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The authors begin this article by highlighting two issues in voice therapy: 1. the high rate of relapse and 2. poor attendance at appointments. They attribute this to there not being carryover (or generalisation) work embedded into most voice therapy techniques. The key principle of generalisation underpins the development of this novel voice intervention called conversation training therapy. A patient is taught to use clear speech techniques within a conversation, accompanied by negative practice (practising old and new voice) in order to label the new voice. Increased awareness of auditory and kinaesthetic aspects of voice production, training on prosody, patterns of stress and projection and specific phonemes (basic training gestures) are embedded in this practice. The authors report on a pilot and an efficacy study that demonstrated a decrease on participants’ Vocal Handicap Index-10 scores after four sessions and three months later. It is increasingly understood that interventions that promote generalisation are more person centred and ecological across communication difficulties. This paper describes this complex intervention in great detail, helpfully promoting replication in a clinical setting.

Conversation Training Therapy: Let’s Talk It Through.
Gardner-Schmidt J, Gillespie AI.
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Anna Volkmer

UCL, London, UK.

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