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Phonotraumatic behaviors that can cause vocal nodules include yelling, excess throat-clearing, speaking too loudly, and screaming (Naqvi & Gupta, 2023)

Therapy may focus on: Managing anxiety and stress Building self-confidence Developing emotional regulation skills Understanding social expectations Mental health support can be especially helpful during adolescence and adulthood when social and academic pressures increase

ResultsStudy selection and population Our initial search identified 1978 potential studies from three databases (i.e., PubMed, Cochrane Central, ClinicalTrials.gov, and Web of Science)

Working With Healthcare Providers Some Canadian physicians and naturopaths have developed expertise in peptide protocols and can provide monitoring and guidance