The Role of Acceptance in Reducing Anxiety in Stuttering: A Theoretical Framework
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Childhood onset stuttering, while being an established speech impediment, operates on a spectrum of severity. Anxiety’s influence on stuttering has yet to be fully explored, however, evidence suggests the two are strongly correlated. With that said, people who stutter (PWS) often find that they lose control of fluency when experiencing strong negative emotions such as fear and anxiety. In the context of the aggravation of a childhood-onset stuttering, behavioral management often focuses on reducing situational anxiety. Anxiety tends to become a habitual response to certain elements in the environment for PWS. This is due to the way in which our brains are wired to obtain information that leads to the triggering of behaviors. The brain consolidates information gathered from the environment which consequently primes the mind for automatic processing. Automatic thought processing leads to the construct of unwanted cognitive belief systems that have to ability to trigger anxiety and unwanted thoughts when experiencing certain events throughout life. A new third wave of Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), has only recently began being utilized as therapy for stuttering. ACT’s uniqueness lies in is its engagement of acceptance, which allows for processes to occur that are vital for long-term functional change of cognitions that sustain anxiety. This paper presents a theoretical framework of the role acceptance plays in reducing anxiety for PWS along with the neurological and psychological mechanisms at play throughout this process.