Financial Disclosure: Ms. Cazden has no financial relationships to disclose. 

Non-Financial Disclosure: Ms. Cazden has no non-financial relationships to disclose.

​​Presentation: Authenticity Issues in Voice Therapy: Case Studies of Actors Onstage and Off Voice

Authenticity Issues in Voice Therapy: Case Studies of Actors Onstage and Off Voice expresses identity. Nevertheless, traditional therapy texts presume that clients will agree to change their vocal sound in order to relieve symptoms. Continuity of vocal identity is prioritized only in regard to public performance; there, the therapist’s job is traditionally to protect the onstage voice by helping the client to modify offstage use and technique. In the current social media environment where public and private identities blur, spoken-word performers (non-singers) may require a consistent vocal sound across all settings. Even when clients differentiate their onstage and offstage voices, they may value perceived authenticity and internal continuity above symptom relief, rejecting therapeutic vocal change as inconsistent with their identity. These psychosocial issues will be explored via anonymized case studies of four actors referred for private therapy with primary diagnoses of reflux and vocal fatigue. One had an additional small pathology but none stated any desire to change how they sounded. Rather, they all sought better throat comfort and endurance. Represented occupations include standup comedy, voice acting (voice-over), social media influencing, and dramatic television. Some clients engaged well with therapy and creatively adapted their voice image—public and/or private—in order to reduce their complaints, while others rejected even symptom-relieving changes in sound as personally unacceptable. Discussion reinforces the importance of patient-centered care over a hierarchical therapist-knows-best approach. Further research is recommended regarding psychological and occupational factors that may influence spoken-word performers’ tolerance for voice therapy.

Joanna Cazden, MFA, MS, CCC-SLP

Joanna Cazden, MFA, MS-CCC is a speech pathologist, singer-songwriter, energy healer and educator in private practice in Santa Cruz CA, who served for 18 years as a senior clinician at Cedars-Sinai Medical Center’s Outpatient Voice Clinic, Los Angeles. Her book Everyday Voice Care: The Lifestyle Guide for Singers and Talkers (Hal Leonard) is in wide use performance and pedagogy programs; other publication credits include the Journal of Voice, Voice and Speech Review, and numerous arts magazines and guest blogs. A lifelong musician with six solo albums to her credit and an ensemble CD with Pete Seeger and others that debuted at the Library of Congress, she directed a folk-chorus in Los Angeles for 30 years and has ongoing music projects in a variety of genres. In addition to her Masters of Science in Communication Disorders from California State University Northridge, which included a special fellowship at UCLA Otolaryngology, she holds an MFA in Theatre from CalArts and is a Certified Teacher of Fitzmaurice Voicework. She has presented at national and international ASHA, NATS, and VASTA conferences as well as The Voice Foundation Annual Symposium. She is also an advanced practitioner of both Reiki and ThetaHealing, and is Certified in HealthCare by the Performing Arts Medicine Association. Online: