Adapting therapy for a new world: storytelling therapy in EVA Park

ABSTRACT

Background

Storytelling is fundamental to human communication yet is under-represented in aphasia therapy research and clinical practice. Access to care may be one obstacle; in the broader healthcare context, remote modes of treatment delivery can increase individuals’ access to care. EVA Park is a highly novel, online platform designed with people with aphasia that has shown capacity to improve aspects of language and communication.

Aims

This study explored whether it is feasible to deliver a storytelling intervention in EVA Park and whether therapy brought about improvements in the content and organisation of their narratives. Changes in functional communication and technology use were also examined.

Methods and procedures

In a pilot feasibility study, three individuals with aphasia were recruited in the UK and Australia. Over five weeks, participants received 20 hours of therapy in EVA Park, consisting of three weekly sessions with a speech therapist and one weekly session in which the participant told the story to a volunteer who was blinded to the content of their story. A repeated-measures, case series design was used to evaluate therapy. The primary measure assessed the content of narratives elicited by novel video stimuli twice before and twice after therapy. Secondary measures investigated structural features of the video narratives and of personal narratives. Functional communication was assessed with the Communication Activities of Daily Living assessment, and technology use was probed via a Technology Screen.

Outcomes and results

Delivery of storytelling therapy via EVA Park was feasible; technology challenges arose and were resolved using multiple strategies. Following therapy, participants’ storytelling improved in content, with a large effect size for the group, and in structure. Generalisation to personal narratives was not observed. Some improvements were seen in functional communication.

Conclusions

Storytelling therapy delivered via an online platform is feasible and may improve the content and organisation of participants’ storytelling, with some evidence of generalisation to functional communication.

KEYWORDS:

• Aphasia
• therapy
• tele-rehab
• story
• communication

Acknowledgments

The authors warmly thank the three participants with aphasia for their time in taking part in the study. We appreciate too the family members who supported our participants to take part in the study. We also thank Professor Stephanie Wilson who co-led the development of EVA Park; Nick Zwart who provided technological support for EVA Park; research assistants – Chiara Scarpelli and Hien My Pham – who assisted with data collection in Melbourne; the student volunteers were assisted with therapy – Thea Johnstone and Naomi Hampel (La Trobe University, Melbourne) and Laura Thomas (City, University of London); Dr Michelle Attard (University of Sydney, Australia) who was the blinded rater; and the student volunteers who assisted with scoring of assessments – Aneesa Malik and Sonally Nyotta (City, University of London).

Disclosure statement

The authors report no conflict of interest.

Supplementary material

Supplemental data for this article can be accessed here.

Notes

1. Firestorm is a 3D web browser that allows users to view 3D web content.

2. LogMeIn (https://www.logmein.com/) enables the therapist to remotely log on to the participant’s computer to provide technical assistance. The software was used on an as-needed basis and was useful for instances when the participant experienced technological difficulty that could not be revolved with verbal instruction alone, e.g., could not navigate to a specific area within EVA Park or struggled to control their volume.

Additional information

Funding

The authors gratefully acknowledge the support of the Tavistock Trust for Aphasia and La Trobe University’s Strategic Research Grant Scheme in funding the current study. The development of EVA Park was supported by the UK Stroke Association.