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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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“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]
In the citing paper
“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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Trait and social anxiety in adults with chronic stuttering: Conclusions following meta-analysis
Craig, A. R., & Tran, Y. (2014) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2014.01.001 · Cited by 219
Stuttering as Defined by Adults Who Stutter
Tichenor, S. E., & Yaruss, J. S. (2019) · Journal of Speech, Language, and Hearing Research · doi:10.1044/2019_jslhr-19-00137 · Cited by 195
Self-citationEnacted stigma and felt stigma experienced by adults who stutter
Boyle, M. (2018) · Journal of Communication Disorders · doi:10.1016/j.jcomdis.2018.03.004 · Cited by 161
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Variability of Stuttering: Behavior and Impact
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“…treatment seek to help speakers understand their thoughts associated with stuttering and to defuse their emotional reactions from those thoughts (Beilby et al., 2013, 2012; Blood, 1995; Boyle, 2011; Cheasman, 2013; Emerick, 1988; Gupta et al., 2016; Harley, 2018; Helgadóttir et al., 2014;…”
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Relationships Between Psychosocial Factors and Quality of Life for Adults Who Stutter
Boyle, M. (2014) · American Journal of Speech-Language Pathology · doi:10.1044/2014_ajslp-14-0089 · Cited by 95
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“2019 Informa UK Limited, trading as Taylor & Francis Group psychological therapies to treat stuttering including Cognitive Behavioural Therapy [15,16] and Acceptance and Commitment Therapy [17], with improvements in psychosocial functioning and speech fluency reported.”
BackgroundPsychosocial Impact of Living with a Stuttering Disorder: Knowing Is Not Enough.
Beilby, J. (2014) · Seminars in Speech and Language · doi:10.1055/s-0034-1371756 · Cited by 71
“The integrated ACT program that we wrote focused on effective communication techniques for improving frequency of stuttering at the same time as strategies addressing psychosocial functioning, readiness for therapy and change, utilization of mindfulness skills, and psychological flexibility for adults who stutter.(69,…”
BackgroundMethodInfluentialRepetitive Negative Thinking, Temperament, and Adverse Impact in Adults Who Stutter
Tichenor, S. E., & Yaruss, J. S. (2019) · American Journal of Speech-Language Pathology · doi:10.1044/2019_ajslp-19-00077 · Cited by 61
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Boyle, M., Beita-Ell, C., Milewski, K. M., & Fearon, A. N. (2018) · Journal of Speech Language and Hearing Research · doi:10.1044/2018_jslhr-s-17-0443 · Cited by 58
Self-efficacy and quality of life in adults who stutter
Carter, A., Breen, L., Yaruss, J. S., & Beilby, J. (2017) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2017.09.004 · Cited by 55
“In recent years, research conducted by Beilby et al. (2012) has investigated the effectiveness of a novel, multi-layered approach to the treatment of adults who stutter, by integrating Acceptance and Commitment Therapy (ACT) with speech fluency tasks.”
BackgroundResultInfluentialLaiho, A., Elovaara, H., Kaisamatti, K., Luhtalampi, K., Talaskivi, L., Pohja, S., Routamo-Jaatela, K., & Vuorio, E. (2022) · Journal of Communication Disorders · doi:10.1016/j.jcomdis.2022.106242 · Cited by 52
Understanding the Speaker's Experience of Stuttering Can Improve Stuttering Therapy
Tichenor, S. E., Herring, C., & Yaruss, J. S. (2022) · Topics in Language Disorders · doi:10.1097/tld.0000000000000272 · Cited by 48
Chard, I., & van Zalk, N. (2022) · Frontiers in Digital Health · doi:10.3389/fdgth.2022.842460 · Cited by 46
Bothelius, K., Jernelöv, S., Fredrikson, M., McCracken, L. M., & Kaldo, V. (2015) · SLEEP · doi:10.5665/sleep.5170 · Cited by 39
Harley, J. (2018) · American Journal of Speech-Language Pathology · doi:10.1044/2018_ajslp-odc11-17-0196 · Cited by 46
Doud, A. K., Hoepner, J. K., & Holland, A. L. (2020) · American Journal of Speech-Language Pathology · doi:10.1044/2020_ajslp-19-00042 · Cited by 36
The Clinical Applications of Acceptance and Commitment Therapy with Clients Who Stutter
Palasik, S., & Hannan, J. (2013) · Perspectives on Fluency and Fluency Disorders · doi:10.1044/ffd23.2.54 · Cited by 34
Stuttering experience of people in China: A cross-cultural perspective
Yan, M., Oxley, J. D., Yaruss, J. S., & Tetnowski, J. A. (2023) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2023.105994 · Cited by 33
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“…can demonstrate why therapy programs address thoughts and beliefs through cognitive behavioral therapy (Menzies et al., 2009), or on mindfulness and acceptance (Bielby et al., 2012; Boyle, 2011), are effective at not only improving quality of life but also on improving lasting changes in fluency.”
BackgroundWhat works for whom? Multidimensional individualized stuttering therapy (MIST)
Sønsterud, H., Halvorsen, M. S., Feragen, K. B., Kirmess, M., & Ward, D. (2020) · Journal of Communication Disorders · doi:10.1016/j.jcomdis.2020.106052 · Cited by 30
Self-Compassion and Quality of Life in Adults Who Stutter
Croft, R. L., & Byrd, C. T. (2020) · American Journal of Speech-Language Pathology · doi:10.1044/2020_ajslp-20-00055 · Cited by 33
“These approaches overlap with self-compassion in their mindful awareness (mindfulness intervention and cognitive – behavioral therapy) and/or acceptance of thoughts and feelings (ACT).”
BackgroundMethodInfluentialWang, J., & Fang, S. (2023) · International Journal of Mental Health Promotion · doi:10.32604/ijmhp.2023.025304 · Cited by 28
What do people search for in stuttering therapy: Personal goal-setting as a gold standard?
Sønsterud, H., Feragen, K. B., Kirmess, M., Halvorsen, M. S., & Ward, D. (2020) · Journal of Communication Disorders · doi:10.1016/j.jcomdis.2019.105944 · Cited by 37
“Thus, both ‘freedom-focus’ and/or ‘fluency-focus’ therapies (Venkatagiri, 2009) could be considered as one integrative approach, as is already the case in some stuttering programs, such as the ISTAR Comprehensive Stuttering Program (Langevin, Kully, Teshima, Hagler, & Narasimha Prasad, 2010) or the Acceptance and Comm…”
How Speech–Language Pathologists Can Minimize Bullying of Children Who Stutter
Reeves, N. A., Herring, C., & Yaruss, J. S. (2018) · Seminars in Speech and Language · doi:10.1055/s-0038-1667163 · Cited by 27
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“Around the same time, the frst author started participating in an Acceptance and Commitment Therapy (ACT) program for people who stutter [9], which emphasized recognizing and accepting emotions and thoughts associated with stuttering rather than letting them dictate one’s actions.”
InfluentialAbsolute and Relative Reliability of Percentage of Syllables Stuttered and Severity Rating Scales
Karimi, H., O’Brian, S., Onslow, M., & Jones, M. (2014) · Journal of Speech Language and Hearing Research · doi:10.1044/2014_jslhr-s-13-0106 · Cited by 26
Emotional Regulation and Its Influence on the Experience of Stuttering Across the Life Span
Tichenor, S. E., Walsh, B. M., Gerwin, K. L., & Yaruss, J. S. (2022) · Journal of Speech Language and Hearing Research · doi:10.1044/2022_jslhr-21-00467 · Cited by 30
Targeting Communication Effectiveness in Adults Who Stutter
Byrd, C. T., Coalson, G. A., & Young, M. M. (2022) · Topics in Language Disorders · doi:10.1097/tld.0000000000000270 · Cited by 24
Bridging the Gap between Cognitive Therapy and Acceptance and Commitment Therapy (ACT)
Harley, J. (2015) · Procedia - Social and Behavioral Sciences · doi:10.1016/j.sbspro.2015.03.252 · Cited by 26
Management of stuttering using cognitive behavior therapy and mindfulness meditation
Gupta, A., Mongia, M., Vijay, A., & Sadhu, R. (2019) · Industrial Psychiatry Journal · doi:10.4103/ipj.ipj_18_19 · Cited by 32
“Mindfulness promotes a focus on the present, where values represent the domains of life that are the most meaningful to the client, and committed actions represent the steps that one takes to reach their goals.[55]”
BackgroundFear of negative evaluation, trait anxiety, and judgment bias in adults who stutter
Brundage, S. B., Winters, K. L., & Beilby, J. M. (2017) · American Journal of Speech-Language Pathology · doi:10.1044/2017_ajslp-16-0129 · Cited by 26
Self-citationAdult stuttering and attentional ability: A meta-analytic review
Doneva, S. P. (2019) · International Journal of Speech-Language Pathology · doi:10.1080/17549507.2019.1665710 · Cited by 23
Psychological counseling as an adjunct to stuttering treatment: Clients’ experiences and perceptions
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“…specific fluency enhancing skills while carrying out activities that focused on the following six core ACT processes that contribute to psychological flexibility: self-concept, defusion, acceptance, mindfulness, values, and committed action (Beilby et al, 2012; Hayes, Strosahl, & Wilson, 1999).”
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Measuring psychological inflexibility in adult and child hearing loss
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Acceptance and commitment therapy for people who stutter.
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The relationship between stuttering anticipation and verbal response time in adults who stutter
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“…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
Resilience in people who stutter: Association with covert and overt characteristics of stuttering
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Speech rate adjustment of adults during conversation
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Variability of Stuttering in Young Children: Caregivers' Perceptions and Experiences
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An Exploration of Mindfulness in Speech-Language Pathology
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“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
“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
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
Feldman, O., Goldstien, E., Rolnik, B., Ganz, A. B., & Lev-Ari, S. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10102187 · Cited by 13
“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
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
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 13
“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
“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
“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
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
Overview of research over the efficiency of therapies of stuttering
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“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
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Immediate Effects of Mindfulness Meditation on the Voice
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Event‐ and interval‐based measurement of stuttering: a review
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Efficacy of the Arabic Modified Fluency Shaping Program in the treatment of stuttering
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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
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
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
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
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
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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
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
Eggers, K., & Leahy, M. M. (2022) · Routledge eBooks · doi:10.4324/9781003179016 · Cited by 7
Alatawi, M., & Good, J. (2025) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2025.106126 · Cited by 7
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
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
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
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
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
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
“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
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
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
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
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
“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
“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
Metadata
- 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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