We describe a brief pilot study undertaken to investigate the potential benefit(s) of using a SenseCam in aphasia therapy. Five post-stroke persons with aphasia and their caregivers agreed to participate. Each person with aphasia wore the SenseCam for 1 day during the daytime. Slide shows and printed images were created from the images obtained and presented at a (videotaped) weekly group conversation session. Therapists’ observations, reflections, and opinions were subsequently elicited in a group interview and online survey. Wearable, sensor-triggered automatic imaging devices offer potential advantages over both conventional cameras and generic pictures when used in aphasia therapy. We identified three advantages of a SenseCam over conventional imaging methods: Images can be acquired without the presence of the researcher, no action is required by the wearer for image acquisition and the continuous point of view is that of the wearer. Acquired images are of personal relevance to the wearer and may have greater efficacy for the person with aphasia in aiding conversation, and for the speech language therapist in setting functional language goals.
Conclusions: These findings demonstrate that a combined phonological and orthographic cueing therapy targeting word retrieval can have lasting benefits, not just on targeted items but also on untreated words, connected speech, and the views of the person with aphasia. Furthermore, such improvements can be achieved within a prevalent service delivery model.
Conclusions: The conversation/rehabilitation treatment partly reconciles the impairment- and consequences-based approaches and this study demonstrates that at least for one man with aphasia, Mr I, the treatment was successful.
This article uses the medium of clinicians’ comments and stories to explore their perceptions of therapeutic relationships and how these relationships come to a close at discharge from aphasia therapy. These narratives are drawn from a qualitative, grounded theory study carried out in South Australia and Northern Territory involving semi-structured interviews with 30 speech pathologists. The stories reported here shed light on the complexities of negotiating boundaries and endings to therapeutic relationships. Interviewees discussed the special nature of their relationships with their clients with aphasia, professional distance, and dependence. Exploration of these narratives is timely because of the increasing emphasis on person-centeredness in rehabilitation, shared decision making, and authentic relationships. This work is important to encourage refl ective practice and greater insight into both speech pathologists’ professional identities and their therapeutic relationships.
Conclusions: Despite the individual circumstances of each person’s account, a common finding was uncertainty and confusion surrounding discharge. Clients were not always sure why therapy ended. They rarely discussed it with their therapists in much depth and often felt unable to question their therapists’ decisions. This paper argues that such findings reflect the disempowered position of our clients with aphasia and that a more open, shared process of decision making would not only be more satisfactory for all parties but also demonstrate better outcomes of therapy itself.
Breaking the connection: Why is it so difficult to talk about discharge with our clients with aphasia?
This paper, drawn from a study into experiences of treatment termination in chronic aphasia, discusses why communication, between speech-language pathologists and clients with aphasia, breaks down so frequently during discharge negotiations. Considering our role as communication experts and our awareness of the barriers faced by people with aphasia in sharing decisions about their care, this is a concern. Eight general reasons for communication breakdown are discussed: the presence of aphasia; inadequate explanations or shared understandings of therapy in general; discharge reflecting other aspects of professional-client communication; discharge as “bad news”; discharge and the limits to negotiation; discharge as an unclear phenomenon; discharge documentation; and discharge evaluation. These reasons are illustrated by several real stories gathered from in-depth interviews with 30 speech-language pathologists, 21 people with aphasia and 16 family members. This paper aims to help speech-language pathologists reflect on how they break the connection, so important in therapy, between themselves and their clients with aphasia at discharge and how this is communicated. This issue is important, not only because of the centrality of communication to our work, but also because it has implications for the overall success of therapy and for our clients’ wellbeing.