The efficacy of an inter-disciplinary community aphasia group for living well with aphasia

Background: Community aphasia groups (CAGs) are argued to have various benefits for people with chronic aphasia. However, there is a paucity of evidence regarding the feasibility of conducting an interdisciplinary programme with content and outcome measures encompassing ICF domains, making it difficult to ascertain the full potential of this service option. As another key population living with aphasia, family members have received little attention in CAG research to date.

Aim: To determine potential efficacy of a speech-language pathologist- and social worker-led CAG model for four people with aphasia (PWA) and their spouses on living well with aphasia within a proof-of-concept trial.

Methods & Procedures: Informed by extensive study of the existing CAG literature, we developed a comprehensive 12-week interdisciplinary CAG model and trial protocol (the InterD-CAG). We used a Phase I pre-post design with a follow-up phase. The group was co-facilitated by a speech-language pathologist and social worker with support from aide staff. The group met at a university clinic for 2 h per week over 12 consecutive weeks. The protocol comprised a combination of communication therapy; conversation practice; social, peer, and psychological support; stroke and aphasia information; and participation in meaningful and accessible activities. Group session time was split into two formats: (1) concurrent sessions dedicated to members with aphasia alone/spouses alone and (2) mixed sessions with both members with aphasia and spouses together. The Therapeutic Factors Inventory was administered at regular intervals during the programme to ascertain participants’ perceptions of group process. Pre, post, and follow-up outcome measures spanned all WHO ICF domains for PWA, with measures for spouses addressing supported conversation skills, psychological health, and carer burden.

Outcomes & Results: Both PWA and spouses perceived the presence of therapeutic factors to be medium or high by Week 12 in the programme. Our hypotheses for significant improvement for PWA in quality of life, aphasia impairment, activity & participation, and contextual factors were partially supported and maintenance of gains was observed in some cases. No clear changes were evident for spouses.

Conclusions: This study contributes preliminary evidence for the efficacy of the InterD-CAG model for people with chronic aphasia. Larger-scale studies with comparison groups are required to build on the present findings with specific attention to spouse support needs.