Basic Concepts in Functional Voice Therapy.
A system for systematizing and quantifying the contents of the functional approach

Philippe H. DeJonckere

Comparison of the outcomes of different treatments is an important element in the search for the optimal clinical care of patients. A necessary condition for such a comparison is a standardization of each kind of treatment. If the possible treatments consist of different pharmacological agents (including placebo) or of different surgical techniques, standardization may be quite easy to achieve. In the case of voice therapy, differentiating between therapeutical approaches is much more difficult. Generally, the therapist uses a customized mixture of different techniques for each patient. This mixture will depend on the etiological (medical) and functional (including the degree of severity) diagnoses, but also on the therapist's own professional experience, and on the personality of the patient. In the context of clinical research, this is undesirable. However, from an ethical point of view, it is seldom justifiable to assign patients at random to a single specific therapeutic technique. The only solution is that the therapist remains free to organize the treatment in an optimal way, but that he/she must specify and quantify each ‘element’ (in the sense of basic concept) of his/her treatment after completion. In this way, different treatment profiles should emerge from the treatment descriptions of individual patients. These profiles could be related to treatment outcomes, for a given diagnosis.A system is described that makes it possible to characterize any type of functional voice therapy, in both a qualitative and a quantitative way. This system is based on nine basic elements, which are not related to any specific method or technique. These nine basic concepts (e.g. : information, training on prerequisites, integration/habituation etc…) are considered to cover all possible approaches to functional voice therapy. After completion of the treatment, the therapist evaluates the importance of each element over the whole course of treatment. A software program has been developed for scoring the different elements, as well as for computation of the relative percentage values, and for defining the global profile of the treatment.

Philippe H. Dejonckere

Utrecht University, The Netherlands ; Catholic University of Leuven , Belgium ; Federal Institute of Occupational Diseases, Brussels, Belgium.