Engagement in small group interactions involving persons with primary progressive aphasia
Keywords:Primary progressive aphasia, Small group, Engagement, Qualitative, Interaction
Purpose: In group therapy, participant engagement is integral for achieving effective and meaningful interactions. Engagement is necessary not only for ensuring participation in the group, but also for promoting overall life engagement. Although engagement is vital to group therapy, it has remained largely unstudied, particularly in treatment for persons with primary progressive aphasia.
Methods: Using samples from a videotaped small group interaction involving two graduate student clinicians and two persons with primary progressive aphasia, conversational actions contributing to engagement were identified and analyzed via content analysis and principles of conversation analysis.
Results: Conversational actions resulting in engagement included clinician-appointed turns, participant affirmation, and member support. These conversational actions were found to maintain and/or increase wavering levels of participant engagement.
Discussion: Findings for the study yielded clinical applications for clinician promotion of engagement during small group interactions involving persons with primary progressive aphasia to increase participant involvement and maximize therapeutic outcomes.
Bright, F. A. S., Kayes, N. M., Worrall, L., and McPherson, K. M. (2015). A conceptual review of engagement in healthcare and rehabilitation. Disability and Rehabilitation, 37, 643–654. https://doi.org/10.3109/09638288.2014.933899
Bright, F. A., Kayes, N. M., Cummins, C., Worrall, L. M., and McPherson, K. M. (2017). Co-constructing engagement in stroke rehabilitation: A qualitative study exploring how practitioner engagement can influence patient engagement. Clinical Rehabilitation, 31, 1396–1405. https://doi.org/10.1177/0269215517694678
Dahl, H.-S. J., Høglend, P., Ulberg, R., Amlo, S., Gabbard, G. O., Perry, J. C., and Christoph, P. C. (2016). Does therapists’ disengaged feelings influence the effect of transference work? A study on countertransference. Clinical Psychology and Psychotherapy, 24(2), 462–474. https://doi.org/10.1002/cpp.2015
Damico, J. S., Oelschlaeger, M., and Simmons-Mackie, N. (1999). Qualitative methods in aphasia research: Conversation analysis. Aphasiology, 13, 667–679. https://doi.org/10.1080/026870399401777
Damico, J., Tetnowski, J., Lynch, K., Hartwell, J., Weill, C., Heels, J., and Simmons-Mackie, N. (2015). Facilitating authentic conversation: An intervention employing principles of constructivism and conversation analysis. Aphasiology, 29, 400–421. https://doi.org/10.1080/02687038.2014.945388
Downe-Wamboldt, B. (1992). Content analysis: Method, applications, and issues. Health Care for Women International, 13, 313–321. https://doi.org/10.1080/07399339209516006
Eastwood, J. (1988). Qualitative research: An additional research methodology for speech pathology? International Journal of Language and Communication Disorders, 23, 171–184. https://doi.org/10.3109/13682828809019885
Elman, R. J. (2007). The importance of aphasia group treatment for rebuilding community and health. Topics in Language Disorders, 27, 300–308. https://doi.org/10.1097/01.TLD.0000299884.31864.99
Elman, R. J., and Bernstein-Ellis, E. (1999). The efficacy of group communication treatment in adults with chronic aphasia. Journal of Speech Language and Hearing Research, 42, 41. https://doi.org/10.1044/jslhr.4202.411
Elo, S., and Kyngäs, H. (2008). The qualitative content analysis process. Journal of Advanced Nursing, 62, 107–115. https://doi.org/10.1111/j.1365-2648.2007.04569.x
Golafshani, N. (2003). Understanding reliability and validity in qualitative research. Qualitative Report, 8, 597–606.
Haley, L. K., Cunningham, T. K., Barry, J., and De Riesthal., M. (2019). Collaborative goals for communicative life participation in aphasia: The FOURC model. American Journal of Speech-Pathology, 28, 1–13. https://doi.org/10.1044/2018_AJSLP-18-0163
Holland, A. L. (2008). Recent advances and future directions in aphasia therapy. Brain Impairment, 9, 179–190. https://doi.org/10.1375/brim.9.2.179
Hsieh, H. F., & Shannon, S. E. (2005). Three Approaches to Qualitative Content Analysis. Qualitative Health Research, 15(9), 1277–1288. https://doi.org/10.1177/1049732305276687
Jokel, R., Meltzer, R., J. D., M., L. D., J., J. C., E., A. N., and T., C. D. (2017). Group intervention for individuals with primary progressive aphasia and their spouses: Who comes first? Journal of Communication Disorders, 66, 51–64. https://doi.org/10.1016/j.jcomdis.2017.04.002
Khayum, B., Wieneke, C., Rogalski, E., Robinson, J., and O’Hara, M. (2012). Thinking outside the stroke: Treating primary progressive aphasia (PPA). Aphasiology, 17, 27–49. https://doi.org/10.1044/gero17.2.37
Kortte, K. B., and Rogalski, E. J. (2013). Behavioral interventions for enhancing life participation in behavioral variant frontotemporal dementia and primary progressive aphasia. International Review of Psychiatry, 25, 237–245. https://doi.org/10.3109/09540261.2012.751017
Kortte, K. B., Falk, L. D., Castillo, R. C., Johnson-Greene, D., and Wegener, S. T. (2007). The Hopkins Rehabilitation Engagement Rating Scale: Development and psychometric properties. Archives of Physical Medicine and Rehabilitation, 88, 877–884. https://doi.org/10.1016/j.apmr.2007.03.030
Kovarsky, D., Curran, M., and Nichols, N. (2009). Laughter and communicative engagement in interaction. Seminars in Speech and Language, 30, 27–36. https://doi.org/10.1055/s-0028-1104532
Krajenbrink, T., Croot, K., Taylor-Rubin, C., and Nickels, L. (2018). Treatment for spoken and written word retrieval in the semantic variant of primary progressive aphasia.Neuropsychological Rehabilitation, 30(5), 1–33. https://doi.org/10.1080/09602011.2018.1518780
Kroll, A. T., Rutter, B., and Oxley, D. J., (2017). Functions of sequential placement: conversational co-construction of a single non-verbal contribution. Journal of Interactional Research in Communication Disorders, 8, 96–120. https://doi.org/10.1558/jircd.32014
Lee, J. B., and Azios, J. H. (2020). Facilitator behaviors leading to engagement and disengagement in aphasia conversation groups. American Journal of Speech-Language Pathology, 29, 393–411. https://doi.org/10.1044/2019_AJSLP-CAC48-18-0220
Medina, J., and Weintraub, S. (2007). Depression in primary progressive aphasia. Journal of Geriatric Psychiatry and Neurology, 20, 153–160. https://doi.org/10.1177/0891988707303603
Merriam, S. B. (1995). What can you tell from an N of 1? Issues of validity and reliability in qualitative research. Pennsylvania Association for Adult Continuing Education (PAACE) Journal of Lifelong Learning, 4, 51–60.
Mesulam, M. M. (2003). Primary progressive aphasia – A language-based dementia. New England Journal of Medicine, 249, 1535–1542. https://doi.org/10.1056/NEJMra022435
Simmons-Mackie, N. (2008). Social approaches to aphasia intervention. In R. Chapey (Ed.), Language intervention strategies in aphasia and related neurogenic communication disorders (pp. 290–317). Philadelphia: Lippincott, Williams and Wilkins.
Simmons-Mackie, N. (2018). Aphasia in North America. Moorsetown: Aphasia Access.
Simmons-Mackie, N., and Damico, J. S. (2009) Engagement for group therapy in aphasia. Seminars in Speech and Language, 30, 18–26. https://doi.org/10.1055/s-0028-1104531
Simmons-Mackie, N., and Elman, R. J. (2010). Negotiation of identity in group therapy for aphasia: The Aphasia Café. International Journal of Language and Communication Disorders, 46, 312–323. https://doi.org/10.3109/13682822.2010.507616
Simmons-Mackie, N., and Kovarsky, D. (2009). Engagement in clinical interaction: An introduction. Seminars in Speech and Language, 30, 5–10. https://doi.org/10.1055/s-0028-1104528
Simmons-Mackie, N., and Schultz, M., (2003) The role of humor in therapy for aphasia. Aphasiology, 17, 751–766. https://doi.org/10.1080/02687030344000229
Simmons-Mackie, N., Elman, R. J., Holland, A. L., and Damico, J. S. (2007). Management of discourse in group therapy for aphasia. Topics in Language Disorders, 27(1), 5–23. https://doi.org/10.1097/00011363-200701000-00003
Taylor, C., Croot, K., Power, E., Savage, S. A., Hodges, J. R., and Togher, L. (2014). Trouble and repair during conversations of people with primary progressive aphasia. Aphasiology, 28, 1069–1091. https://doi.org/10.1080/02687038.2014.930411
Werbart, A., Hägertz, M., Ölander, N. B. (2018). Matching patient and therapist anaclitic–introjective personality configurations matters for psychotherapy outcomes. Journal of Contemporary Psychotherapy, 48, 241–251. https://doi.org/10.1007/s10879-018-9389-8
How to Cite
© Equinox Publishing Ltd.
For information regarding our Open Access policy, click here.