the best treatments are speech therapy, exposure, building confidence, getting your anxiety under control, and ingraining the usage of tools to get past blocks and issues. the issue is that these are hard, and require work and vulnerability, and lot of people are afraid of these, or want to wait until there's a magic pill, or would rather use sign language or write on a piece of paper or just say 5 - 10 words a day, and so they ingrain their own fear and feelings of inadequacy and never address it.