11.5 Requirements for the therapist

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Patients having a functional voice or speech disorder have very special needs, not in the sense of sophisticated equipment for assessment of the physiology and acoustics of speech and voice, but in the sense of a trustworthy and empathic therapist. Renowned institutions have been shown to fail in this respect, when their culture was more scholastic than humanistic. The therapist should be a role model for those functions he expects to develop in his patient. If he is suffering from "thymophobia", the fear of emotional issues, this will result in over-accentuation of organic pathology at the cost of the functional aspect, which is the relevant part in reeducation. We recapitulate the concentrical spheres of the communicating individual, this time with the ideal therapist in mind:

1. Basic trust in himself and in even the most difficult client

2. The capacity to experience intimacy

3. True motivation, emotionally dynamic personality

4. Genuine affect and social skills

5. Imagination, resolution, power, persistence

6. A broad understanding and clear insight in life-histories and life scripts

We have seen interesting recent developments in the area of attitude- and personality training. There has been a sudden and unexpected recognition of a large family of therapy procedures which had been leading an underground existence. Active relaxation, body-awareness, controlled breathing, stretching and other forms of body-oriented work had been common practice in many private institutions in Europe. They were, with very few exceptions not taught at universities: these practices belonged more to the crafts than to the arts and sciences. The occasional young scientist who discovered the value in these "crafts" and brought this to the attention of his colleagues put his reputation at stake. It is appropriate in this connection to mention B.Stokvis at the medical department of the university of Leiden, who was one of the early psychiatrists practising body-oriented therapy. When the sixth floor scientists began to open half an eye to explore the "new" possibilities, they were surprised to find that the clinicians in the basement already had a long body-oriented therapy tradition. It was the start of a productive cooperation between upstairs and downstairs. There have perhaps been disputes over questions of competence and qualification. However in the light of present day attempts at accurate task descriptions and professional quality improvement, conflicts can be solved.

Many people are in need of reeducation of voice or speech impediments or want to improve communication skills. When they can receive the required training from a professional in voice- and speech therapy they will opt for this sooner than if they would have to apply for psychotherapy. In the first place the threshold for entering therapy is lower and secondly the objectives of the therapy program remain in sight.

11.6 Processes of change in other contexts.