, ▁introdu cing ▁and / or ▁maintain ing ▁safe ▁voice ▁practices ▁( there by ▁reducing ▁opportun ities ▁for ▁ph on ot ra uma ) ▁and , ▁occasionally , ▁implementing ▁vocal ▁rest . ▁Direct ▁approaches ▁involve ▁reducing ▁the ▁phys i ological ▁stra in ▁on ▁the ▁vocal ▁system ▁while ▁the ▁voice ▁is ▁being ▁used ▁( e . g . ▁during ▁speaking ▁or ▁singing ), ▁such ▁as ▁by ▁reducing ▁collision ▁forces ▁between ▁the ▁vocal ▁fol ds , ▁ens uring ▁sufficient ▁pul mon ary ▁support ▁while ▁speaking ▁( e . g . ▁by ▁changing ▁the ▁individual ' s ▁breath ing ▁pattern ), ▁and ▁optim izing ▁reson ance ▁of ▁the ▁l ary nx ▁and ▁other ▁structures ▁of ▁the ▁vocal ▁appar atus . ▁ ▁Be hav iour al ▁treat ments ▁also ▁vary ▁in ▁delivery ▁model . ▁Trad itional ▁ther apy ▁distribution ▁( e . g . ▁eight ▁sessions ▁within ▁eight ▁weeks ), ▁more ▁int ensive ▁approaches ▁( e . g . ▁eight ▁session ▁within ▁three ▁weeks ) ▁and ▁remote ▁ther apy ▁( i . e . ▁tele he alth ) ▁have ▁all ▁shown ▁effect iveness ▁in ▁tre ating ▁vocal ▁fol d ▁nod ules . ▁ ▁Ass ess ment ▁of ▁out comes ▁of ▁behaviour al ▁treat ments ▁also ▁var ies ▁greatly . ▁Effect s ▁can ▁be ▁measured ▁vis ually ▁( e . g . ▁by ▁the ▁same ▁methods ▁typically ▁used ▁to ▁confirm ▁the ▁presence ▁of ▁vocal ▁fol d ▁nod ules : ▁video ▁end os copy ▁and ▁video ▁st rob os copy ), ▁aer od ynam ically ▁( e . g