Clinical Question: Would an adolescent who stutters (P) exhibit long-term improvement in stuttering management from fluency shaping approaches (I) or speech modification techniques (C), as shown by increases in controlled and spontaneous fluency, reduced severity of moments of stuttering, and decreased negative impact of stuttering (O)? Method: Evidence-based practice process guidelines (Cordes, 1998; Pietranton, 2006). Study Sources: Electronic search of relevant ASHA journals ("Journal of Speech, Language, and Hearing Research"; "American Journal of Speech-Language Pathology"; "Language, Speech, Hearing Services in Schools"), "Journal of Fluency Disorders" and "Journal of Communication Disorders"); electronic search of Science Direct; hand search of clinical textbooks devoted to stuttering treatment. Search Terms: stuttering, fluency, adolescents, treatment, therapy, intervention Primary Results: There are more published studies, and thus more empirical support, for treatment strategies that yield controlled fluency or stutter-free speech, as opposed to techniques leading to stuttering modification. Addressing the cognitive and affective components of stuttering in treatment has limited impact on the behavioral dimensions of stuttering, but significantly reduces avoidance, social anxiety, perceived stress, and severity of stuttering, and significantly improves quality of life and perceptions of self-efficacy. Conclusions: While limited, there is strong evidence that speech modification techniques result in changes in both fluent and stuttered speech in the short-term. Maintenance of these changes appears more likely for fluency shaping or controlled fluency approaches when compared to stuttering modification approaches. Overall, stuttering therapy is effective, and the evidence that one approach is significantly better than another remains to be seen.