Psychogenic voice disorder unresponsive to speech therapy: psychological characteristics and cognitive-behaviour therapy.

An exploration was undertaken of the psychological characteristics of 19 patients with psychogenic voice disorders who failed to respond to standard methods of speech therapy. Excessive anxiety, musculoskeletal tension and difficulties in expressing feelings or being assertive were common, usually associated with unsatisfactory interpersonal relationships, especially with members of the family. Fifteen were offered psychological therapy, 14 being offered joint therapy with a speech therapist and a psychologist employing a cognitive-behavioural approach. Of the 12 who participated in the co-therapy programme, six improved both in their voice and psychosocial adjustment.