We have started to transfer the learned techniques into a real life environment. Every patient had to introduce him/herself briefly to students at a police training school, and then ask questions about the work of the police. The police students also asked questions about stuttering. We also practised making phone calls, and we went into the town centre and practised on by-pasers or shop assistents. This is quite a novel and frightening experience for many people who stutter. But I think most mastered the situations quite well, and many experience for the first time in their life some more or less inner calm in talking in such situations.
The biggest problem really is to use the techniques (like gentle onset or connecting syllables) in all situations. Most patients have no problem using the techniques when asked to do so. And they speak very well without any apparent symptoms, even for many people with severe stutters. But once the therapy session is over, they immediately switch to the old speech pattern with stuttering symptoms. This is also one of the main criticism of fluency shaping therapies. Patients have to learn a new way of speaking, this new way sounds and feels strange, and patients will revert to the old way of speaking (sorry stuttering). It is certainly true that change requires hard work, and for some especially with severe stuttering the end product will be decent fluency but with some unnaturalness to the speech like long onsets or slowing down speech. On the other hand, this is hundred times preferable for the listener that hearing hAAAAAArd and loooonnnng blocks and seeing pronounced face grimaces. But for people who experience relative fluency and stutter without severe and long blocks, the costs of fluency at the cost of unnaturalness might seem and feel too high. However, the answer of fluency shaper would surely be that they can use softer version of the taught techniques and mix them with their natural speech. A careful listener might spot the gentle onset but the average listener will not. The real difficulty is to find the right balance, and this is hard work.
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