Desensitization-Based Structured Intervention Program for Individuals With Stuttering

Stuttering is a common fluency disorder characterized by involuntary interruptions in speech flow, such as repetitions, prolongations, and blocks. It affects approximately 1% of the world's population and typically emerges in the early stages of language development, particularly in preschool. The exact cause of stuttering is still unknown, but it is believed to involve various combinations of genetic, developmental, environmental, and neurophysiological factors (Yairi and Ambrose, 2013). Stuttering not only affects an individual's communication skills but can also significantly impact their psychological and emotional state. Individuals may experience persistent anxiety about being ridiculed or negatively evaluated by others during stuttering episodes, and the pressure to speak fluently in everyday situations can create significant stress and anxiety (Guitar, 2013). The ICF model, developed by the World Health Organization, suggests examining an individual's health status not only at the biological level but also in the context of activity, participation, and environmental factors (WHO, 2001). In particular, the ICF-based model proposed by J. Scott Yaruss and Robert W. Quesal for stuttering offers an important framework for explaining the impact of stuttering on an individual's quality of life. In this context, stuttering is characterized by limited participation in social and professional life in terms of the level of participation (Yaruss & Quesal, 2004). Individuals with stuttering may experience a number of problems in their professional lives. Job interviews can be given as an example of these situations. Job interviews are an important starting point in the employment process. Job interviews are a situation that creates anxiety and causes avoidance behaviors for individuals with stuttering (Hohulin et al., 2010). Anxiety is defined as "unease, irrational fear, anxiety, worry, distress caused by an unknown danger, misfortune, fear or expectation originating from the unconscious" (Bakırcıoğlu, 2016: 893). When adult individuals with stuttering are faced with a socially threatening, anxiety-inducing environment, they show physical strain and their anxiety increases during stuttering (Bloodstein, 1995; Craig, 2003). The literature reports a positive correlation between threatening or challenging stimuli and the severity of stuttering. For example; Stuttering is observed to increase when speaking to an authority figure, a group, or impatient or critical listeners (Guitar, 2013). Conversely, the frequency of stuttering generally decreases in non-anxiety-inducing situations, such as speaking to a familiar person or someone who is not an authority figure (Craig, 2006). Furthermore, speakers with severe stuttering are more likely to be subjected to negative evaluations and labeling/stigmatization compared to speakers with less severe stuttering (Gabel, 2006). The fear of negative evaluation is defined by Leary (1983) as the individual being evaluated negatively and hostilely by others, or being stigmatized. Stigmatization, in turn, is described as a multidimensional phenomenon encompassing negative attitudes and behaviors towards individuals (Corrigan & Watson, 2002). The literature includes various therapies for stuttering and the accompanying negative emotional states. One of these approaches is known as desensitization. Desensitization for stuttering is considered an important component of therapy for individuals who stutter. According to most research findings in foreign literature, individuals with stuttering perceive job interviews as a difficult area (Bricker-Katz, Lincoln, and Cumming, 2013; Klein and Hood, 2004; Rice and Kroll, 2006). Furthermore, while many studies focus on the working lives of individuals with stuttering, there are only a few studies specifically addressing job search processes and interviews. No studies addressing job interviews for individuals with stuttering have been found in the local literature. Due to this gap in the literature, our research aims to contribute to the literature and guide future studies in this area. Our study will develop a 10-week desensitization-based therapy program and aims to examine the effects of this structured program on stuttering frequency, fear of negative evaluation, internalized stigma, and anxiety experienced during interviews for individuals with stuttering.