Supporting people with aphasia to ‘settle into a new way to be’: speech and language therapists’ views on providing psychosocial support

Northcott, S., Simpson, A., Moss, B., Ahmed, N. & Hilari, K. (2017). Supporting people with aphasia to ‘settle into a new way to be’: speech and language therapists’ views on providing psychosocial support. International Journal of Language and Communication Disorders, doi: 10.1111/1460-6984.12323

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Abstract

Background: People with aphasia are at risk of becoming depressed and isolated. On-line surveys have found that the majority of Speech and Language Therapists (SLTs) lack confidence in addressing the psychological needs of people with aphasia.

Aims: To explore how SLTs conceptualise the scope of their role; barriers and facilitators to SLTs addressing psychosocial needs; and SLTs’ experiences of specialist training and support, and working with mental health professionals (MHPs).

Methods and procedures: Focus groups conducted in stroke healthcare settings. Purposive sampling was used in selecting sites so as to capture a range of experiences. Results were analysed using Framework Analysis.

Outcomes and Results: Twenty-three SLTs took part in six focus groups. Participants’ psychosocial work included counselling-type interactions, psychoeducation, working with families, facilitating peer support, and training other healthcare professionals. There was a lack of consensus on the scope of the SLT role. Many expressed a sense of conflict, both perceiving it as valuable to spend time addressing psychological well-being, while simultaneously feeling uneasy if they deviated from ‘direct SLT’ work. Barriers to addressing psychosocial wellbeing were: emotionally challenging nature of this work, particularly for those who felt unsupported; caseload and time pressures; attitude of senior managers and commissioners; difficulties measuring and documenting more ‘fluid’ psychosocial work; and the complexity of needs and backgrounds of some patients. Enabling factors were: specialist on-going support; peer support from colleagues; experience; support of management; and personal belief. Specialist training was valued. It changed how participants viewed the therapist-client relationship (more client-led); the assessment and goal setting process; and gave them more confidence to acknowledge client emotions. However, many felt that there was a need for on-going specialist advice, and to be able to see approaches modelled for this client group. In terms of mental health professionals (MHPs), a subset of stroke specialist clinical psychologists worked directly with people with marked aphasia and families, as well as supporting the multidisciplinary team to provide holistic care. However, a main theme was that participants perceived many MHPs did not consider people with aphasia as ‘appropriate candidates’ for psychological input.

Conclusions and Implications: All participants cared about the emotional well-being of their clients; however, they identified a number of barriers to people with aphasia receiving appropriate psychological support. A cultural shift, whereby psychological care for people with aphasia is seen as valuable, feasible and necessary, delivered collaboratively by SLTs, MHPs and the wider team, may improve services.

Item 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), Supporting people with aphasia to ‘settle into a new way to be’: speech and language therapists’ views on providing psychosocial support. International Journal of Language & Communication Disorders., which has been published in final form at http://dx.doi.org/10.1111/1460-6984.12323. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Uncontrolled Keywords: psychological well-being; social well-being; aphasia; clinical practice
Subjects: B Philosophy. Psychology. Religion > BF Psychology
P Language and Literature
Divisions: School of Health Sciences > Department of Adult Nursing
School of Health Sciences > Department of Language & Communication Science
URI: http://openaccess.city.ac.uk/id/eprint/17216

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