Facilitating Authentic Conversation: an intervention employing principles of constructivism and conversation analysis

Abstract

Background: The progressive interest in social activities within the life and clinical efforts of persons with aphasia makes it necessary to focus more clinical attention on conversation as a site for therapy and as a goal for intervention. A number of innovative approaches have been designed, but most fall sort when authentic conversation is considered.

Aims: This article provides one alternative to those intervention approaches. It aims to improve the interactional abilities of persons with aphasia by addressing authentic conversation. The intervention approach, Facilitating Authentic Conversation (FAC), is described in detail by providing its theoretical basis, the practical guidelines for its organisation and design, and its implementation procedure. Additionally, a case study is provided that addresses two questions: does this approach reduce targeted problematic behaviours in conversations and does this approach increase the utilisation of effective strategies during conversations.

Methods & Procedures: Constructivism and conversation analysis are used to design a therapy approach that includes an analysis procedure and various strategies to achieve a therapeutic effect during authentic conversation. Using qualitative and quantitative techniques derived from conversation analysis, evidence for change within conversations is provided.

Outcomes & Results: Evidence suggests that this intervention approach assisted in changing the conversational behaviours of the person with aphasia (PWA) who served as the case study. Two conversational strategies that were highlighted via several specific therapeutic techniques were found to have reduced specific problematic conversational behaviours 19 months post-onset.

Conclusions: The article describes an innovative therapeutic approach that employs authentic conversation as the primary vehicle for intervention. The case study provided with this description provides evidence that identified problematic behaviours can be modified through constructivist principles that expose the PWA to beneficial strategies used to overcome conversational barriers due to aphasia.

Keywords:

• aphasia
• conversation
• therapy
• constructivism