Elpida Koutsoubaki
25 years of clinical and teaching experience
The Voice Therapy Journey
INTEGRATED VOICE THERAPY

VOICE THERAPY
For anyone facing difficulties with voice production, including those that present with functional voice problems such as hoarseness, voice weakness, breathiness, vocal fatigue, reduced intensity, projection or vocal range, reduced sense of vocal control or any aspect of your voice that makes you feel distressed. It also includes voice difficulties related to organic lesions on the vocal folds as well conditions that impact on voice and swallowing, such as vocal fold paralysis, Parkinson's disease, dysparthria, etc.

TRAINING WORKSHOPS
Workshop-based training offering comprehensive practical training for clinical application of Integrated Voice Therapy techniques. Workshop training is for voice professionals and speech therapists wanting to specialize in vocal rehabilitation. The approach is based on a bio-mechanical model of voice production and integrates the latest clinical developments from the fields of neurolaryngology, kinaesiology and affective neuroscience.

Common voice problems are characterized by a combination of difficulties that give rise to multifaceted diagnoses. Nonetheless, for the benefit of sharing a simplified understanding of the most basic characteristics of voice issues, we rely on 3 basic categories that are not mutually exclusive. The categories of voice problems that benefit from voice therapy intervention include the following:
Voice difficulties related to organic lesions of the vocal folds or the periphery. Voice therapy targets the symptoms associated with the lesions, including vocal hoarseness and strain. Voice therapy is about training the voice user on how to modify the way he uses the vocal mechanism so that the voice can return to safe and efficient production, irrespective of the organic condition of the vocal folds. Common organic conditions that benefit from voice therapy intervention are:
- Vocal nodules
- Unilateral & Bilateral Paralysis of vocal folds (see relevant section)
- Polyps (pre and post operational)
- Vocal fold scarring
- Vocal fold cysts (post-operational)
- Layngeal papillomatosis (HPV)
- Chronic laryngitis
- Neurological conditions affecting the voice/swallowing mechanism (eg. Parkinson’s disease, myasthenia gravis, multiple sclerosis)
- Chordectomy
Functional voice difficulties are related to the way the voice is used and managed. These difficulties are successfully managed with specialized voice therapy which targets mindful awareness of voice use while also developing skills for efficient and comfortable voicing. The symptoms commonly related with functional voice difficulties include:
- Voice fatigue and discomfort
- Hoarse, strained, harsh, gravely voice
- Breathy, weak, asthenic voice
- Vocal instability – tremulous voice
- Loss of tonal range or a specific part of the tonal range
- Loss of ability to produce or maintain vocal intensity
- Breath – Voice coordination
- Localized pain in jaw or neck area (may require additional intervention from a specialist physiotherapist or manual therapist).
These functional difficulties may appear with or without associated organic pathology of the larynx, in individuals who have excessive vocal demands and are in need of specialized vocal technique, for efficient voice use. In certain cases, these same functional symptoms appear in in the absence of increased vocal loading and may be related to behavioral, muscular or psychological factors.
Psychological voice disorders develop in relation either to intense emotional situations or difficulty with expressing powerful emotions of anger, fear, sorrow, stress and anxiety such that the person is overwhelmed by these emotions.
As the significant third of the triadic synergy of Mind-Body-Emotion, emotional balance is critically related to healthy vocal expression and is frequently aetiologically related to the development of voice problems. Voice therapy targets guiding the voice user to acknowledge the relevance of emotions to healthy voicing while also integrating vocal techniques to overcome the functional imbalance of the vocal mechanism that these emotions had created.
For voice specialists who want to develop as
clinicians or voice coaches.

INTEGRATED VOICE THERAPY ACADEMY
The first digital voice therapy training platform for clinical application and artistic expertise of the voice.

Abit about me
I have been in private practice in Athens since 1996 as a Voice Specialist – Speech Therapist – Psychologist. As creator of the multidisciplinary approach to the rehabilitation of voice disorders -Integrated Voice Therapy – I apply my work clinically and I also teach practical training workshops. With 25 years of clinical experience and a broad range of collaborations during my professional path, I feel passionate about sharing my diverse training and clinical experience in the treatment of voice disorders.