How do people with aphasia view their discharge from therapy?

Abstract

Background: The aphasiology literature contains very little on how therapy ends. However, the events surrounding discharge are complex and are an integral part of therapy as a whole.

Aims: This article focuses on how people with aphasia view their discharge from therapy in order to shed some light on this rarely explored issue.

Methods & Procedures: This research is based on the results of a larger qualitative study that explored the experiences of treatment termination for both clients and speech pathologists. This paper draws on in‐depth interviews with 21 people with aphasia and 16 family members. Data collection and analysis were carried out using principles and techniques of grounded theory.

Outcomes & Results: Interviewees' narratives of discharge reflected three broad influences: their biographies, their notions of recovery, and their feelings about their aphasia therapy. This paper summarises interviewees' perceptions on why they were discharged, how it happened, and how they felt about it.

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.

Keywords:

• Discharge
• Aphasia therapy
• Client perspective
• Qualitative research

Notes

1. In one particular case, Michael and Julia contradicted their own story, telling me “we were just told that that's the end of it, that's all you can have” (Julia 214) and yet later suggesting that they chose not to take up the offer of more help.