People with stroke aphasia are traditionally discharged from speech and language therapy when they have plateaued; meaning they are making no further progress in language recovery. This service model has been problematic, leading to people being discharged when they are emotionally and socially vulnerable. Self-management allows a person intrinsic control of the medical, life participation and emotional consequences of their aphasia. This approach is often considered novel or unfamiliar to speech and language therapists. The present study aims to explore and document speech and language therapists’ perspectives of aphasia self-management from an Australian outlook. Fifteen speech and language therapy participants from five Australian states were recruited to participate in semi-structured interviews. Interviews were transcribed and analysed using qualitative content analysis. Six main themes and 18 subthemes were identified. The main themes focused on wanting to see people but not having time, requiring the person with aphasia to take responsibility, including family and friends, this being a role for speech and language therapy, knowing people with aphasia are physically, mentally and cognitively able to cope and the potential challenges. Speech and language therapists were unanimous in their agreement that self-management is an important component of aphasia care but identified that staff have training needs to enhance their skills in this area. Over and above, there is a pressing resource requirement, with more therapists required to enable the adequate provision of these services. This work is likely to reflect the situation in the UK as well as Australia, where self-management approaches are extremely valuable for people with aphasia yet, in order to deliver these, we require adequate provision of services.
Doing it for yourself: self-management in speech and language therapy
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