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BSc (Hons) Speech-Language Pathology (UCT)
Speech-Language Therapist
I am based in Gardens, Cape Town
Sessions are available in-person, or online to anyone in South Africa
This practice is a safe space. I welcome and respect all people regardless of
religion, sexual orientation or gender identity.
MY FOCUS AREAS:
Saskia Lilienfeld
(She/They)
1.
Gender-Affirming Voice and Communication Therapy:
I offer gender affirming voice and communication therapy for gender diverse clients. This is a safe and affirming space for you to establish voice and communication techniques that align with your expression of gender, and find your true voice.
Understanding the Importance of Voice
Communication and voice are critical parts of identity. Rather than finding a “generic” masculine, feminine, or gender-neutral voice, my therapy emphasises exploring each individual’s unique identity, and guides you to find your own individual voice. It is crucial that your voice makes you feel confident, and like your authentic self.
Therapy Approach
Therapy generally falls under the broad categories of ‘feminising’, ‘masculinising’, or ‘neutralising’, but there is no right or wrong way for anyone to sound. We do not have to stick within the limits of gender binaries. I believe each client to be the expert on themselves, and you will know what feels and sounds correct for you.
The human voice is extremely flexible, and there is much that can be done in the gender affirming journey to modify the various elements of the voice to better match your identity. However, the voice is also sensitive, and it can be injured. Voice and speech modification is done using evidence-based techniques that emphasise healthy, comfortable, and sustainable vocal changes.
Areas Therapy Might Target
Vocal health
Breath support
Pitch
Resonance
Vocal quality
Intonation patterns
Articulation
Volume
Non-verbal communication
Commitment to the Process
For the best outcome, weekly sessions are recommended. The duration of therapy will depend on the individual’s therapy goals and their dedication to the process. Therapy can take on average 4-8 months, but this is variable. Commitment is required to successfully modify one’s voice, and clients should ideally practise daily outside of sessions.
2.
Neurodiversity Affirming Communication Therapy:
I offer a gentle and affirming space for individuals to explore and embrace their true selves while discovering how to communicate authentically.
Understanding Masking
Masking is a common phenomenon where individuals suppress or hide their true thoughts and feelings, greatly inhibiting their ability to express themselves both verbally and non-verbally. This behavior often develops as individuals grow up in a society that makes them feel unsafe to be their true selves.
We learn to mask to keep ourselves safe. While we can be grateful for this protective mechanism, it’s important to recognize when masking is no longer serving us. Not living as your true self can be very lonely, as it hinders real-life connections. It can also be utterly draining, resulting in feelings of anxiety, depression, and loss.
Embracing Your Authentic Self
If you are at the point in your life where you are ready to embrace your authentic self and start reducing masking in communication, you can gently thank yourself for protecting you in the best way you knew how. You can do so without judgment, while recognizing that it is time to find a newer and fuller way of being. It is time to take up space in the world!
Our Journey Together
In my sessions, I will guide you to reconnect with your true self so you can express yourself with authenticity. I believe each person is the expert on themselves, and I am here to guide and support you on this journey.
Each person’s journey is unique, but important components include:
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Exploring your current beliefs around expressing yourself and interacting with others.
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Becoming more aware of your thoughts and feelings, and practicing how to express them in a way that feels true to you.
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Learning to slow down and be more present in communication.
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Retraining your inner voice to be loving, gentle, and supportive of you.
3.
Speech, Language and Dysphagia Rehabilitation:
Speech and language rehabilitation:
Speech and language difficulties (e.g. aphasia, dysarthria) are common when recovering from or managing a neurological pathology such as a stroke, trauma to the head or a condition affecting the brain (e.g. encephalopathy, myesthenia gravis).
These conditions can also effect one's cognitive communication abilities, such as attention, memory, picking up on social cues, reasoning and problem-solving skills.
I offer assessment of speech, language and cognitive-communication abilities. I will create a individualised treatment plan for each client, which will take into consideration their specific needs and goals.
Dysphagia Assessment and Management:
I offer evidence-based and comprehensive assessment, management and treatment for adults with any feeding or swallowing difficulties (dysphagia).
I work with any diagnosis that has resulted in difficulties with feeding or swallowing.
I adjust my therapeutic approach and intervention to fit the unique needs of each individual and their family or caregiver(s).
I can assess feeding and provide recommendations for safe feeding techniques, or implement therapy to work towards safe feeding techniques.
Please note that some clients require tube feeds and are not safe for oral feeds.
I will always be realistic and upfront about what I believe my intervention can achieve.
I offer evidence-based and comprehensive assessment, management and treatment for clients with any feeding or swallowing difficulties (dysphagia).
4.
Fluency Therapy:
For Individuals who
Stutter
Fluency therapy for people who stutter is a gentle and therapeutic journey that teaches mindfulness, acceptance and strategies to enhance fluency and communication.
Although there is not a 'cure' for a stutter, much can be done to reduce how frequently one stutters. Additionally, through therapy you can learn to stutter differently, in a way that is 'relaxed' and 'easy'. This results in the stutter sounding like a 'typical' disfluency' (every person, including those who do not stutter, has moments of disfluency in their speech, these are referred to as a 'typical' disfluency).
Although there are strategies that can make your speech more fluent and your moments of disfluency sound 'typical', the most important part of fluency therapy is to explore your feelings and your beliefs around your stutter in a gentle and safe environment so you can learn to accept it. The act of acceptance has been proved to significantly reduce and improve stuttering!
Remember, you might be someone who stutters, but your stutter is not your identity. In the same way as someone who wears glasses or contact lenses is not defined by their vision, you are not defined by your stutter. Yes, it is one part of you, but you are so much more than that!
5.
Learning to Project, Be Articulate and Improve Your General Communication Skills:
The human voice is an extremely dynamic and flexible instrument, but we don't always instinctively know how to use it to our best advantage.
Whether you wish to be more articulate, speak more clearly (and mumble less) or sound more authoritative, speech therapy can help you master your voice and achieve these goals.
This type of therapy is especially useful for individuals who rely on their voice and their ability to communicate clearly in their day-to-day lives, such as lawyers, lecturers, politicians and so on, but it would also benefit anyone who wishes to communicate more skilfully and mindfully.
Therapy is tailored to each individual's specific needs and goals.
6.
Public Speaking and Presentation Skills:
Presenting and public speaking is a daunting task for many, but you can learn to be good at it!
Speech therapy can teach you how to prepare, how to keep your audience engaged and interested and how to communicate your message clearly and effectively. In addition, you will learn how to project your voice and how to use your voice to add meaning and expression to your message.
This therapy is useful for anyone who needs to do presentations or speak publicly, including students.
About Me
I completed my degree in Speech-Language Pathology at the University of Cape Town (UCT) in 2011. Since then, I have worked as a Speech Therapist in South Africa in both private practice and in the public healthcare sector. I also gained invaluable experience working abroad in the United Kingdom for two years.
Most recently, I ran the Speech Therapy Department at Khayelitsha Hospital in Cape Town, a position I held for five years before leaving to start my own practice.
I have more than ten years experience.
I am passionate about evidence-based and holistic, client-centred care.
My practice is inclusive of everyone. I welcome any person, irrespective of their background or identity.
Testimonials From Clients
"Saskia treated my aunt who suffered a stroke. She saw her for a period of one month and during that time we noticed a remarkable improvement in her speech. She also gained so much confidence in herself. Saskia’s professional and caring manner gives me great confidence in recommending her. I am only sorry that due to relocation my aunt was not able to continue therapy with her."
- Relative of Stroke Client
"I was really anxious for my first appointment, but Saskia is wonderful, and throughout the informative session I felt comfortable, safe and in good hands. I absolutely recommend them for gender affirming vocal therapy, especially if you are just starting your journey."
- Transfemme client
"I recently started my Gender Affirming Voice Therapy with Saskia and it has been nothing short of awesome. Saskia does a thorough assessment to determine exactly what you want and what you want your journey to look like. Saskia also creates a very safe environment and reminds you to be gentle with yourself as you undertake this journey. What impressed me the most is that Saskia has a wonderful way of explaining concepts, in a manner which anyone can understand. 10 out of 10 would recommend!"
- Transmasc Client
"Masculinising Speech Therapy:
I live in Durban and have been seeing Saskia through video calls. In the past 6 months Saskia has given me an entire toolkit for lowering my voice and helped me with a variety of techniques to make my voice sound more masc, and comfortable at the same time.
What I love about Saskia's approach is that they don't only work with gender binaries: Saskia consistently asks me HOW I WANT my voice to sound (stressing that it does not need to fit a stereotypical box to pass).
I often hear FTM's ask if speech therapy is worth the money, and my honest response is YES! It does make a significant difference. Even though I am on HRT, without Saskia i wouldn't know how to make the most of my voice. It helped me understand my dysphoria, and as I hear my voice learning new tricks, lessened it.
Currently, we are working on my confidence to implement the skills i have learned in a wider social setting; There's more to Saskia's speech therapy than just making the right sounds."
- Transmasc Client
"I have just completed my journey of gender affirming speech and communication therapy with Saskia. It has been incredibly helpful. After every session with Saskia, I felt like I had made more progress. The handouts are very informative and easy to understand. In under 4 months of therapy, I am able to confidently speak in a femme voice."
- Transfemme Client
"I have been having remote sessions with Saskia for 7 months and greatly look forward to every session. Saskia is kind, understanding and empathic, and her sessions focus on making the process one's own and allow a lot of flexibility towards achieving one's ideal voice. An aspect I hugely appreciate is how thoughtfully she approaches every element of this, often suggesting excellent practical exercises to drill home some associations or techniques, which I have found immensely beneficial. Working with Saskia changed how I thought about what I was doing in making my voice my own, and has resulted in me feeling confident and proud of what I have achieved.
- Transfemme Client
Testimonials From Health Professionals
"Saskia is my GO-TO when it comes to anything related to gender affirming voice and communication therapy or voice training. I've happily referred numerous clients to her for quite some time now. Not only are they one of the most knowledgeable and experienced speech therapists in South Africa when it comes to gender affirming care, she's also a lovely, compassionate professional who ensures every client is encouraged to be their most authentic selves with individualized goals and techniques. I can't recommend them enough! She also provides more generalised speech therapy services which include feeding and swallowing, neurological rehab, fluency therapy and public speaking skills. An all-round powerhouse!"
- Dr Megan Martin (Gender affirming & sexual health GP)