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Barb, I concur with your notion re the difficulty of keeping up with Lee Silverman therapy, due to other life issues that get in the way (like working a full- time job, etc.). It is essential to keep practicing it to have any long-term benefit, in my experience. I did a great job with it when I took the course last summer (at Beth Israel Hospital, in Boston); and yet I had let go of the daily practicing by mid-fall, and my voice has deteriorated significantly since. Now, as I have just gone on short-term disability to work on a batch of health issues, I'm going back to the Lee Silverman books and exercises and intend to restore myself to last Summer's levels, if I can, and then, indeed, to sustain it. It'll take major discipline for me to succeed; but the loss of voice (plus the remembrance of successes past) is a great motivator! John Bachman