Four crisis-precipitating events are identified that have the potential to interfere with the individual's overall adjustment following laryngectomy. Important to the success of alaryngeal speech rehabilitation is the clinician's ability to recognize how laryngectomy may influence the individual's physical, social, psychological, and occupational well-being. The speech-language pathologist must be cognizant of and sensitive to the impact that the individual's perception of the quality of life has on alaryngeal speech rehabilitation. The design and implementation of an intervention protocol within the group setting using themes--educational, speech activities, social interaction, and support-counseling--are based on how well the individual is coping, adjusting, and communicating in the process of alaryngeal speech rehabilitation.