Disclaimer: this resource is intended for speech and language therapists and students of this profession. If you require therapy for aphasia please contact a speech and language therapist.
Aphasia Groups
Summary: A therapy approach where individuals with aphasia are given the opportunity to interact with and work alongside others with aphasia in order to develop communication skills and improve psychosocial well-being. While most groups focus on functional communication skills, impairment-based goals can be incorporated (Worrall et al., 2007). Groups can be a means of promoting carry-over of skills into more meaningful, real-life settings (Kearns & Elman, 2001).
Example: Activities that can be incorporated into aphasia groups:
(Adapted from Pound et al., 2000)
Alternatively, therapists may wish to use Holland’s more structured approach to group sessions:
(Adapted from Holland cited in Richman, Redmond, & Williamson, 2009)
- Team building / introductory activities, e.g. each member of the group shares a something positive or challenging that occurred that week.
- Modelling, e.g. the therapist or a more experienced member of the group might demonstrate a Total Communication approach.
- Role playing of difficult interactions group members have experienced followed by group problem solving of these.
- Feedback, e.g. group members observe and feed back on an aspect of another member’s communication during a task (e.g. eye contact, volume of speech, use of gesture.
(Adapted from Pound et al., 2000)
Alternatively, therapists may wish to use Holland’s more structured approach to group sessions:
- Opening: group given time for unstructured socialising.
- Context building: a short task (10-15 minutes) that is easily attainable for the group and that relates to the overall topic of the group, e.g. if the overall topic was ‘food’, members could be asked to name as many types of food in given category in 30 seconds.
- Language tasks: the group is given a more complex language task or tasks (30-40 minutes), e.g. each participant given an object and is supported to describe this using a semantic feature analysis approach. This could be followed by a discussion about how attitudes to food have changed during their lifetimes.
- Discourse: the content covered in the session is used in a more functional interaction, e.g. by answering questions such as ‘What is the strangest food you have eaten?’ or ‘What is your favourite food?’.
(Adapted from Holland cited in Richman, Redmond, & Williamson, 2009)
Evidence Base: Wertz, Collins, & Weiss (1981) compared individual and group therapy for individuals with aphasia. 67 male participants were randomly assigned to receive either individual therapy or group therapy. Those in the individual therapy condition received 4 hours of direct therapy and a further 4 hours of machine-supported intervention each week. Those in the group therapy condition received 4 hours of group sessions, facilitated by a speech pathologist, and 4 hours of social activities each week. While participants who received individual therapy performed significantly better than those receiving group therapy on the Porch Index of Communicative Abilities, there was no significant difference across other language measures.
Elman & Bernstein-Ellis (1999) carried out a randomised-controlled trial to investigate the effects of a functional communication skills group for adults with chronic aphasia. 24 participants were split into immediate and deferred treatment groups. Treatment in the aphasia groups, which took place for 5 hours a week over a 4 month period, focused on using a range of functional communication approaches. While awaiting treatment the participants in the deferred group attended 3 or more hours of social/movement group events per week.
Following attendance at the block of aphasia group therapy, Elman & Bernstein-Ellis noted improvements on linguistic measures (i.e. the Shortened Porch Index of Communicative Abilities and the Western Aphasia Battery–Aphasia Quotient) but not on the functional communication measure (the Communicative Abilities in Daily Living test). These gains were maintained at follow-up for the treatment group at follow-up 4-6 weeks later. Participants in the deferred treatment group saw no significant change on these language measures whilst engaging in social/movement groups.
For a more in depth discussion of the evidence base for group aphasia therapy see Layfield et al. (2013).
Elman & Bernstein-Ellis (1999) carried out a randomised-controlled trial to investigate the effects of a functional communication skills group for adults with chronic aphasia. 24 participants were split into immediate and deferred treatment groups. Treatment in the aphasia groups, which took place for 5 hours a week over a 4 month period, focused on using a range of functional communication approaches. While awaiting treatment the participants in the deferred group attended 3 or more hours of social/movement group events per week.
Following attendance at the block of aphasia group therapy, Elman & Bernstein-Ellis noted improvements on linguistic measures (i.e. the Shortened Porch Index of Communicative Abilities and the Western Aphasia Battery–Aphasia Quotient) but not on the functional communication measure (the Communicative Abilities in Daily Living test). These gains were maintained at follow-up for the treatment group at follow-up 4-6 weeks later. Participants in the deferred treatment group saw no significant change on these language measures whilst engaging in social/movement groups.
For a more in depth discussion of the evidence base for group aphasia therapy see Layfield et al. (2013).
References
Elman, R.J., & Bernstein-Ellis, E., 1999. The efficacy of group communication treatment in adults with chronic aphasia. Journal of Speech Language & Hearing Research, 42(2), 411–419
Kearns, K. & Elman, R. J., 2001. Group therapy in aphasia: Theoretical and practical considerations. In: Chapey, R. ed. Language intervention strategies in aphasia and related neurogenic communication disorders. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 316-337
Layfield, C.A., Ballard, K.J., & Robin, D.A., 2013. Evaluating group therapy for aphasia: What is the evidence. EBP Briefs, 7(5), 1-17
Pound, C., Parr, S., Lindsay, J., & Woolf, C., 2000. Beyond aphasia: Therapies for living with communication disability. Bicester: Speechmark
Richman, M.S., Redmond, S.C., & Williamson, D., 2009. The ABC’s of group treatment for aphasia. ASHA Convention 2009. [online] Available at: <http://www.asha.org/events/convention/handouts/2009/2363_redmond_suzanne_coyle/> [Accessed 03/08/2016]
Wertz, R.T., Collins, M.J., Weiss, D., Kurtzke, J.F., Friden, T., Brookshire, R. H., Pierce, J., Holtzapple, P., Hubbard, D.J., Porce, B.E., West, J.A., Davis, L., Matovitch, V., Morley, G.K., Resurreccion, E., 1981. Veterans Administration cooperative study on aphasia: a comparison of individual and group treatment. Journal of Speech & Hearing Research, 24(4), 580–594
Worrall, L.E., Davidson, B.J., Howe, T.J., & Rose, T.A., 2007. Clients as teachers: Two aphasia groups at the University of Queensland. In: Elman, R.J. ed. Group treatment of neurogenic communication disorders: The expert clinician’s approach. 2nd ed. Abington: Plural Publishing, 127-144
Elman, R.J., & Bernstein-Ellis, E., 1999. The efficacy of group communication treatment in adults with chronic aphasia. Journal of Speech Language & Hearing Research, 42(2), 411–419
Kearns, K. & Elman, R. J., 2001. Group therapy in aphasia: Theoretical and practical considerations. In: Chapey, R. ed. Language intervention strategies in aphasia and related neurogenic communication disorders. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 316-337
Layfield, C.A., Ballard, K.J., & Robin, D.A., 2013. Evaluating group therapy for aphasia: What is the evidence. EBP Briefs, 7(5), 1-17
Pound, C., Parr, S., Lindsay, J., & Woolf, C., 2000. Beyond aphasia: Therapies for living with communication disability. Bicester: Speechmark
Richman, M.S., Redmond, S.C., & Williamson, D., 2009. The ABC’s of group treatment for aphasia. ASHA Convention 2009. [online] Available at: <http://www.asha.org/events/convention/handouts/2009/2363_redmond_suzanne_coyle/> [Accessed 03/08/2016]
Wertz, R.T., Collins, M.J., Weiss, D., Kurtzke, J.F., Friden, T., Brookshire, R. H., Pierce, J., Holtzapple, P., Hubbard, D.J., Porce, B.E., West, J.A., Davis, L., Matovitch, V., Morley, G.K., Resurreccion, E., 1981. Veterans Administration cooperative study on aphasia: a comparison of individual and group treatment. Journal of Speech & Hearing Research, 24(4), 580–594
Worrall, L.E., Davidson, B.J., Howe, T.J., & Rose, T.A., 2007. Clients as teachers: Two aphasia groups at the University of Queensland. In: Elman, R.J. ed. Group treatment of neurogenic communication disorders: The expert clinician’s approach. 2nd ed. Abington: Plural Publishing, 127-144
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