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Voice Therapy

What is Voice Therapy? 

Singing & Voice Coaching

Voice therapy is a specialized form of treatment aimed at addressing voice disorders and improving vocal function, quality, and efficiency. After a diagnosis by ENT colleagues a person centred program is developed with a certified Speech and Language Therapist to address specific needs.

This program is developed with the aim to improve voice symptoms and work toward achieving vocal goals outlined by yourself and your Speech Therapist in your initial consultation.

 

The goals of voice therapy vary depending on the nature and severity of the voice disorder but commonly include:

 

Improving Vocal Technique

 

Alleviating Vocal Strain

 

Modifying Vocal Behaviours

 

Enhancing Vocal Resilience

Improving Vocal Hygiene

 

Facilitating Vocal Rehabilitation

Voice therapy alone can be enough to treat the voice difficulties present or can work alongside other surgical management with ENT colleagues. It can greatly maximise the outcomes of surgical interventions with pre- and post-habilitation plans.

Research indicates that voice therapy can lead to significant improvements in individuals with voice disorders, including those caused by vocal misuse, nodules, polyps, or neurological conditions. Studies examining the efficacy of voice therapy have demonstrated varying degrees of vocal improvement, with outcomes influenced by factors such as the type and severity of the voice disorder, duration of therapy, adherence to treatment, and individual responsiveness.

 

The aim for all therapy with Lucy is to establish positive vocal behaviours and empower you with the tools to manage and get the best from your voice.

Efficient and reliable voice use is within reach…

What is a Voice Disorder?

The Royal college of Speech and Language Therapists defines a Voice Disorder as:

“a range of conditions which affect the larynx. They can cause changes to the voice (dysphonia) or loss of voice (aphonia). These changes can affect the way the voice sounds, for example, making it sound hoarse, croaky, strained, breathy or weak. Voice disorders can also make the throat feel different, for example it might feel sore, achy or dry.

Voice disorders can cause difficulties in day-to-day life for some people. For example, it may be difficult to be heard by other people, or it may affect your work, school, or hobbies. Voice disorders can also cause frustration, low mood, or isolation in some cases.” (RCSLT, 2019)

Voice Difficulties that Lucy can help you with:

  • Muscle tension dysphonia’s

  • Vocal Fold Inflammation, inc. pre-nodular swelling

  • Vocal Nodules

  • Vocal Fold Polyps

  • Vocal Fold Cysts

  • Vocal fold Haemorrhage

  • Presbyphonia (ageing voice)

  • Atrophic vocal fords (bowing)

  • Vocal fold Palsy / Paresis

  • Throat symptoms such as Globus Pharyngeus

**These difficulties should be diagnosed by an Ear Nose and Throat Doctor before commencing therapy. 

What are the signs of needing voice investigation or therapy?

The following are some examples of symptoms you may experience:

  • A change in ‘quality’: ie: hoarse or ‘croaky’ voice or a breathy voice.

  • Strain or ‘press’ in speech or singing.

  • Feeling as though you need more effort to produce your voice.

  • Gradual or sudden change to the quality, pitch, or loudness of the voice.

  • Breaks or cracks in speech or singing.

  • Loss of range.

  • Loss of power.

  • Pitch change, instability, or stagnation in intonation patterns.

  • Vocal fatigue.

  • Aching, discomfort, or pain in the throat.

  • The bottom line is: Has there been a change to your voice that has lasted for more than 3weeks? If the answer is yes, then the next step is to go to your GP and ask for a referral to ENT. Please contact Lucy if you would like advice on this, she is happy to help. 

 

If you’re a professional performer,  it is beneficial to you to ask for an ENT that is part of a Voice MDT with a Singers clinic including Nasoendoscopy with Stroboscopy.

  • You can find a list of these clinics HERE. Please note you may have to travel.

 

The Risks of not seeking input for your voice

If left unattended your voice difficulties may worsen, this can make future treatment lengthier and more difficult. They can reduce your ability to communicate, attend work, social events, and converse with family. This can impact mental health and quality of life outcomes. 

Why a Speech Therapist?

After seeing an ENT you maybe referred for Speech Therapy. Voice Therapy is a specialist area within SLT which can provide:

  • Education around your voice difficulty.

  • Give advice and information on voice use and care.

  • Help with vocal hygiene.

  • Explore environmental management and changes.

  • Guide you in learning specific therapy techniques and exercises for your voice. Designed to alleviate your symptoms whilst establishing new behavioural patterns.

  • Educate friends family or work establishments and how they can

     support you.

  • Specialist input (if experience) in singing and performers

     voice rehabilitation.

Why Lucy?

Lucy is a Specialist Speech therapist who works predominantly with professional voice users, and within that group, particularly performers. Before undertaking her Master of Science Lucy was a professional Vocal and Singing Coach for 8 years and before that a professional performer, working in London alongside touring in the UK, and concerts in Europe.

Lucy is open, honest and a good listener. She works with people from all walks of life and background. Adaptable to your needs, availability, and vocal/life goals, she will do her utmost to support you. Empowering you with the confidence and skill to safely manage your voice and get best out of your performance.

She understands the pressures put on you as professional and elite voice users, having been ‘part of your world’ for many years of her life, she is aware of the pressures on your time, finances, body, voice, and mind. This is all incorporated into how you will work together, holistically. 

 

Your voice is your whole performative self, not just your larynx!

How do I get a referral?

Voice Therapy is available on the NHS. However, some areas do not provide specialist input for voice and is especially sparse for performers voice input.

You can be referred after an ENT appointment, GP appointment or can investigate some Vocal Coaching if your goal is to improve certain areas of your voice.

Performers: You can get funding through your performative unions & organisations, when recommended by a clinical professional, please see the list below for your consideration:

Equity

Musicians Union

Independent Society of Musicians

Help Musicians

Royal Society of Musicians

BAPAM

 

**Please note singing and vocal coaching does not come under private healthcare remits. However, funding can be provided by unions if recommended by a clinician ie ENT or SLT. 

See the RSCLT Guidelines on the recommendation for Voice service Provision HERE

References:

British voice Association – Voice Care Articles

RCSLT – Voice Disorders

Boone, D. R., & McFarlane, S. C. (Eds.). (2013). The Voice and Voice Therapy. Pearson.

Titze, I. R., & Verdolini Abbott, K. (2012). Vocology: The Science and Practice of Voice Habilitation. National Center for Voice and Speech.

Van Lierde, K. M., Claeys, S., D'haeseleer, E., Deley, S., Derde, K., Herregods, I., & Strybol, I. (2017). The treatment of hyperfunctional voice disorders: A systematic review. Journal of Voice, 31(1), 102-e1.

Behrman, A., Rutledge, A., & Cantor-Cutiva, L. C. (2001). Outcomes of benign vocal fold lesions. In Otolaryngology-Head and Neck Surgery (Vol. 125, No. 6, pp. 536-539). Sage CA: Los Angeles, CA: SAGE Publications.

Roy, N., Bless, D. M., & Heisey, D. (2003). Personality and voice disorders: A multitrait-multidisorder analysis. Journal of Voice, 17(1), 49-62.

Titze, I. R., & Verdolini Abbott, K. (2012). Vocology: The Science and Practice of Voice Habilitation. National Center for Voice and Speech.

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ENT Pathway

Your Kind Words of Recommendation

Phoebe Haines 

Performer

"By combining her scientific knowledge of the voice with her real-life experience as having been a professional singer, she is able to advise her clients in a very unique way. Lucy is so very passionate about her subject area - we have often talked for hours on end about subjects from vocal health, to pedagogy, to performance psychology and more… what always strikes me is how knowledgable she is, and is able to reference numerous scientific studies and theories within the course of a conversation. The ease with which she is able to do so speaks of her deep engagement not only with the vast array of academic literature, but also presumably with the hands-on experience she garners every day as a working SLT. I know that over the course of her career she will continue to contribute very meaningfully to her field. I highly recommend Lucy Dexter as an SLT, singing teacher, and key opinion leader."

Damien

Head of Acting

"Lucy is an intelligent, articulate and thoughtful person.  She gives clear, concise instruction, offers firm and fair feedback, and supports and encourages her students with compassion and a warm sense of humour. Lucy is a confident and engaging communicator with a lively personality, constantly motivating her students and colleagues to do their best. Lucy’s background in singing and acting means that she is very aware of the importance of body language, vocal clarity, articulation and expressiveness when speaking or presenting. Her insight and recent industry experience meant that everything was rooted in current good practice. She routinely undertakes continuing professional development in order to extend and broaden her own knowledge which has been fed directly into the curriculum. I have no hesitation in recommending Lucy."
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