Abstract
A case study is presented of a boy, age 10–11, who had a “severe voice problem” characterized by hoarseness, stridency, tension, low pitch and the presence of vocal cord nodules. He proved resistive to traditional voice therapy techniques in two separate blocks of voice therapy. Only minimal changes were made initially in psychotherapy alone. Nodules continued to recur. However, the modest gains initiated in psychotherapy became more marked in a second block of psychotherapy. The voice therapy alone did not produce such consistent gains. A discernible voice change in the range of normal quality was noted. Behavior became characterized by less manifest tension and diminished aggression in overt acts. Self-insight into how the voice was used aggressively in social interactions was developed. At an ENT examination 4 mo. after termination of psychotherapy, no vocal-cord nodules were found. At an interview follow-up 13 mo. after psychotherapy, personality functioning appeared to be adequate. It is suggested that (1) psychotherapy may be the preferred method of treatment for functional voice deviations which are resistive to the “usually successful” voice therapy and (2) voice therapy in conjunction with psychotherapy seems to yield lasting improvement in both the voice and the behavior of a client.