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Improving access to psychological therapies in voice disorders: a cognitive behavioural therapy model

Miller, Tracya; Deary, Vincentb; Patterson, Joc

Current Opinion in Otolaryngology & Head and Neck Surgery: June 2014 - Volume 22 - Issue 3 - p 201–205
doi: 10.1097/MOO.0000000000000056

Purpose of review The improving access to psychological therapies initiative has highlighted the importance of managing mental health problems effectively, and research has shown excellent outcomes from cognitive behavioural therapy (CBT) interventions. Patients presenting with functional dysphonia will often also describe psychological distress including anxiety, depression and reduced general well-being, and it is felt that effective voice therapy needs to include the management of psychological well-being. The evidence for the use of CBT enhanced voice therapy is limited to date. Recent research has only started to identify the benefits of this approach and questions regarding how to achieve and maintain competence are essential.

Recent findings Voice therapy outcomes are positive and patients receiving CBT with voice therapy have shown more improvement in their general well-being and distress.

Summary CBT is a very well evidenced therapy and recommended by The National Institute for Health and Care Excellence (NICE) as the treatment of choice for mental health difficulties and medically unexplained symptoms. Allied health professionals are increasingly being trained to use CBT skills in the management of a number of symptoms/illnesses, and this should be considered for the management of functional dysphonia. However, there is a need for more research and detailed consideration of how therapists should be trained and supervised and how cost-effective this approach may be.

aThe Freeman Hospital, Newcastle Upon Tyne

bNorthumbria University, Newcastle Upon Tyne

cSunderland Royal Hospital, Sunderland, UK

Correspondence to Tracy Miller, Department of speech, voice and swallowing, Freeman Hospital, High Heaton, Newcastle Upon Tyne NE7 7DN, UK. Tel: +44 191 2137646; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins