The implementation of a learner-centred conversation training programme for spouses of adults with aphasia in a community setting

Abstract

Background: Conversational training programmes are increasingly being reported for partners of people with aphasia. The approach, formats used and ways in which these programmes have been evaluated vary. The literature to date provides evidence that conversation partner training can be effective, but it remains unclear as to what specific components contribute to successful outcomes. In this regard, the effectiveness of a learner-centred training programme was demonstrated in the author’s previous work with five couples living with chronic aphasia. Results of this programme, which was delivered in a one-to-one format, included improvements in the quality of conversation for the couples who participated.

Aims: The aim of this study was to determine whether similar results could be obtained if the programmes’ original format was modified to include a combination of both individual and group sessions. An additional aim was to describe the content and contribution of both the types of sessions.

Methods & Procedures: Four couples living with aphasia participated in this study with a case series descriptive design. The training, delivered by a speech-language pathologist (SLP) and communicative disorders assistant (CDA), consisted of an 8-week communication training programme incorporating content and adult learning strategies similar to the original programme. The modified format included four individual and four group sessions. Couples were seen once a week and were encouraged to practice conversation strategies at home.

Outcomes & Results: Results were consistent with those previously reported using the one-on-one format and included an increase in spouses’ use of supportive conversation strategies and an increase in the partner with aphasia’s participation in conversation. Couples reported improved ability to discuss more complex topics, increased positive feelings about conversation and perceived the supportive communication strategies as being useful in their interactions at home. Additional positive effects were reported related to the group experience including the reinforcement of communication strategies learned in training sessions as well as mutual aid and peer support.

Conclusions: The use of a format incorporating both individual and group learner-centred training sessions demonstrated positive changes in attitudes and communication behaviours for couples in this study. The group process enhanced the value of the programme by promoting mutual aid and the validation of the personal experiences of each couple. These results have implications for SLPs’ work with couples living with aphasia in the community and demonstrate the benefits of using an adult learning approach that includes both individual and group sessions.

Keywords:

• Communication
• Adult learning
• Training
• Couples
• Aphasia

The authors gratefully acknowledge the contribution of Anne Hrabi, Communicative Disorders Assistant, March of Dimes Canada, York-Durham Aphasia Programs, who helped implement the programme and speech-language pathologists Bonnie Moore and Diane Mulholland, who contributed useful clinical information about clients that helped guide the training. We thank the administrative staff and volunteers at the March of Dimes Canada Central Region office for their support and assistance. We also thank the clients, families, staff and volunteers of the March of Dimes Canada, York-Durham Aphasia Programs, who contributed to the Aphasia Awareness Walk and Roll-a-Thon fundraising campaign which helped fund this study, as well as the people with aphasia and their partners who participated in this programme.