Abstract/Summary

Introduction: This study investigates the efficacy of integrating Speech Modification (SM) and Mindfulness-Based Cognitive Therapy (MBCT) for managing adult stuttering in Saudi Arabia. SM, a well-established approach to stuttering, seeks to enhance speech fluency and reduce stuttering occurrences by modifying speaking behaviours and addressing underlying emotional factors. In contrast, MBCT introduces a cognitive dimension, focusing on emotional regulation and acceptance, crucial elements for managing the psychological impacts of stuttering. The integration of these approaches referred to as the Speech Modification and Mindfulness Therapy (SMMT) approach, is designed to provide a comprehensive intervention that targets both the behavioural and cognitive-affective components of stuttering. The ultimate goal is to enhance the quality of life for adults who stutter by addressing the disorder holistically. Methodology: This study employed a single-arm efficacy design with a mixed-methods approach, involving 30 adult participants. The intervention was delivered via telepractice over eight consecutive weeks, with weekly two-hour group therapy sessions. Quantitative assessments included the Five Facet Mindfulness Questionnaire (measuring key facets of mindfulness), the Overall Assessment of the Speaker’s Experience of Stuttering (evaluating the psychological and quality-of-life impact of stuttering), and the Stuttering Severity Instrument (assessing the frequency and severity of stuttering). Data were collected at three time points: immediately post-therapy, as well as at 3- and 6-month follow-ups, to evaluate sustained effects. In addition to the quantitative measures, qualitative data were gathered through open-ended questions and semi-structured interviews to capture participants' experiences, perceptions of the intervention, and overall satisfaction with the therapy and its delivery. Results: The study observed statistically significant improvements in all quantitative measures, including self-reported speech naturalness, with these benefits persisting through the 6-month follow-up. Qualitative data identified four key emerging themes: 1) Readiness for Therapy, 2) Therapeutic Intervention Components, 3) Service Delivery Format, and 4) Perceived Challenges and Constraints. Discussion and Conclusion: The findings from this study underscore the efficacy of the SMMT approach as a comprehensive treatment strategy for adult stuttering. By merging traditional speech therapy techniques with mindfulness practices, the intervention not only led to improvements in speech fluency but also significantly bolstered emotional regulation, communication skills, and social engagement among participants. These advancements contributed to an overall enhancement in participants' well-being and quality of life. The group therapy format emerged as a critical factor in the success of the intervention, fostering a supportive community that facilitated skill acquisition and encouraged self-acceptance. This sense of community was instrumental in maintaining participant motivation and engagement throughout the treatment process. Despite some logistical challenges, such as telepractice technological and environmental difficulties, the high satisfaction rates and the sustained treatment outcomes strongly support the effectiveness of the telepractice model. This model not only expanded access to treatment for individuals who might have otherwise encountered barriers to participation but also proved to be a viable method for delivering comprehensive stuttering therapy. The SMMT approach, therefore, holds promise as a valuable framework for future stuttering interventions, particularly in contexts where access to traditional in-person therapy is limited. Further research is recommended to explore the validity and applicability of this model across various demographic and cultural groups, ensuring it can be broadly implemented and sustained over time.