Keywords
affirmative therapies
neurodiversity
ableism
CARE model
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Abstract
This article addresses affirmative approaches to stuttering therapy in the context of contemporary neurobiological, psychosocial, and socio--cultural understandings. The subject of the paper is the current paradigm shift from fluency-oriented intervention toward approaches that prioritize communicative participation, psychological well-being, agency, and quality of life. The article is aimed to present the theoretical foundations of this transformation, discuss the main assumptions of affirmative therapy with reference to the CARE model, and demonstrate the relevance of these developments for Polish conditions.
The paper is theoretical and review-based. It is grounded in a narrative review and critical synthesisof recent international and Polish stuttering literature. It includes studies on neurobiology, self-stigma, ableism, communicative participation, and lived experience, as well as publications and reports related to the first Polish implementation of Camp Dream. Speak. Live. and CARE-inspired therapeutic practice.
The analysis shows that stuttering is best understood as a complex neurodevelopmental phenomenon rather than a learned habit or a deficit that is reduced to speech disfluency alone. It also indicates that the most harmful consequences associated with stuttering arise not from disfluency itself, but from fluency pressure, both social and internalized stigma, avoidance, as well as communicative microaggressions. From this perspective, therapeutic models focused exclusively on reducing observable disfluency appear insufficient and may, in some cases, reinforce shame, masking, and reduced communicative autonomy.
The article concludes that affirmative approaches, including the CARE model, provide a well-grounded framework for redefining stuttering intervention. Their value lies in supporting communication, advocacy, resilience, education, and self-acceptance rather than fluency alone. The paper argues that implementing such approaches in Poland is justified and necessary, and that the evaluation of stuttering therapy should be based on broader outcome criteria reflecting the real-life experience of people who stutter and the need to reduce ableist assumptions in clinical practice.
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