Therapy Thursday: Courage Points

February 10, 2022
Gregory Scott, M.A., CCC-SLP
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It’s Therapy Thursday!

Today we’re talking about a simple tool for tracking success in stuttering therapy: “Courage Points”. Hat tip to Carl Herder, Clinic Director at our Atlanta location, for coming up with this fun, concrete way to document the victories our clients might otherwise gloss over.

The idea is simple: When a client is faced with a speaking scenario—or sets an intention for a speaking challenge—both client and clinician will assess the level of courage needed to face the scenario. They then assign the challenge a certain amount of points. Holding eye contact during a block may count for 20 points. Delivering a presentation at school might count for 100. Over time, the client builds towards a “high score” that can serve as a benchmark of accomplishment.

While it sounds basic, the beauty of this approach is that it allows for smaller, harder-to-notice victories—like, say, simply showing up to school when you really wanted to call in sick—to be recorded and to accumulate. Like a savings account, the courage score illustrates that incremental change over time can amount to significant growth. And, as always, the exercise removes perfect fluency from the definition of success.

How to do it:

First, get a firm assessment of your client’s comfort zone. During sessions, check in with them frequently to see where and when their “traffic light” is changing from green (comfort) to yellow (anxious). Is simply showing up to sessions a daunting task? Are they showing up and speaking, but feeling the fear creep in when letting their stutter out? Note these points of increased anxiety. At first, the clinician may need to pro-actively “award” courage points during session, noting all efforts the client is making. Slowly, the client is coached in noticing their own victories, encouraged to call them out and do their own “awarding” in session. Eventually, this point system can be applied to speaking challenges outside the therapy room. When a client arrives in session, they can report a recent “courage victory” and collect their points.


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The American Institute for Stuttering is a leading non-profit organization whose primary mission is to provide universally affordable, state-of-the-art speech therapy to people of all ages who stutter, guidance to their families, and much-needed clinical training to speech professionals wishing to gain expertise in stuttering. Offices are located in New York, NY, Atlanta, GA, and Minneapolis, MN, and services are also available Online. Our mission extends to advancing public and scholarly understanding of this often misunderstood disorder.

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