Acceptance and Commitment Therapy for Adults Who Stutter: Psychosocial Adjustment and Speech Fluency
Abstract
Unlabelled The aim of the present study was to assess the effectiveness of an Acceptance and Commitment Therapy group intervention program for adults who stutter (N=20). The program consisted of 2-h therapeutic sessions conducted weekly for eight consecutive weeks. It was an integrated program designed to improve: (a) psychosocial functioning, (b) readiness for therapy and change, (c) utilisation of mindfulness skills and psychological flexibility, and (d) frequency of stuttering. The findings provide innovative evidence for Acceptance and Commitment Therapy as an effective intervention with statistically significant improvements in psychosocial functioning, preparation for change and therapy, utilisation of mindfulness skills, and overall speech fluency. Follow-up data collected at three months post-treatment revealed that therapeutic gains were successfully maintained over time. These findings enhance the understanding of the impact of stuttering on psychological wellbeing and offer a new perspective on what might constitute successful stuttering treatment. Further, clinical research support is provided for Acceptance and Commitment Therapy delivered in a group format as a promising and novel intervention for adults who stutter.Educational objectives The reader will be able to: (a) appreciate the potential for Acceptance and Commitment Therapy for adults who stutter; (b) identify the improvements participants experienced in psychosocial functioning and frequency of stuttered speech; (c) appreciate the six core processes of Acceptance and Commitment Therapy; and (d) appreciate the differences between an ACT model of intervention for adults who stutter compared to a CBT approach.
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Beilby and colleagues (2012) found that ACT improved OASES scores and reduced the adverse impact of stuttering on the lives of adults who stutter.
“Similar findings were reported by Beilby and colleagues (2012) who investigated the effect of the psychological–behavioral intervention, ACT, on adults who stutter. Their results demonstrated an improvement in the OASES instrument and major reductions in the adverse impact of stuttering on the lives of the participants, following participation in the program [50].”
From Inquiry based stress reduction (Ibsr) improves overall stuttering experience among adults who stutter: A randomized controlled trial (2021) · cites this paper as [50]
Other well-documented, effective approaches include the Comprehensive Stuttering Therapy Program and the Integrated Fluency and Acceptance and Commitment Therapy Intervention approach.
“Other well-documented, effective approaches include the Comprehensive Stuttering Therapy Program (Langevin et al., 2010) and the Integrated Fluency and Acceptance and Commitment Therapy Intervention approach of Beilby et al. (2012) and Hart et al. (2024).”
From Multidimensional Individualized Stuttering Therapy Outcomes At 24 Months Post Clinic: An Embodiment and Awareness Perspective. (2025) · cites this paper as Beilby et al. (2012)
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Beilby, J. M., & Byrnes, M. L. (2012) · Perspectives on Fluency and Fluency Disorders · doi:10.1044/ffd22.1.34 · Cited by 21 · see citing works
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Connery, A., Yaruss, J. S., Lomheim, H., Loucks, T. M. J., Galvin, R., & McCurtin, A. (2021) · International Journal of Language & Communication Disorders · doi:10.1111/1460-6984.12680 · Cited by 22 · see citing works
To be or not to be: Stuttering and the human costs of being “un-disabled”
Watermeyer, B., & Kathard, H. (2015) · International Journal of Speech-Language Pathology · doi:10.3109/17549507.2015.1060528 · Cited by 20 · see citing works
Marocchini, E., & Baldin, I. (2024) · International Journal of Language & Communication Disorders · doi:10.1111/1460-6984.13095 · Cited by 23 · see citing works
Attentional Bias Among Adolescents Who Stutter: Evidence for a Vigilance–Avoidance Effect
Rodgers, N. H., Lau, J. Y. F., & Zebrowski, P. M. (2020) · Journal of Speech Language and Hearing Research · doi:10.1044/2020_jslhr-20-00090 · Cited by 19 · see citing works
Rodgers, N. H., Berquez, A., Hollister, J., & Zebrowski, P. M. (2020) · Perspectives of the ASHA Special Interest Groups · doi:10.1044/2020_persp-20-00124 · Cited by 18 · see citing works
Rodgers, N. H., & Gerlach, H. (2022) · American Journal of Speech-Language Pathology · doi:10.1044/2022_ajslp-21-00251 · Cited by 19 · see citing works
Incorporating a Mindfulness Meditation Exercise Into a Stuttering Treatment Program
Emge, G., & Pellowski, M. W. (2019) · Communication Disorders Quarterly · doi:10.1177/1525740118783516 · Cited by 23 · see citing works
The relationship between stuttering anticipation and verbal response time in adults who stutter
Arenas, R. M., & Zebrowski, P. M. (2016) · Speech Language and Hearing · doi:10.1080/2050571x.2016.1201346 · Cited by 17 · see citing works
“…increases the likelihood of stuttering does in fact contribute to actual stuttering, it may justify the use of approaches like cognitive behavioral therapy (Menzies et al., 2009) or acceptance and commitment therapy (Beilby et al., 2012) to modify, manage, and increase awareness of these beliefs.”
BackgroundSelf-efficacy beliefs: Experiences of adults who stutter
Carter, A., Breen, L. J., & Beilby, J. M. (2019) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2019.03.002 · Cited by 20 · see citing works
Resilience in people who stutter: Association with covert and overt characteristics of stuttering
Freud, D., & Amir, O. (2020) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2020.105761 · Cited by 19 · see citing works
Speech rate adjustment of adults during conversation
Freud, D., Ezrati-Vinacour, R., & Amir, O. (2018) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2018.06.002 · Cited by 17 · see citing works
Li, J., Wu, S., & Leshed, G. (2024) · Designing Interactive Systems Conference · doi:10.1145/3643834.3661533 · Cited by 17 · see citing works
Variability of Stuttering in Young Children: Caregivers' Perceptions and Experiences
Jokar, A. H. R., Salehi, S., & Yaruss, J. S. (2025) · American Journal of Speech-Language Pathology · doi:10.1044/2025_ajslp-24-00341 · Cited by 17 · see citing works
Johnson, C. A., Gerwin, K. L., Tichenor, S. E., Boyle, M. P., & Walsh, B. M. (2024) · Journal of Speech Language and Hearing Research · doi:10.1044/2024_jslhr-24-00069 · Cited by 18 · see citing works
Behavioral and social competency profiles of stutterers
Giorgetti, M. D. P., de Oliveira, C. M. C., & Giacheti, C. M. (2015) · CoDAS · doi:10.1590/2317-1782/20152013065 · Cited by 15 · see citing works
An Exploration of Mindfulness in Speech-Language Pathology
Medina, A. M., & Mead, J. S. (2020) · Communication Disorders Quarterly · doi:10.1177/1525740120942141 · Cited by 15 · see citing works
“For instance, Acceptance and Commitment Therapy (ACT) is a program for clients who stutter that addresses psychosocial functioning, readiness for therapy and change, utilization of mindfulness skills and psychological flexibility, and stuttering frequency (Beilby & Byrnes, 2012; Beilby et al., 2012).”
BackgroundMethodMoreno‐Jiménez, J. E., Rodríguez‐Carvajal, R., García‐Rubio, C., Gualda, R. C., & Montero, I. (2021) · Clínica y Salud · doi:10.5093/clysa2021a1 · Cited by 14 · see citing works
“PWS are at risk of meeting criteria for panic disorder, social phobia, and generalized anxiety disorder (Iverach et al., 2009), and their quality of life and social and emotional functioning are decreased (Beilby et al., 2012; Craig et al., 2009).”
BackgroundRepetitive Negative Thinking in Adolescents Who Stutter
Tichenor, S. E., Gerwin, K. L., & Walsh, B. M. (2023) · Journal of Speech Language and Hearing Research · doi:10.1044/2023_jslhr-23-00147 · Cited by 15 · see citing works
Finding the Good in the Challenge: Benefit Finding Among Adults Who Stutter
Boyle, M., Beita-Ell, C., & Milewski, K. M. (2019) · Perspectives of the ASHA Special Interest Groups · doi:10.1044/2019_pers-sig4-2019-0024 · Cited by 16 · see citing works
Feldman, O., Goldstien, E., Rolnik, B., Ganz, A. B., & Lev-Ari, S. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10102187 · Cited by 13 · see citing works
“Their results demonstrated an improvement in the OASES instrument and major reductions in the adverse impact of stuttering on the lives of the participants, following participation in the program [50].”
ResultO’Donoghue, J., Egan, G., Moss, H., & Clements-Cortés, A. (2021) · The Arts in Psychotherapy · doi:10.1016/j.aip.2021.101809 · Cited by 13 · see citing works
Understanding the Broader Impact of Stuttering: Suicidal Ideation
Tichenor, S. E., Palasik, S., & Yaruss, J. S. (2023) · American Journal of Speech-Language Pathology · doi:10.1044/2023_ajslp-23-00007 · Cited by 14 · see citing works
Counseling Confidence in Preservice and Early Career Speech-Language Pathologists
Johnson, L. W., & Hall, K. D. (2023) · Perspectives of the ASHA Special Interest Groups · doi:10.1044/2023_persp-22-00224 · Cited by 12 · see citing works
“Several models and frameworks for counseling within our field have emerged including the narrative therapy approach to counseling (Nourse, 2015), mindfulness approaches (Boyle, 2011), and acceptance and commitment therapy (Beilby et al., 2012).”
McNaney, R., Bull, C., Mackie, L., Floriane, D., Stringer, H., Richardson, D., & Welsh, D. (2018) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3173574.3173841 · Cited by 12 · see citing works
“As it becomes more widely accepted that there is more to PwS than just their dysfluencies [39], more holistic models of therapy are being used, such as Cognitive Behavioral Therapy (CBT) [28] and Acceptance and Commitment Therapy (ACT) [1].”
BackgroundMethodStuttering Treatment Approaches from the Past Two Decades: Comprehensive Survey and Review
Gupta, G., Chandra, S., Dautenhahn, K., & Loucks, T. M. J. (2022) · Journal of Student Research · doi:10.47611/jsr.v11i2.1562 · Cited by 12 · see citing works
“Live. and Acceptance and Commitment Therapy (ACT) are more recently developed intervention programs that show therapeutic potential, but are not described further in order to manage the length of the review (Beilby et al., 2012; Byrd et al., 2018; Freud et al., 2020).”
BackgroundHart, A. K., Breen, L. J., & Beilby, J. M. (2021) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2021.105852 · Cited by 11 · see citing works
Coalson, G. A., Byrd, C. T., Werle, D., Croft, R. L., & Mahometa, M. J. (2024) · American Journal of Speech-Language Pathology · doi:10.1044/2024_ajslp-23-00234 · Cited by 10 · see citing works
Overview of research over the efficiency of therapies of stuttering
Humeniuk, E., & Tarkowski, Z. (2016) · Polish Annals of Medicine · doi:10.1016/j.poamed.2016.11.007 · Cited by 11 · see citing works
“Twenty adult individuals who participated in the programme displayed improvement in each of the parameters tested and the effects were still visible 3 months after the therapy.(26)”
BackgroundEnhancing the Therapy Experience Using Principles of Video Game Design
Folkins, J. W., Brackenbury, T., Krause, M. O. P., & Haviland, A. (2015) · American Journal of Speech-Language Pathology · doi:10.1044/2015_ajslp-14-0059 · Cited by 11 · see citing works
Immediate Effects of Mindfulness Meditation on the Voice
Becker, D. R., Shelly, S., Kavalieratos, D., Maira, C. P., & Gillespie, A. I. (2022) · Journal of Voice · doi:10.1016/j.jvoice.2022.10.022 · Cited by 12 · see citing works
Event‐ and interval‐based measurement of stuttering: a review
Valente, A. R., Jesus, L. M. T., Hall, A. O., & Leahy, M. M. (2014) · International Journal of Language & Communication Disorders · doi:10.1111/1460-6984.12113 · Cited by 10 · see citing works
Efficacy of the Arabic Modified Fluency Shaping Program in the treatment of stuttering
Rifaie, N. A. A., Saber, A. S., El-Din, S. T. K., Sallam, Y. A. N., & Algamal, A. M. A. S. (2016) · The Egyptian Journal of Otolaryngology · doi:10.4103/1012-5574.192546 · Cited by 10 · see citing works
Participation in Camp Dream. Speak. Live.: Affective and Cognitive Outcomes for Children who Stutter
Byrd, C. T., Hampton, E., McGill, M., & Gkalitsiou, Z. (2016) · Journal of Speech Pathology & Therapy · doi:10.4172/jspt · Cited by 10 · see citing works
Efficacy of Acceptance and Commitment Therapy on Breast Cancer Female Patients’ Hope
Montazer, A., Nemati, F., Dehghani, F., & Fallah, T. (2017) · International Journal of Cancer Management · doi:10.5812/ijcp.5526 · Cited by 9 · see citing works
Effortful control and adaptive functioning in school-age children who stutter
Hollister, J., Zebrowski, P. M., Horne, A. O. V., McGregor, K., Vispoel, W., & Walden, T. A. (2015) · doi:10.17077/etd.1z9h6ynb · Cited by 10 · see citing works
Can Stoicism inspire stuttering intervention? The clinical usefulness of an ancient philosophy
Connery, A., Cavanna, A. E., & Coleman, R. (2022) · International Journal of Language & Communication Disorders · doi:10.1111/1460-6984.12832 · Cited by 9 · see citing works
Israel, S., Reuveni, O., Glick, I., & Levit‐Binnun, N. (2023) · American Journal of Speech-Language Pathology · doi:10.1044/2023_ajslp-22-00388 · Cited by 10 · see citing works
Moulaei, K., Dinari, F., Hosseini, M., Almasi, S., Sabet, B., Anabestani, R., & Afrash, M. R. (2025) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2025.105784 · Cited by 8 · see citing works
Lamoureux, G., Finlay, S., Moïse‐Richard, A., Ménard, L., & Verduyckt, I. A. (2024) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2024.106075 · Cited by 8 · see citing works
Zenner, E., Grondelaers, S., Rosseel, L., Speelman, D., Esselinckx, M., & Rombouts, E. (2021) · Language & Communication · doi:10.1016/j.langcom.2021.08.002 · Cited by 7 · see citing works
3Es: An All-Inclusive Stuttering Therapy Tool
Gore, K., & Margulis, C. L. (2022) · Perspectives of the ASHA Special Interest Groups · doi:10.1044/2022_persp-20-00300 · Cited by 7 · see citing works
Eggers, K., & Leahy, M. M. (2022) · Routledge eBooks · doi:10.4324/9781003179016 · Cited by 7 · see citing works
Alatawi, M., & Good, J. (2025) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2025.106126 · Cited by 7 · see citing works
A professional perspective on EBP in stuttering: How far have we come in 20 years?
Ratner, N. B., & Brundage, S. B. (2025) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2025.106171 · Cited by 13 · see citing works
Reimagining stuttering therapy and outcomes through an acceptance and collaborative lens
Irani, F., Azios, M., Boyle, M., Coalson, G. A., Palasik, S., Rodríguez, J. E. I., & Swartz, E. R. (2025) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2025.106105 · Cited by 6 · see citing works
The Utility of Cinematherapy for Stuttering Intervention: An Exploratory Study
Azios, M., Irani, F., Bellon-Harn, M. L., Swartz, E. R., & Benson, C. (2020) · Seminars in Speech and Language · doi:10.1055/s-0040-1716705 · Cited by 6 · see citing works
Hart, A. K., Breen, L. J., Hennessey, N. W., & Beilby, J. M. (2024) · Journal of Speech, Language, and Hearing Research · doi:10.1044/2023_jslhr-23-00252 · Cited by 6 · see citing works
Speech Therapy and Earnings: Economic Benefits for Individuals Who Stutter
Briley, P. M., & Jacobs, M. (2022) · Seminars in Speech and Language · doi:10.1055/s-0042-1748882 · Cited by 7 · see citing works
Characteristics of adults who stutter by treatments sought
Iverach, L., Jones, M., Lowe, R., O’Brian, S., Menzies, R. G., Packman, A., & Onslow, M. (2019) · Logopedics Phoniatrics Vocology · doi:10.1080/14015439.2018.1452976 · Cited by 5 · see citing works
“Consequently, several psychological treatment packages have been developed to deal with the unique fears and anxieties experienced by people who stutter, including Acceptance and Commitment Therapy (32) and Cognitivebehaviour therapy (CBT) (33).”
BackgroundSønsterud, H., Costain, K., & Ward, D. (2025) · American Journal of Speech-Language Pathology · doi:10.1044/2024_ajslp-24-00074 · Cited by 5 · see citing works
Repetitive Negative Thinking as a Mechanism of Stuttering Anticipation
Tichenor, S. E., Walsh, B. M., Gerwin, K. L., & Yaruss, J. S. (2025) · Journal of Speech Language and Hearing Research · doi:10.1044/2025_jslhr-24-00175 · Cited by 6 · see citing works
Identifying perspectives of adults who stutter on therapeutic alliance in stuttering intervention
Byrne, E., & Connery, A. (2023) · Advances in Communication and Swallowing · doi:10.3233/acs-230009 · Cited by 5 · see citing works
Cognitive processing biases of social anxiety in adults who do and do not stutter
Swift, M. C., Depasquale, M., & Chen, J. (2024) · Journal of Communication Disorders · doi:10.1016/j.jcomdis.2024.106472 · Cited by 9 · see citing works
Turn-Taking Behaviors during Interaction with Adults-Who-Stutter
Freud, D., Moria, L., Ezrati-Vinacour, R., & Amir, O. (2016) · Journal of Developmental and Physical Disabilities · doi:10.1007/s10882-016-9488-y · Cited by 5 · see citing works
“Because the subjective experience of the interaction is viewed as an important pivot in many stuttering therapy programs (e.g., Beilby et al. 2012; Menzies et al. 2008), this could alter the PWS’s perception, and consequently adjust his/her reaction to the situation.”
BackgroundNilsson, C., Nyberg, J., & Strömbergsson, S. (2021) · Child Language Teaching and Therapy · doi:10.1177/0265659021995538 · Cited by 5 · see citing works
“Treatment methods incorporating the perspective of contextual and individual attitudes towards these unresolved speech traits are indeed represented in the scope of stuttering therapy, i.e. acceptance and commitment therapy (Beilby et al., 2012).”
Method
- Authors
- Beilby, J. M., Byrnes, M. L., & Yaruss, J. S.
- Affiliations
- Curtin University (AU)
- The University of Western Australia (AU)
- University of Pittsburgh (US)
- Corresponding author
- Beilby, Janet M.
- Venue
- Journal of Fluency Disorders
- Publisher
- Elsevier BV
- Published
- 2012-12
- Volume
- 37
- Issue
- 4
- Pages
- 289-299
- ISSN
- 0094-730X (ISSN-L)
- OpenAlex
- W2071779407
- Cited by
- 188
- References
- 56
- Citations by year
- 2026: 16 · 2025: 21 · 2024: 13 · 2023: 17 · 2022: 23 · 2021: 13 · 2020: 15 · 2019: 11 · 2018: 11 · 2017: 8 · 2016: 18 · 2015: 11 · 2014: 6 · 2013: 3 · 2012: 1
- FWCI
- 7.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Fluency Disorders (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- eSpace (Curtin University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Stuttering Research and Treatment
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- acceptance and commitment therapy, stuttering, adults who stutter, group intervention, psychosocial adjustment, speech fluency, mindfulness, psychological flexibility, readiness to change, maintenance therapy, psychological well-being
- MeSH terms
- Adult, Aged, Female, Humans, Male, Middle Aged, Psychotherapy, Surveys and Questionnaires, Social Adjustment, Speech, Stuttering, Treatment Outcome, Mind-Body Therapies, Young Adult
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