An adult case which improved to the point of transition phase to normal range with the chronological mental rehearsal training program

[Purpose] An adult case who was able to reach the transition stage to normal range from phase 4 of classification of stuttering developmental phases with training using the chronological mental rehearsal (MR) training program based on Retrospective Approach to Spontaneous Speech (RASS) theory. The goal of this study is to examine factors behind the improvement by elucidating the relationship between the disappearance of fear in life scenes and what patients imagine in their heads.
[Methods] The patient was a male in his 20s. MR method involves creating instructions addressing factors that may worsen stuttering from early childhood up to the current age based on the content analysis of questionnaire regarding stuttering, and promoting patients imagining one scene per day. Also, fear in life scenes were assessed on a 7-point scale (6: Very strong, 0: No fear). In this study, we examined the scene of “Make a phone call and identify himself” that had the strongest fear.
[Result] 1. Initial assessment: Fear was assessed as 4. Training was not performed. 2. Second assessment (Five months later): Fear was assessed as 1. contents of a confrontation No.1 to 21 were performed. The age setting was 3-6 years old. It was mainly domestic communication such as seeking attention from parents and expressing requests. 3. Third assessment (ten months later): Fear was assessed as 0. Instructions No.22 to 35 were performed. The age setting was grade 1 to 6 of elementary school. It was mainly communication at school; for instance, a chitchat with friends, introducing himself and reading aloud in the class, which did not involve scenes of phone calls.
[Discussion] Before the training, the fear for the scene of “Make a phone call and identify himself” was 4, but by imagining scenes up to six years old, it improved to 1. By the time he imagined scenes up to grade 6 of elementary school, his fear became 0. Based on the results, improvement of stuttering was related to approach to the past of the patient. By repeatedly imagining himself talking naturally in various scenes in his head, fear for talking decreased, ultimately leading to reduction of fear for the phone call scene, which the patient had not even imagined.