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Research paper

People with aphasia’s perception of the therapeutic alliance in aphasia rehabilitation post stroke: a thematic analysis

ORCID Icon, , , &
Pages 1397-1417 | Received 09 Aug 2017, Accepted 13 Feb 2018, Published online: 23 Feb 2018
 

ABSTRACT

Background: The therapeutic alliance has been found to be a critical component of treatment delivery in mental health interventions. This construct may have the potential to inform both treatment efficacy and adherence in aphasia rehabilitation. However, little is known about how people with aphasia perceive therapeutic alliance construction in the context of aphasia rehabilitation.

Aims: This study aimed to investigate people with aphasias’ subjective experiences and reflections of constructing and maintaining therapeutic alliances in aphasia rehabilitation.

Methods & procedures: In-depth interviews were conducted with eighteen people with aphasia who had received aphasia rehabilitation following a stroke. Interviews were subject to thematic analysis.

Outcomes & results: Data analysis revealed five core themes: (1) readiness to contribute to the alliance; (2) proximity with the therapist; (3) perceived attunement with the therapist; (4) receiving information; and (5) collaborative engagement. The therapist’s perceived ability to read and respond effectively to individuals’ relational and situational needs contributed to the success of the alliance.

Conclusions: These findings offer novel insights into current practice, highlighting considerable variation in alliance formation across the profession, with ineffectual alliances obstructing engagement and eroding hope and effective alliances promoting adherence and instilling hope. Further research is recommended to understand which aspects of the therapeutic alliance are essential for optimising therapeutic efficacy.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This work was supported by the Stroke Association [Grant number: TSA JRFT 2013/2].

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