased. The aim then is to find the point where can you can speak with minimal stammering but still sound natural.

You will start by using these more fluent patterns in practise sessions. Then you'll gradually use these in other settings. 

3.    Block modification or 'stammer more fluently' approaches

Block modification, or stammering modification, doesn't aim to help you speak more fluently. Instead it aims to help reduce the tension involved in speaking, so that there's less of a struggle.

You'll firstly identify the different aspects involved in stammering. These include physical behaviours as well as how you feel about your stammer. This will help you understand what's going on. 

You'll then learn techniques to relieve excess tension when stammering. 

You'll also work on desensitising yourself to stammering so you feel better about it. This can help reduce unhelpful negative feelings or panic you may feel. 

4.    Psychological approaches

These approaches can help address any negative thoughts and feelings linked with stammering. This can help reduce the worry and anxiety you might be feeling about speaking. 

They include: 

• Cognitive Behaviour Therapy (CBT)
• Mindfulness
• Acceptance and Commitment Therapy (ACT)
• Solution-focused Brief Therapy.

Some SLTs offer these. They're also used in other contexts for people experiencing general stress, anxiety or depression. 

In SLT sessions they'll focus on supporting you with your stammer and the impact it has on your life. 

Is therapy for me? 

If you can access NHS speech & language therapy, the obvious advantage is that it's free. And they may offer regular sessions if you want them. 

Therapists often have a toolbox of different approaches they can use to suit you. 

It's not just about 'fixing' a stammer nowadays, and many help to address the mental health side of things.

Not everywhere has a service for adults, though. There might also be a long waiting list depending on the demand in your area. So, group courses provided by organisations such as City Lit are an option. 

Private speech & language therapy is another option, but it can be expensive. 

Non-therapy courses

An alternative to speech & language therapy is an intensive stammering course. The McGuire Programme and The Starfish Project are the biggest ones, and Empowering Voices is the newest one.

These are not classed as 'therapy' as such, because they're not run by qualified therapists. Instead they're facilitated by people who have been on the courses before and found them helpful.

Costal breathing

McGuire, Starfish and Empowering Voices offer a particular breathing technique which they call 'costal breathing'. Another term they use is 'diaphragmatic retraining'. 

With this, you learn a new way of breathing at the beginning of words or phrases. It's a kind of fluency-shaping approach that aims to reduce stammering. You may have seen it on TV, with people wearing belts around their chests to learn the technique. 

It's not just about increasing fluency, though. They also include desensitisation exercises to increase confidence speaking in front of others.

Costal breathing is taught on short, intensive group courses held over three or four days. They're normally held at hotels, with participants staying for the duration of the course. 

Once you've been taught the technique you practise it one-to-one with returning graduates for the duration of the course.

Are non-therapy stammering courses for me? 

Unlike NHS speech & language therapy, stammering courses cost money. It's often a one-off fee and you can return as many times as you want, just paying for accommodation. 

They might have a policy where you can leave the course early if it isn't for you, without being charged for it.

They are often intensive, with days starting in the morning and finishing late afternoon/early evening.

Organisers stress that it's a long-term process requiring constant coaching and support. Ongoing commitment is needed and they emphasise the importance of practise. They have well-established support networks to help with this. Students can also attend self-help groups and refresher events. 

They often have free taster events where you can see what the courses involve.

What do others say?

Read articles from people who have been on the courses and found them helpful: we've got links to those on our pages about the The McGuire Programme, The Starfish Project and Empowering Voices. 

For balance, you might also like to read the article 'Reflections on costal breathing a decade later' by Naheem, Laura and Patrick.

Conclusion

Different people find different things helpful, so try things out and see what suits you. 

If you don't get on with an approach don't beat yourself up. It's not your fault, it just wasn't for you. It might not fit in with your current circumstances. Try something else.

There are lots of other things that can help, like joining a stammering group and meeting others. See Self-help For Stammering, which has details of lots of things you can try yourself.

More support & information

• Don't think therapy or a course is going well? See What To Do If Therapy Isn't Working Out.
• See what Stammering Apps & Devices are available.

What next?

• Become A STAMMA Member for free and join the community. We'll keep you updated with our activities and events.
• Get involved with the STAMMA community. Find an event, fundraise, share your story, volunteer, take part in research and more.

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