The "e;VIP"e; is a user-friendly, point-in-time assessment tool which provides an 'at a glance' vocal profile for the clinician, voice coach and client. It examines the potential impact of a number of specific factors on the voice: general health; vocal history; vocal health; voice care; vocal status; voice genogram; anxiety and stress; social functioning; vocal demand; and environmental factors, and offers an overview of the theory to support this choice. The questions have been carefully designed to elicit easily-recorded information from the client about a range of factors that are known to affect vocal quality. The tick-box answers then translate into the Vocal Impact Profile, a visual presentation of the areas of greatest impact on voice. In addition to offering a point-in-time profile, the "e;VIP"e; may also be used as a template for achieving change in a specific area of vulnerability and provide a robust visual reinforcement of that change over time. It is, therefore, helpful as a therapy-monitoring tool and as an evaluation of client awareness, behavioural change and clinical effectiveness. Self-administered by the client, the questionnaire should take approximately ten to fifteen minutes to complete. The clinician or voice coach enters the responses into the computer programme (supplied on CD-ROM) or transfers them manually on to the hard copy thus offering a clear visual representation of the results. Worked examples of the VIP are included, presenting six clients with very different aetiologies and with a range of vocal problems. These examples clearly demonstrate the value of the Profile and its visual impact. As a clinical tool the "e;VIP"e; provides a subjective qualitative measure, which may be used as an adjunct to other assessment procedures. In addition, it provides a concrete method of determining and ordering the factors to be targeted in terms of therapy or voice work. Using the "e;VIP"e; should shorten the time necessary for completion of case history in the case of a voice therapy client, and, when used by a voice coach, the profile will identify areas for further discussion. The Profile is not time-sensitive so it may be repeated to evaluate client awareness of vocal change and implementation of agreed strategies. The "e;VIP"e; provides the clinician or voice coach with an efficient and effective means of auditing the therapy or coaching process and promotes a holistic partnership model of intervention.
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