1. For sure - there are myriad options that all achieve similar goals. Namely the goals should be: (1) Increase awareness of unhealthy behavior (thoughts, actions), (2) Attenuate unhealthy thoughts either by systematically correcting them or, more often, learning to defuse the power these thoughts have over us. Plenty of options here to do this as you point out. The problem with these approaches is they aren't easy to do. It is not easy to learn to accept stuttering - that is - to not let stuttering get in the way of your life. The best way to accept stuttering is to take tools with you along the acceptance journey - and the tools are motor skills. 2. PWS are primarily triggered by fear of stuttering - so this fear needs to be reduced and eventually eliminated. But like in #1, this cannot be done in insolation - it's best done in conjunction with skills that boost fluency. Tying this back to the thread topic, fear reduction and motor skills impact the dopaminergic system and likely this is a two way street. 3. I don't understand this question. I think you're implying something to the effect that spontaneous speech needs to be practiced by PWS, which I would agree with. Neurons that fire together wire together. When PWS are relaxed, spontaneous speech comes naturally. When fear is present, speech becomes premeditated. Electing to use calm and confident behaviors (like spontaneous speech) can produce a self fulfilling prophecy. Just like choosing to maintain good posture has been proven to make you feel more confident - choosing to deploy fluent behaviors that are easier for us to control may bring about more fluency.