Psychosocial Perspectives on the Management of Voice Disorders

Bringing to bear her extensive experience as a speech-language pathologist, with additional credentials in psychotherapy and family therapy, Jan Baker clearly, succinctly, and authoritatively presents clinical and empirical evidence for psychosocial factors related to the onset, aggravation, and outcomes of functional and organic voice disorders, and offers treatment strategies and approaches that are centred not only on traditional approaches to voice therapy, but also incorporate and demonstrate appropriate models of counselling. A brief overview of several models of counselling and psychotherapy is given, with particular emphasis on the principles of systems theory and family therapy practice. Psychosocial factors that become evident during the different stages of voice therapy are discussed, including ways in which these issues may shape the therapeutic process and influence longer-term outcomes.These factors may occur, for instance, during the initial consultation and psychosocial interview; following assessment when explaining diagnostic findings; when clients ask searching questions about the 'mind-body' relationship; during therapy as sensitive information emerges; or towards the final stages of therapy when helping clients and families grieve over permanent changes to their voice or and an altered sense-of-self. They may become more pronounced in response to a client's challenging behaviours, or as a reflection of problems in the therapeutic relationship. Strategies for speech-language pathologists to integrate appropriate counselling strategies in their voice work are proposed, with clinical vignettes to illustrate and support these approaches. These strategies are presented in a way that is in keeping with the professional scope of SLP practice, with criteria for recognizing the need for supervision, collaboration with other mental health professionals, or referring on.Jan Baker's book takes voice therapy for this challenging population into a new dimension; aside from its clear coverage of psychosocial factors and options for clinical treatment, the incorporation of counseling considerations and strategies gives speech pathologists and their clinical colleagues a powerful, holistic management tool.