Therapy Thursday: Phone Calls

February 24, 2022
Gregory Scott, M.A., CCC-SLP
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It’s Therapy Thursday!


Today we’re talking about a classic: phone calls. Getting our clients on the phone is a staple of speech therapy at AIS.


Why phone calls? The phone is an ideal laboratory for testing out effective communication, as it’s a medium where miscommunication lurks at every turn. Bad connections, lack of visual cues, time pressure—to get the message across, the speaker has to navigate a lot. And many of these obstacles are specific fears for the person who stutters. But, as fraught with peril as a phone call might seem, it can also be very low-stakes, especially if you start with “throw-away” conversations, like calls to shops to ask what time they close.  You quite literally will never see the person on the other end!


SLPs often think of phone calls as a way to demonstrate the strategy of self-disclosure. (Giving a heads-up that you stutter clears up a lot of confusion, and can buy you more time and peace-of-mind in the call.) But the phone can also be a great place for all kinds of other avoidance-reduction experiments: things like resisting time pressure, extending the conversation, providing your name and personal info.


How to do it:

Assessing your client’s comfort level is essential. Too many SLPs push their clients to make their first call without taking baby steps up to the challenge—which risks reinforcing the very sense of fear and threat that we are trying to defuse. In fact, we often have our clients observe someone else making calls, first, for several sessions.  This could be either a more seasoned peer in a therapy group or the clinician themselves, who may use pseudostuttering for the purpose of demonstration.


Once your client is ready, have them choose a call that feels low-stakes. It’s very important to set them up for success! We often select a record store or a coffee shop in a completely different city, looking up the phone number online. Then, establish a clear target for the call (e.g., the client will self-disclose prior to asking a question). Make it clear that the target is all that matters. It doesn’t matter whether the client stutters or not; if they hit their target, it’s a victory.  Finally, have the client place the call on speaker phone, so the clinician (or the therapy group) can hear the exchange.


Afterwards, make sure you save plenty of time to debrief. What was the anxiety level before the call? Did it change at any point? Was any negative self-talk present? If something didn’t go well, is there a reasonable explanation for why? What would they do differently on the next call?


Clients often get “a rush” from making their first call, the thrill of having just successfully faced a long held fear. The clinician can use this as momentum, moving through several additional phone calls in the session. The more “reps” a client can get, in quick succession, the more quickly they can chip away at the fear of the phone.

Photo by Robin Jonathan Deutsch on Unsplash

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