When Words Fail: Providing Effective Psychological Treatment for Depression in Persons with Aphasia

More than 2 million people in the United States are living with some form of aphasia, a communication disorder that has been associated with high incidence of clinical depression. Despite their large numbers, persons with aphasia have received little clinical attention from psychologists and other mental health providers. The life participation interventions and supported communication methods developed and routinely employed by speech-language pathologists could assist mental health professionals in addressing the needs of this underserved population. This paper examines the psychological challenges facing individuals living with aphasia and the factors contributing to depressive symptoms among those with significant communication loss. In addition, it explores the potential compatibility between life participation interventions developed by speech-language pathologists and evidence-based cognitive-behavioral interventions for depression, such as behavioral activation. Specific adaptations to behavioral activation for individuals experiencing aphasia-related depressive symptoms are explored, along with strategies for integrating supported communication in the provision of mental health treatment.