You mentioned that self esteem is a contributing factor for him. How familiar is he with the concept of openly stuttering? It’s more a mindset than a strategy, and I have to admit that I’ve only supported stutterers in the pediatric setting… but I know with the older kids I’ve seen and the one young adult I worked with in grad school, a big part of our therapy was shifting mindsets from trying to prevent the stutter to openly stuttering and accepting oneself as a person who stutters (while still using our strategies to practice or as needed). I think about it like this- It’s a heavy load to carry knowing that you’ll have to do strategies the rest of your life if you want to stutter less. Since I’m not a stutterer, I think about how I’m a person who has OCD. I always will. And if I want to be off of my medication (or even if I’m on my medication), I do need to regularly practice strategies to regulate my nervous system. Some days, all I can do is say to myself “I have OCD” because every strategy I have may not work on some days, weeks, months, or even just some hours or it’s too much for me to try and hold it all back. Like I said, I don’t have a stutter and I always rely heavily on the perspective of those who are experiencing the thing they need help with. I have no idea if that is what it’s like to have a stutter; but, I heard my clients tell me how defeated it would make them feel trying to prevent themselves from stuttering all the time. In our sessions, it was a relief to have as much space and time to communicate as they needed, stutter and all. It was a relief to say and hear that they had a stutter and that doesn’t change how great they were to talk to and spend time with. Even if the strategies work and are helpful, at its core, a person with a stutter will always be a person with a stutter.