Addressing Anxiety in Fluency Therapy

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I think it is important to talk a little bit about why we tackle speaking anxiety with our fluency students. A good number of you ask the question, “Is this in our scope of practice?” and the short answer is, absolutely.

So very many of our fluency students experience anxiety, and anxiety leads to muscle tension, which leads to MORE stuttering.


We have touched on using guided relaxation to manage muscle tension, but how do we help our fluency students learn to manage their feelings of stress and anxiety so that they can become more fluent?

Recognizing and understanding anxiety does not come naturally to children, so it helps to guide them through what anxiety is in general before just diving head first into talking to them about their speaking anxiety.

  1. Talk to about what worries are.IMG_1757.jpg
  2. Talk about negative feelings that worries cause and the difference between negative and positive feelings.IMG_1758.jpg
  3. Talk about how we can get rid of worries and turn negative feelings into positive feelingsIMG_1761.jpg

For these and other great fluency worksheets, please consider purchasing our Stuttering Made Simple Resource, which can be found here or click any of the pictures above.

Some students will pick speaking anxiety as an example, and if that is what they pick it is fine to to talk through it with them. If they pick something else, such as a fear of the dark, test taking, etc. that is still extremely effective. Although it may SEEM off topic, you are helping the student learn important strategies that they can then carry over into fluency related tasks.

If you feel that the topics of conversation are out of your area of expertise and require more intensive, non speech related therapy beyond just discussing simple positive and negative emotions, that is when I personally would choose to involve a social worker or mental health professional. Working as a collaborative team is important in these instances. Make sure the professional knows your fluency goals and that they are respectful of those goals as they move forward with their therapy. Keep in contact and collaborate as a team with any mental health professionals involved in the care of your client. This may require a signed release of information, which can be completed at the discretion of the parent or guardian of the client or by the client themselves if they are an adult.

It is important that we do not ignore anxiety as it is an integral part of fluency therapy.

As always, if you have any questions about this or any fluency related topic, feel free to comment on this post or email us at!



Using Relaxation in Fluency Therapy

Hi everyone!

I’m excited to begin the first of many blog posts helping walk you through fluency therapy! If you feel like you don’t have the background you need to help your fluency students, you are not alone. I know fluency is a dreaded part of our job for good number of my colleagues, and there’s a good reason why! Most of us just don’t get the hands on experience in school that would make us confident in using treatment techniques. I am going to give an overview of what works for me, and hopefully it will make you more confident in working with these students/clients.

Guided Relaxation for Fluency Therapy

Fluency Lesson #1- Relaxation

Why is relaxation an important part of fluency therapy?

  1. Relaxation can help with anxiety

Our students are coming from their busy lives into a fluency treatment session. It doesn’t matter if they are a child, an adolescent, or an adult, it helps to come into the room and relax, leaving the worries of the day behind before beginning treatment.  When a student is feeling anxious, we can teach them to use relaxation to calm down and consider the emotional aspects of stuttering. We can help them to think of why they are feeling anxious, and learn to relax their bodies to help their minds prepare for a new activity.

  1. Relaxation can help with proprioceptive awareness

Proprioceptive awareness, or awareness of the body in space, is shown to be an area of weakness for some people who stutter. Guided relaxation brings attention to the tension and relaxation of individual muscle groups, improving overall body awareness. By thinking of our various muscle groups and how they work, we are focusing attention to our body in space and how we are moving, as well as the basic feelings of tension and relaxation. This will be helpful as you move forward in discussing tension and relaxation as it pertains to fluency. It is good to have a general understanding of these terms, and practice in a non-communication context before moving on to practicing fluency shaping techniques.

  1. Relaxation can help with mindfulness

Mindfulness is the practice of being present in the moment. The practice of mindfulness has been found to help some people who stutter to become more fluent. When we help clients/students relax and become present in the moment, it helps set the stage for a productive fluency treatment session. You can help your students to focus on there here and now, instead of getting wrapped up in all of the “what ifs” of what is to come.

  1. Relaxation can help with muscle tension

Muscle tension can occur anywhere in the body during a moment of dysfluency. Being aware of the muscle groups of the body, the feelings of tension and relaxation, and how to achieve muscle relaxation can be useful in managing this physical component of dysfluency.


So how can I work on relaxation?

There are many ways to approach relaxation with your students. Some of these include, exercise, meditation, listening to music, stretching, yoga, and guided relaxation.

My personal favorite is guided relaxation because unlike listening to music and other techniques, the therapist can lead the activity. It is also less intimidating and less physical than yoga or other exercises, which I think makes it more accessible to the average person. It can also be used in mixed groups, since it can be a good way to start any session, regardless of student goals.

In guided relaxation, the speech pathologist reads a script, and the students close their eyes and follow along. The script will typically work through major muscle groups from head to toe, and the SLP can choose whether to read the whole script, or focus on a specific muscle group in any given session.

You can purchase and download my personal script for guided relaxation by clicking the link below:

Guided Relaxation Script For Kids- $3.25


Speech, Teach, & Love,