What is the most direct way to address a patient’s fear of coworkers reacting to disfluent speech?

Addressing a patient’s fear of coworkers reacting to disfluent speech effectively involves understanding and reshaping the patient's thoughts and beliefs about their speech and the context in which it occurs. The application of cognitive behavioral therapy (CBT) principles is particularly suited for this purpose because CBT targets the specific fears and anxieties that the patient may experience, which can exacerbate their speech disfluencies.

Through techniques such as cognitive restructuring, patients can learn to identify and challenge negative thoughts related to how they perceive others' reactions to their speech. By addressing these cognitive distortions, patients can develop healthier coping strategies and reduce the anxiety associated with speaking in front of others, thus potentially improving their fluency over time.

In contrast, fluency-shaping therapy primarily focuses on the mechanics of speech production to reduce disfluency itself, rather than addressing the emotional and cognitive aspects of communication. Pharmacological management may provide relief from anxiety symptoms but does not directly tackle the root cognitive concerns related to fear of judgment. Lastly, progressive relaxation therapy can help reduce overall anxiety but lacks the direct cognitive reframing needed to specifically manage the fear of coworkers' reactions.

Thus, applying CBT principles directly addresses the emotional and cognitive components tied to the patient’s fear, making it the