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.
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.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
36
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.
Fenerbahce
Ataşehir, Istanbul, Turkey (Türkiye)
RECRUITINGStuttering frequency
Change in stuttering frequency calculated from standardized speech samples.
Time frame: Baseline (Week 0) and Week 10
ANXIETY IN SELECTION INTERVIEWS
MEASURE OF ANXIETY IN SELECTION INTERVIEWS (MASI)
Time frame: Baseline (Week 0) and immediately after completion of the 10-week intervention (Week 10)
fear of negative evaluation
Change in fear of negative evaluation measured using the Brief Fear of Negative Evaluation Scale (BFNE). Higher scores indicate greater fear of negative evaluation.
Time frame: Baseline (Week 0) and immediately after completion of the 10-week intervention (Week 10)
self-stigma
Change in self-stigma related to stuttering measured using the Self-Stigma of Stuttering Scale (4S-TR). Higher scores indicate greater self-stigma.
Time frame: Baseline (Week 0) and immediately after completion of the 10-week intervention (Week 10)
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