title: Is more intensive better? Client and service provider outcomes for intensive versus standard therapy schedules for functional voice disorders.
abstract: BACKGROUND
  Functional dysphonias are commonly associated with reduced treatment attendance leading to variable treatment outcomes. Preliminary research has proposed that intensive treatment may improve client adherence and outcomes; however, further research into the application of intensive models in functional dysphonia in comparison with standard intensity models is warranted.
  
  
  OBJECTIVE
  The present study evaluated the impact of intensive and standard treatments on functional, well-being, and service outcome measures in clients with functional dysphonia.
  
  
  METHODS
  Participants with a functional dysphonia were randomly allocated to one of two treatment groups: (1) intensive treatment (n = 7) or (2) standard treatment (n = 9). Participants completed the voice handicap index (VHI) and the Australian therapy outcome measures voice assessment (conducted by a blinded assessor) before and after treatment and 4 weeks after treatment. Satisfaction questionnaires were completed after treatment and data pertaining to attendance and duration of intervention were collected throughout treatment. In addition to a vocal hygiene education session, all participants received a total of 8 hours of treatment; intensive treatment consisted of four 1-hour treatment sessions per week over 2 weeks, whereas the standard group received one 1-hour treatment session per week over 8 weeks.
  
  
  RESULTS
  High satisfaction and statistically significant improvements on the VHI ratings were found after treatment in the intensive group. Significantly greater attendance rates were found in the intensive group. Intensive treatment is a potentially viable service delivery option for functional dysphonia and warrants further larger scale investigation.
authors.affiliation: Gold Coast Hospital and Health Service, Queensland Health, Brisbane, Queensland, Australia. Electronic address: Rachel_wenke@health.qld.gov.au.
authors.forename: Rachel J
authors.initials: RJ
authors.lastname: Wenke
authors.affiliation: Gold Coast Hospital and Health Service, Queensland Health, Brisbane, Queensland, Australia.
authors.forename: Penny
authors.initials: P
authors.lastname: Stabler
authors.affiliation: Gold Coast Hospital and Health Service, Queensland Health, Brisbane, Queensland, Australia.
authors.forename: Chloe
authors.initials: C
authors.lastname: Walton
authors.affiliation: Gold Coast Hospital and Health Service, Queensland Health, Brisbane, Queensland, Australia.
authors.forename: Leah
authors.initials: L
authors.lastname: Coman
authors.affiliation: Gold Coast Hospital and Health Service, Queensland Health, Brisbane, Queensland, Australia.
authors.forename: Melissa
authors.initials: M
authors.lastname: Lawrie
authors.affiliation: Gold Coast Hospital and Health Service, Queensland Health, Brisbane, Queensland, Australia.
authors.forename: John
authors.initials: J
authors.lastname: O'Neill
authors.affiliation: Division of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Theodoros
authors.affiliation: Speech Pathology Program, School of Rehabilitation Sciences, Griffith University, Gold Coast, Queensland, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Cardell
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006920:Hygiene; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D017060:Patient Satisfaction; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014832:Voice Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D014833:Voice Quality / Q000502:physiology*; D014834:Voice Training
keywords: Functional dysphonia; Intensive; Motor learning; Treatment