Is Communication Training for Significant Others a Reasonable Rehabilitation Goal in Aphasia Therapy?

This study was motivated by goal samples from practicing speech-language pathologists (SLPs) that were submitted to a website our group maintains about treatment planning for aphasia. Upon analyzing the goals, we found that less than 3% involved any form of communication partner training (CPT). Considering this finding, we sought to understand how and to what extent aphasia clinicians in the United States use CPT with significant others.

We constructed a survey that included a mixture of multiple-choice and open response questions around goal setting and CPT for significant others. The survey was posted to the same website where we had originally collected the goal samples. Responses were summarized with descriptive statistics and thematic analysis.

One hundred fifty-six SLPs and 138 graduate students completed the survey. Almost all SLPs (97%) reported engaging in CPT with family members, and approximately half indicated they also wrote goals about this service at least occasionally. However, most explained that CPT was typically handled without goal setting. Graduate students reported limited experience with CPT. Thematic analysis of the open responses yielded five themes and 24 codes that collectively display a multidimensional implementation problem.

SLPs recognize the importance of CPT and employ a range of training techniques with significant others. Nevertheless, they face barriers that lead to ambivalence about writing goals for this service. On the rationale that explicit goals ensure accountability and transparency, we address some of the barriers by providing practical resources as steps toward solution-focused collaboration.