The "VIP" is a user-friendly, point-in-time assessment tool which provides an 'at a glance' vocal profile for the clinician, voice coach and client. It examines the potential impact of a number of specific factors on the voice: general health; vocal history; vocal health; voice care; vocal status; voice genogram; anxiety and stress; social functioning; vocal demand; and environmental factors, and offers an overview of the theory to support this choice. The questions have been carefully designed to elicit easily-recorded information from the client about a range of factors that are known to affect vocal quality. The tick-box answers then translate into the Vocal Impact Profile, a visual presentation of the areas of greatest impact on voice. In addition to offering a point-in-time profile, the "VIP" may also be used as a template for achieving change in a specific area of vulnerability and provide a robust visual reinforcement of that change over time. It is, therefore, helpful as a therapy-monitoring tool and as an evaluation of client awareness, behavioural change and clinical effectiveness. Self-administered by the client, the questionnaire should take approximately ten to fifteen minutes to complete. The clinician or voice coach enters the responses into the computer programme (supplied on CD-ROM) or transfers them manually on to the hard copy thus offering a clear visual representation of the results. Worked examples of the VIP are included, presenting six clients with very different aetiologies and with a range of vocal problems. These examples clearly demonstrate the value of the Profile and its visual impact. As a clinical tool the "VIP" provides a subjective qualitative measure, which may be used as an adjunct to other assessment procedures. In addition, it provides a concrete method of determining and ordering the factors to be targeted in terms of therapy or voice work. Using the "VIP" should shorten the time necessary for completion of case history in the case of a voice therapy client, and, when used by a voice coach, the profile will identify areas for further discussion. The Profile is not time-sensitive so it may be repeated to evaluate client awareness of vocal change and implementation of agreed strategies. The "VIP" provides the clinician or voice coach with an efficient and effective means of auditing the therapy or coaching process and promotes a holistic partnership model of intervention.
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