Drawing on Allied Fields in Improving Attitudes of Graduate Students toward Stuttering Isabella Reichel1 , Ken St. Louis2, Susanne Cook3 1 Touro College, NY; 2 West Virginia University; 3Stuttering Therapy Evans, GA. Most of the curricula in fluency disorders courses are based, predominantly, on knowledge in the field of speech-language pathology, and frequently do not draw on the resources of allied fields. This limited focus may restrict the understanding of the nature and treatment of this multifaceted neurologic disorder. In addition, many people who stutter (PWS) have expressed the opinion that, often, speech-language pathologists (SLPs) hold negative attitudes toward PWS, and are not well prepared to treat this complex communication disorder. Points of criticism were: - promises of quick fixes - failing to conduct efficacy studies - inducing false hopes - lack of a multidisciplinary perspective - negative attitudes towards their clients - inadequate emotional competencies Therefore, the authors have explored multidisciplinary curricula and integrated them into otherwise-traditional courses in fluency disorders at different times and in different classes. Results Theoretical Framework of the Second Curriculum Some Students’ Opinions on Additional Curricula Introduction Quantitative results measured with the POSHA-S for three curricula “Stuttering is more in the minds of others, who conceive only good speech as the accepted behavior.” “It is enlightening to learn the perspectives of other cultures, and how they view disorders in general, and their attitudes toward people with disabilities.” “PWS do not want our sympathy; through therapy and counseling, there is hope.” “It has given me encouragement that stuttering is treatable, especially after seeing actual stutterers’ improvements.” “It is incredible how different cultures differ so vastly in their perspectives.” “Understanding different cultures will help empathy.” “What ignorance does for these people made me realize how negative our views are.” “My interest became even more intense.” “An emotional intelligence construct will help me to be more aware of clients’ emotions, and to become in touch with their feelings as well.” “Emotional intelligence provides knowledge and understanding to address clients’ emotional needs and to understand why they are experiencing these negative emotions.” “Emotional intelligence provides a helpful tool to approach not only fluency disorders but also any communication disorder.” “I usually only focus on what I think the client is feeling, but now I have gained insight regarding my emotions, and how they impact on therapy.” Mitigating stigma Stereotypes – Personal beliefs Prejudice – Emotionally colored attitudes Discrimination –behaviors of people who mistreat individuals with disabilities Behaviors are interrelated and present a multi-faceted combination that is persistent and resistant to change (Schneider, 2004). Mitigating negative stereotyping of stuttering in a fluency disorders class by Conceptualization of stereotyping, stigma and prejudice Current approaches of ameliorating these processes The role of culture in definition, interpretations and management of illnesses, disabilities and communication disorders including stuttering Cross-cultural theories in the treatment of PWS. Theoretical Framework of the Third Curriculum Goals of the third curriculum Reduce negative attitudes toward PWS Increase students’ emotional and multicultural competencies Increase problem solving from multidisciplinary perspectives Develop appreciation of the contribution of other disciplines to the understanding and treatment of stuttering Increase students’ confidence in using innovative approaches to prepare tomorrow’s clinicians Figure 2 Figure 1 Qualitative results measured with the open-ended questionnaire: Theoretical Framework of the First Curriculum Curriculum 1 Students believe that EI construct can help: In success in stuttering intervention (77%); understanding emotions of PWS (64%); clinicians managing emotions in their clients (38%); clinicians understanding their own emotions toward PWS (19%); believing that their emotional competencies improved (70%) . Curriculum 2 Ninety percent reported that their attitudes had improved The reasons for improved attitudes toward PWS were: awareness of the cultural perspective on stuttering (50%); improvements in students’ emotional competencies (45%); understanding affective and cognitive factors of stuttering (40%); reduction of negative stereotyping toward PWS (35%); appreciation of meeting with PWS (10%). Multidisciplinary curriculum Emotional INTELLIGENCE Psychotherapists’ characteristics don’t get enough focus in research (Vocisano et al., 2004) Up to 22% of successful treatment attributed to quality of therapist (Wampold, 2001) The emotional intelligence (EI) construct provides a set of emotional competencies which may ensure efficacious clinician attributes (Kaplowitz, et al, 2011). "EI is the ability to perceive, access and generate emotions so as to assist thought, to understand emotions and emotional knowledge, and to reflectively regulate emotions so as to promote emotional and intellectual growth" (Mayer and Salovey, 1997, p. 5) References  Bar-On, R. (1997). The Emotional Quotient Inventory (EQ-i): Technical manual. Toronto, Canada: Multi-Health Systems, Inc. Kaplowitz, M.J., Safran, J.D., & Muran, C.J. (2011). Impact of therapist emotional intelligence on psychotherapy, Journal of Nervous & Mental Disease, 199(2), 74-84. Link, B. G., & Phelan, J. C. (2006). Stigma and its public health implications. The Lancet, 367,528-529. Mayer, J. D., & Salovey, P. (1997). What is emotional intelligence? In P. Salovey & D. J. Sluyter (Eds.), Emotional development and emotional intelligence: Educational implications (pp. 3-34). New York: Basic Books.   Reichel, I. K., & St. Louis, K. O. (November, 2011). The Effects of Multidisciplinary Curricula in Graduate Fluency Disorders Courses. Seminar. American Speech-Language-Hearing Association Convention, San Diego.  Reichel, I. K. (2007). Emotional intelligence and stuttering intervention. 10th International Stuttering Awareness Day Online Conference. For retrieval, http://www.mnsu.edu/comdis/isad10/isadcon.html  Reichel, I. K., & St. Louis, K. O. (2007). Mitigating negative stereotyping of stuttering in a fluency disorders class. In J. Au-Yeung & M. Leahy (Eds.), Research, treatment, and self-help in fluency disorders: New horizons: 236 --244. International Fluency Association. Reichel, I., & St. Louis, K. O. (2004). The Effects of Emotional Intelligence Training in Graduate Fluency Disorders Classes. In H.-G. Bosshardt, J. S. Yaruss, & H. F. M. Peters (Eds.), Fluency disorders: Theory, research, treatment, and self-help (pp. 474—481). Nijmegen, The Netherlands: International Fluency Association/Nijmegen University Press.  Schneider, D. J. (2004). The psychology of stereotyping. New York/London: Guilford.  Schutte, N. S., & Malouff, J. M. (1999). Measuring emotional intelligence and related constructs. Lewiston, NY: Edwin Mellen Press.  St. Louis, K. O. (2011). The Public Opinion Survey of Human Attributes-Stuttering (POSHA-S): Summary framework and empirical comparisons. Journal of Fluency Disorders, 36(4), 256-261. Vocisano, C., Klein, D. N., & Arnow, B. (2004). Therapist variables that predict symptom change in psychotherapy with chronically depressed outpatients. Psychother Theory Res. Pract. Train. 41, 255— 265.  Wampold, B. E. (2001). The great psychotherapy debate: Models, methods, and findings. Mahwah, NJ: Lawrence Erlbaum Associates.  Woods, C. L., & Williams, D. E. (1976). Traits attributed to stuttering and normally fluent males. Journal of Speech and Hearing Research, 19, 267-278.   Five Factors of Stigma Labeling of individual differences Stereotyping of persons by linking them to undesirable attributes Separating labeled persons in a “them” vs. “us” dichotomy Discriminating against labeled people, resulting in loss of status and acceptance Exercising power where lower power groups have little influence to discriminate or assign stigma (Link & Phelan , 2006). Curriculum 3 Ability Model Four-Branch Model of Emotional Intelligence (Mayer&Salovey,1997) Methods Participants: 49 graduate students completed curriculum 1 (in 2002), 20 graduate students completed curriculum 2 (in 2005) and 17 graduate students completed curriculum 3 (2011). There were 86 respondents in total. Assessment Instruments Assessment instruments were presented before and after each course. The Emotional Intelligence Scale (EIS) (Schutte & Malouff, 1999) The Public Opinion Survey of Human Attributes – Stuttering (POSHA-S) (St. Louis, 2011) The 25 Bipolar Adjective Scale (BAS) (Woods & Williams,1976) Open-ended qualitative questionnaire about the curricula were presented after the courses concluded (Reichel & St. Louis, 2004, Reichel & St. Louis, 2006, Reichel & St. Louis, 2011. The additional curricula were integrated into graduate fluency disorders classes and included short lectures, student presentations, role playing, group discussions, and laboratories with PWS Conclusions Mixed Model Bar-On's model Emotional-cognitive abilities & personality traits An analysis of the students’ responses to the questionnaires demonstrated very modest changes on the POSHA-E suggesting that three additional curricula did not have a significant effect on stuttering attitudes. The students’ responses on open-ended qualitative questionnaires, however, demonstrated that three additional curricula conducted at three different times did reduce negative attitudes toward PWS. Such outcomes on qualitative questionnaires may inspire additional studies in the future and the creation of further educational projects emphasizing the reduction of negative stigma toward PWS. The three curricula showed once again that the process of stereotyping cannot be totally mitigated by a single curriculum or training program. Change in attitudes comes “with a hefty price tag of time, effort, and often traumatic inner struggle. When we are trying to change attitudes that have deep roots in culture, other beliefs, and personality dynamics, we are in for tough sledding” (Schneider, 2004, p. 401).