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How do Speech and Language Therapists address the psychosocial well-being of people with aphasia? Results of a UK on-line survey

Northcott, S., Simpson, A., Moss, B., Ahmed, N. and Hilari, K. (2017). How do Speech and Language Therapists address the psychosocial well-being of people with aphasia? Results of a UK on-line survey. International Journal of Language and Communication Disorders, 52(3), pp. 356-373. doi: 10.1111/1460-6984.12278

Abstract

Background and Aims: The psychosocial impact of stroke and aphasia is considerable. We aimed to explore UK speech and language therapists’ clinical practice in addressing psychological and social needs of people with aphasia including their experiences of working with mental health professionals.

Methods and Procedures: A 22-item on-line survey distributed to UK speech and language therapists via British Aphasiology Society mailing list and Clinical Excellence Networks. Results were analysed using descriptive statistics and qualitative content analysis.

Outcomes and Results: UK speech and language therapists (n=124) overwhelmingly considered that addressing psychological well-being (93%) and social participation (99%) was part of their role. To achieve this they frequently/very frequently used supportive listening (100%) and selected holistic goals collaboratively with clients (87%) including social goals (83%). However, only 42% felt confident in addressing the psychological needs of clients. Main barriers to addressing psychosocial well-being were time/caseload pressures (72%); feeling under-skilled/lack of training (64%) and lack of on-going support (61%). Main barriers to referring on to mental health professionals were that mental health professionals were perceived as under-skilled working with people with aphasia (44%); were difficult to access (41%); and provided only a limited service (37%). A main theme from the free text responses was concern that those with aphasia, particularly more severe aphasia, received inadequate psychological support due to the stretched nature of many mental health services, mental health professionals lacking skills working with aphasia, and speech and language therapists lacking the necessary time, training and support. Main enablers to addressing psychosocial well-being were collaborative working between speech and language therapists and stroke-specialist clinical psychologists; speech and language therapists with training in providing psychological and social therapy; and ongoing support provided by the voluntary sector.

Conclusions and Implications: The vast majority of speech and language therapists consider the psychosocial well-being of their clients, and work collaboratively with people with aphasia in selecting holistic goals. It is, however, of concern that most respondents felt they lacked confidence and received insufficient training to address psychological well-being. In order to improve psychological services for this client group, there is a strong case that stroke-specialist mental health professionals should strive to make their service truly accessible to people with even severe aphasia, which may involve working more closely with speech and language therapists. Further, improving the skills and confidence of speech and language therapists may be an effective way of addressing psychological distress in people with aphasia.

Publication Type: Article
Additional Information: This is the peer reviewed version of the following article: Northcott, S., Simpson, A., Moss, B., Ahmed, N. and Hilari, K. (2017), How do speech-and-language therapists address the psychosocial well-being of people with aphasia? Results of a UK online survey. International Journal of Language & Communication Disorders, 52: 356–373., which is published in final form at http://dx.doi.org/10.1111/1460-6984.12278. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Subjects: P Language and Literature > P Philology. Linguistics
Departments: School of Health Sciences > Language & Communication Science
URI: http://openaccess.city.ac.uk/id/eprint/14907
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