Objective:
The purpose of this study is to examine whether patients undergoing voice therapy experience a temporary increase in Voice Handicap Index-10 (VHI-10) scores before eventual improvement. This potential pattern may reflect heightened self-awareness of vocal challenges as therapy progresses and has implications for patient counseling and expectation management.

Methods:
A retrospective chart review was conducted of adult patients referred for voice therapy at one tertiary voice, airway and swallowing care outpatient clinic between 2021 and 2025. Inclusion criteria were: (1) completion of at least four sessions of therapy, (2) completion of a full course of therapy as determined by the treating speech-language pathologist, (3) voice therapy recommended as the first-line intervention, and (4) no history of laryngeal surgery or prior procedural intervention. Patients’ VHI-10 scores were collected at three time points: the initial evaluation, after the fourth session, and at discharge (if that was longer than 4 sessions). Demographic and diagnostic data were also recorded. Descriptive statistics and group-level analysis were conducted. .

Results: Pattern changes in VHI-10 scores over time will be reported. Associations of these changes with Diagnoses and/or treatment duration will be explored.

Conclusions:
Understanding short-term fluctuations in perceived voice handicap may help clinicians better interpret mid-therapy outcome measures and provide reassurance to both patients and clinicians if an initial increase in self-reported vocal handicap is observed. Identifying whether a transient rise in VHI-10 is a common phase of the therapeutic process may guide counseling strategies and improve patient adherence and satisfaction. Findings from this study aim to contribute to the growing literature on patient-reported outcomes and the dynamic nature of perceptual change during behavioral voice therapy.