Psychotherapy and Speech Therapy


Psychotherapy and Speech Therapy

Partners in developing stronger communication skills for adults


When it comes to communication training, voice therapy, and speech therapy for adults- I encounter many people who experience anxiety, nervousness, or general discomfort when communicating in their daily lives. In some cases the anxiety has been brought on by thoughts, feelings, or beliefs that a person has with respect to their communication. In other cases, the anxiety was not necessarily brought on by the communication difficulty- but a person will report they notice feelings of anxiety modify their communication or exacerbate any communication challenges that are already present.

For example, one adult who has a stutter may come to me reporting they are consistently anxious they are going to stutter and this prevents them from saying what they want to say or speaking up when they want to at home or at work. Another adult who has a stutter may come to me reporting that they don't think about their stutter until it happens and then they get anxious and uncomfortable- which only makes the stutter more apparent. In another example, one adult may come to me reporting that the pitch or quality of their voice makes them anxious about how others perceive them, while another adult may report they suffer from anxiety, and have noticed a consistent change in the quality of their voice whenever they are in an anxiety-provoking situation.

The common thread in every adult who steps through the doors of my clinic is that they recognize or have experienced the symbiotic and reciprocal relationship that thoughts, beliefs, and feelings have with communication. Many understand that our communication is such an integral part of our daily lives and who we are that it cannot possibly be separated from our perception of our self and our capabilities.

As a result of this close relationship and in an attempt to provide a more holistic model of care for my clients, I often collaborate or refer clients to a psychotherapist. Sometimes this is met with skepticism or uncertainty on the simple basis that a person does not have a good understanding of what psychotherapy is and how it may be able to benefit them. So, I reached out to my friend Gio Iacono who is a practicing psychotherapist in Toronto, who generously agreed to answer some basic questions about psychotherapy and its relationship to speech therapy and communication. Here's what he had to say.

Getting to Know Psychotherapy


What is Psychotherapy?/ Why does someone typically seek out psychotherapy services?

Psychotherapy provides individuals, couples, and families a way to help address and overcome life and relationship challenges, and improve mental health challenges (e.g., depression, anxiety), confidence and self-esteem. Psychotherapy can also help people change problematic behaviours (e.g., alcohol/drug misuse, overeating, gambling, etc.). Psychotherapy provides an opportunity for us to confidently explore our lives, cultivate self-awareness, growth and well-being.
Far from the traditional view that only people with “mental illness” are in therapy, today many people see a psychotherapist for a variety of human challenges! Facing life’s challenges alone can feel overwhelming – I believe that working with a psychotherapist can be helpful in sorting out difficult feelings, thoughts and beliefs. Psychotherapists aim to develop a therapeutic relationship that is sensitive to people’s needs and employ a wide range of skills to facilitate the client's goals.
While psychotherapy can, at times, be challenging, I believe that it is well worth the journey. I think psychotherapy can be a journey that provides us with a chance to stop amidst our busy lives, connect with ourselves more authentically, and move towards living more fully.
Psychotherapy addresses personal difficulties. It allows an individual, family, or couple, to talk openly and confidentially about their concerns and feelings with a trained professional. Almost all types of psychotherapy involve developing a therapeutic relationship, communicating and creating a dialogue, and working to overcome problematic thoughts, feelings or behaviours. Registered Psychotherapists are licensed professionals and may have training in a variety of backgrounds such as psychology, social work, nursing, and psychiatry.


What are the primary differences between psychology and psychotherapy?


Psychotherapy is mainly about working in a therapeutic relationship with individuals, couples, families or groups in order to talk about life issues (e.g., mental health, emotional problems, communication problems, family conflict, relationship issues, behavioural issues, spiritual matters, personal growth, etc.) and find ways to address or overcome these issues. Working with a psychotherapist can help bring meaningful change to our lives.


Psychology is the discipline and scientific study of the mind and human behaviour. The field of psychology focuses on understanding the mind, behaviours and relationships. Some areas of scientific exploration in psychology are: learning and memory, sensation and perception, motivation and emotion, thinking and language, personality and social behavior, intelligence,  child development, mental health problems. A psychologist may work as a psychotherapist, conduct psychological testing or research.


What does a typical psychotherapy session look like?

A typical individual session lasts approximately 45-60 minutes and may look like this: a check-in about how you have been doing overall (e.g., mentally, emotionally, physically) and your current situation; exploring what you may want to talk about/work on in the session; and collaboratively working with the psychotherapist to help gain understanding and potentially problem solve/set goals to help you move in the direction you want life to go.
Each session typically involves a level of sharing with the psychotherapist about your struggles and challenges. Psychotherapists are trained to work through various human problems and will provide a non-judgmental and open space to explore these challenges. Your session is completely confidential and private, unless you disclose that you are in danger to yourself (e.g., wanting to hurt yourself or end your life) or others, or suspected child abuse. Each session involves exploring any progress made towards improving your situation or reaching your goals.


Improving Communication Through Psychotherapy and Speech Therapy


How would you describe the relationship between speech therapy and psychotherapy in working with people who experience communication challenges?

Communication challenges are frequently addressed in psychotherapy, given that communication is foundational to personal well-being and healthy relationships. Furthermore, many health and mental health professionals, as well as researchers have identified communication difficulties as a primary concern for those who struggle with mental health problems such as anxiety, depression, etc. Both speech therapy and psychotherapy aim to enhance a person’s well-being and improve communication, albeit with different and complementary approaches.


What kind of communication challenges can benefit from psychotherapy?/ In your opinion, if an adult is experiencing difficulty with their communication, is there potential to benefit from both psychotherapy and speech therapy at the same time?

Psychotherapy can definitely help improve communication. It can help a person be more comfortable and relaxed when communicating in general. Psychotherapists use various approaches and techniques to help people increase communication confidence and ease. Psychotherapists address a number of communication problems such as helping people speak assertively, with clarity, volume, confidence, and with persuasion. They also help people develop skills to manage social and speaking anxiety and to have difficult conversations and communicate their needs despite the issues they face. In addition, psychotherapists can support speech therapists in addressing specific issues such as articulation of words and voice challenges related to volume and quality. Speech therapists who support people with communication challenges often find that their clients experience elevated stress and other mental health challenges related to communication challenges. Certainly, communication challenges can take a toll on a person’s well-being and relationships. Psychotherapists can help in addressing these stressors that are associated with communication challenges.    


What is the most rewarding thing for you in your work with adults who have communication difficulties.

The most rewarding thing in my work with people who have communication difficulties is seeing their confidence and self-esteem increase upon discovering that they can cope and thrive despite communication challenges. It is also rewarding to see how people with communication challenges can improve their stress levels, anxiety, and depression by taking charge of their lives through psychotherapy and speech therapy.

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Gio Iacono, MSW, RSW, PhD (c)

Gio has worked as a psychotherapist, educator, and researcher in a variety of health and community-based settings. He has a particular expertise in delivering psychotherapy to vulnerable and marginalized populations, particularly youth. Gio’s community development work has been focused on promoting the mental health of diverse and marginalized communities. Clinically, Gio applies the principles of social justice and harm reduction through trauma-informed approaches such as experiential, mindfulness-based, cognitive behavioural, psychodynamic and narrative. Working with various communities, Gio addresses relationship concerns, and co-occurring mental health issues and substance use. His clinical practice includes individual, couple and group therapy. Gio is currently working on a PhD in Social Work at the University of Toronto. He teaches at the University of Toronto and Ryerson University. His research and scholarly interests include: LGBTQ youth mental health, resilience, and mindfulness-based treatment approaches.