Therapy Thursday: Avoidance Is not a Bad Word

November 11, 2021
Margaret Miller, M.A., CCC-SLP
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It's Therapy Thursday!

Today we're talking about the benefits of avoidance. Yes, the benefits!

Avoidance reduction is hard. Many people who stutter have had years of practice avoiding feared words and situations. And sometimes, no matter how much someone wants to dive headfirst into exposure challenges, they get stuck. Both therapist and client become confused: it seems clear that avoidance reduction is the way to go, so why isn’t it happening?

As a speech therapist, you can talk up the reasons for avoidance reduction until you’re blue in the face. But we all know there’s nothing less convincing than someone else telling you what’s good for you. Focusing only on the reasons to reduce avoidance ignores a huge piece of the puzzle: why the person is avoiding in the first place. Avoidance has real advantages: less risk, less embarrassment, less vulnerability. It’s only once those up sides are made clear that we can begin to genuinely weigh the costs of avoiding against the costs of taking risks.

How to do it:

Ask your client what benefits they get from avoidance. What needs are being met? What discomforts are being postponed or eliminated? Work with them to make a list of pros and cons - and be open and honest that the pros of avoiding are very real! Remember that your goal is not to convince your client of anything. This process is about determining the real costs and benefits of moving forward. Once we have a full inventory of the client's avoidances, we can help them establish a hierarchy for addressing those they feel most committed to changing first off.

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