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Desensitization-Based Structured Intervention Program for Individuals With Stuttering

2026年8月9日 更新者:DİLARA BASER

Examining the Effectiveness of a Desensitization-Based Structured Intervention Program for Individuals With Stuttering in Job Interviews

Stuttering is a common fluency disorder characterized by involuntary interruptions in speech flow, such as repetitions, prolongations, and blocks. It affects approximately 1% of the world's population and typically emerges in the early stages of language development, particularly in preschool. The exact cause of stuttering is still unknown, but it is believed to involve various combinations of genetic, developmental, environmental, and neurophysiological factors (Yairi and Ambrose, 2013). Stuttering not only affects an individual's communication skills but can also significantly impact their psychological and emotional state. Individuals may experience persistent anxiety about being ridiculed or negatively evaluated by others during stuttering episodes, and the pressure to speak fluently in everyday situations can create significant stress and anxiety (Guitar, 2013). The ICF model, developed by the World Health Organization, suggests examining an individual's health status not only at the biological level but also in the context of activity, participation, and environmental factors (WHO, 2001). In particular, the ICF-based model proposed by J. Scott Yaruss and Robert W. Quesal for stuttering offers an important framework for explaining the impact of stuttering on an individual's quality of life. In this context, stuttering is characterized by limited participation in social and professional life in terms of the level of participation (Yaruss & Quesal, 2004). Individuals with stuttering may experience a number of problems in their professional lives. Job interviews can be given as an example of these situations. Job interviews are an important starting point in the employment process. Job interviews are a situation that creates anxiety and causes avoidance behaviors for individuals with stuttering (Hohulin et al., 2010). Anxiety is defined as "unease, irrational fear, anxiety, worry, distress caused by an unknown danger, misfortune, fear or expectation originating from the unconscious" (Bakırcıoğlu, 2016: 893). When adult individuals with stuttering are faced with a socially threatening, anxiety-inducing environment, they show physical strain and their anxiety increases during stuttering (Bloodstein, 1995; Craig, 2003). The literature reports a positive correlation between threatening or challenging stimuli and the severity of stuttering. For example; Stuttering is observed to increase when speaking to an authority figure, a group, or impatient or critical listeners (Guitar, 2013). Conversely, the frequency of stuttering generally decreases in non-anxiety-inducing situations, such as speaking to a familiar person or someone who is not an authority figure (Craig, 2006). Furthermore, speakers with severe stuttering are more likely to be subjected to negative evaluations and labeling/stigmatization compared to speakers with less severe stuttering (Gabel, 2006). The fear of negative evaluation is defined by Leary (1983) as the individual being evaluated negatively and hostilely by others, or being stigmatized. Stigmatization, in turn, is described as a multidimensional phenomenon encompassing negative attitudes and behaviors towards individuals (Corrigan & Watson, 2002). The literature includes various therapies for stuttering and the accompanying negative emotional states. One of these approaches is known as desensitization. Desensitization for stuttering is considered an important component of therapy for individuals who stutter. According to most research findings in foreign literature, individuals with stuttering perceive job interviews as a difficult area (Bricker-Katz, Lincoln, and Cumming, 2013; Klein and Hood, 2004; Rice and Kroll, 2006). Furthermore, while many studies focus on the working lives of individuals with stuttering, there are only a few studies specifically addressing job search processes and interviews. No studies addressing job interviews for individuals with stuttering have been found in the local literature. Due to this gap in the literature, our research aims to contribute to the literature and guide future studies in this area. Our study will develop a 10-week desensitization-based therapy program and aims to examine the effects of this structured program on stuttering frequency, fear of negative evaluation, internalized stigma, and anxiety experienced during interviews for individuals with stuttering.

研究概览

详细说明

The structured therapy program designed for job interviews is planned for a total of 10 weeks, with pre-tests administered in the first week and post-tests in the last week. (Pre-test measurements will be taken in the 1st week, and post-test measurements in the 10th week.) Data collection will be conducted by the researcher through 40-50 minute individual therapy sessions once a week. Participants who approve the Informed Consent Form (Appendix 8) will be included in the study. Pre-test and post-test measurements will be collected via Google Forms, and the intervention program will be conducted face-to-face in the office in the 8th week, while the other weeks will be conducted online, in a hybrid format. A pilot application will be conducted before the main study begins. Job interviews in the 7th and 8th weeks will be conducted by an expert experienced in job interviews. After the intervention group completes the process, an accelerated program will be applied to the control group. While developing the content of the therapy, the literature was reviewed and desensitization-focused programs were examined (Hohulin and Sawyer, 2010; Çağlayan, 2024). Care was taken to ensure a systematic hierarchical structure in the development of the intervention, and the therapy content included desensitization strategies; education, voluntary stuttering, self-disclosure statements, gradual exposure, cognitive restructuring, scenario-based work, and role-playing exercises.

The program was finalized after obtaining expert opinions from 5 faculty members specializing in stuttering with at least 5 years of experience. The weekly general content plans for the therapies are presented below. WEEK 1:

- Taking pre-tests (via Google Forms) and providing information about the therapy process.

  • Demographic Information Form
  • Stuttering Frequency Measurement (400-syllable speech video recording sample)
  • Internalized Stigma Scale
  • Fear of Negative Evaluation Scale
  • Interview Anxiety Scale
  • Beck Depression Scale (The individual will complete the Beck Depression Scale for exclusion criteria.)
  • Beck Anxiety Scale (The individual will complete the Beck Anxiety Scale for exclusion criteria.)

WEEK 2:

- Providing information about stuttering (types of stuttering, frequency, prevalence, causes, effects of stuttering in adulthood), working on desensitization strategies to training strategies, and supporting the individual in gaining awareness. - Identifying the individual's stuttering moments and types. Talking about their stuttering.

WEEK 3:

  • Discussing career stages and job interviews. (Definitions, content, etc.)
  • Discussing the effects of target variables (fear of negative evaluation, anxiety in selection interviews, self-stigma, frequency of stuttering) on job interviews.

WEEK 4:

  • Discussing SWOT analysis and conducting individual analysis.
  • Based on the results of the analysis, conducting studies on cognitive restructuring strategies from desensitization strategies.

WEEK 5:

  • Practicing with different employer models, both supportive and challenging, created by the researcher.
  • Prioritizing role-playing exercises from desensitization strategies; defining and incorporating strategies such as self-disclosure, acceptance of stuttering, and voluntary stuttering.

WEEK 6:

- Meeting and chatting with an individual who stutters and has job interview experience via the Google Meet platform.

WEEK 7:

- Conducting a job interview over the phone. (by an experienced interviewer using a standard question list)

Planned questions:

"Could you tell us a little about yourself?" "Could you briefly summarize your education and career path?" "What are your strengths?" "What are your areas for improvement?" "How do you cope when faced with a difficult situation? Can you share an example?" "What are your expectations from the job and from us?" "Where do you see yourself in five years?"

WEEK 8:

Conducting a face-to-face job interview. (by an experienced interviewer using a standard question list)

Planned questions: "Could you tell us a little about yourself?" "Could you briefly summarize your education and career path?" "What are your strengths?" "What are your areas for improvement?" "How do you cope when faced with a difficult situation? If you have an example from your own experience, can you share it?" "What are your expectations from work and from us?" "Where do you see yourself in five years?"

WEEK 9:

Discussion with the participant about the intervention process conducted in previous weeks.

A conversation about how they evaluate their desensitization experiences and the termination of the therapy process.

WEEK 10:

Taking final test measurements. (Stuttering Frequency, Internalized Stigma Scale, Fear of Negative Evaluation Scale, Interview Anxiety Scale, Social Validity Form)

These are the measurements taken.

研究类型

介入性

注册 (估计的)

36

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习联系方式

学习地点

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 成人

接受健康志愿者

不

描述

Inclusion Criteria:

  • Aged 18-35,
  • Having had at least one job interview before,
  • Not actively receiving speech and language therapy support,
  • Having a stuttering frequency of 3% or higher

Exclusion Criteria:

  • Lacking an ethical statement
  • Above-average results on Beck Depression and Beck Anxiety Inventories

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:非随机化
  • 介入模型:并行分配
  • 屏蔽:无(打开标签)

武器和干预

参与者组/臂
干预/治疗
实验性的:Experimental
Participants will receive the structured desensitization-based job interview intervention program.
Participants will receive a structured desensitization-based job interview intervention program consisting of eight weekly individual sessions. The program includes psychoeducation about stuttering and job interview processes, identification of anxiety-provoking situations, cognitive restructuring, voluntary stuttering, graded exposure through simulated job interviews, and individualized feedback. The intervention aims to reduce job interview anxiety and improve communication confidence and interview performance in adults who stutter.
无干预:Control
Participants will not receive any intervention during the study period and will complete the same evaluation program. Following the study proposal and subsequent analysis, the program will be implemented within the framework of freedom and ethical values.

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Stuttering frequency
大体时间:Baseline (Week 0) and Week 10
Change in stuttering frequency calculated from standardized speech samples.
Baseline (Week 0) and Week 10
ANXIETY IN SELECTION INTERVIEWS
大体时间:Baseline (Week 0) and immediately after completion of the 10-week intervention (Week 10)
MEASURE OF ANXIETY IN SELECTION INTERVIEWS (MASI)
Baseline (Week 0) and immediately after completion of the 10-week intervention (Week 10)
fear of negative evaluation
大体时间:Baseline (Week 0) and immediately after completion of the 10-week intervention (Week 10)
Change in fear of negative evaluation measured using the Brief Fear of Negative Evaluation Scale (BFNE). Higher scores indicate greater fear of negative evaluation.
Baseline (Week 0) and immediately after completion of the 10-week intervention (Week 10)
self-stigma
大体时间:Baseline (Week 0) and immediately after completion of the 10-week intervention (Week 10)
Change in self-stigma related to stuttering measured using the Self-Stigma of Stuttering Scale (4S-TR). Higher scores indicate greater self-stigma.
Baseline (Week 0) and immediately after completion of the 10-week intervention (Week 10)

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

有用的网址

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2026年7月20日

初级完成 (估计的)

2027年1月1日

研究完成 (估计的)

2027年3月1日

研究注册日期

首次提交

2026年8月9日

首先提交符合 QC 标准的

2026年8月9日

首次发布 (实际的)

2026年8月14日

研究记录更新

最后更新发布 (实际的)

2026年8月14日

上次提交的符合 QC 标准的更新

2026年8月9日

最后验证

2026年8月1日

更多信息

与本研究相关的术语

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)?

不

IPD 计划说明

because of ethical values

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

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