Psychological interventions, whether directed at cognitive functioning or emotional expression, are frequently offered on a group basis to people with dementia. This paper aims to review the range of therapies offered and to evaluate the evidence for their effectiveness. Four categories of group therapy are identified: early approaches to enhancing well-being (reality orientation, validation and reminiscence); methods aimed at improving memory and cognition (cognitive stimulation and memory training); psychotherapy; and support. Although the review demonstrates the wide range of group work offered, and the creativity of practitioners in this area, relatively little formal evaluation has been undertaken. It is therefore difficult to reach firm conclusions regarding evidence for efficacy. There is a need for more research, and future evaluations should pay increased attention to the selection of appropriate methodologies and outcome measures, the question of clinical relevance and the issue of individual differences in response to intervention. In addition, it will be important to (Alberoni, Baddeley, Della Sala, Logie, & Spinnler, 1992). Cognitive changes make it much more difficult to take new information on board, relate to other group members and join in a group situation. For example, it will be harder to focus if several group members are conversing at the same time. Despite these potential difficulties, group-based interventions are widely reported (Cheston, 1998).In this paper we review a range of group-based psychological therapies for people with dementia and explore the evidence for their effectiveness. We begin with the therapies that first demonstrated the possibilities for psychological work with people who have dementia: reminiscence, reality orientation and validation. We then consider more recent developments in cognition-based therapies and psychotherapy, and discuss the rapid EARLY APPROACHES TO ENHANCING WELL-BEINGGroup therapies have played a significant role in fostering acceptance of the relevance of psychological therapy for people with dementia. The early development of group therapies for people with dementia reflects a tension between cognitionoriented and emotion-oriented therapies that is still evident in the current literature. The main approaches to be considered here are reality orientation, validation therapy and reminiscence. Reality Orientation GroupsReality orientation (RO) uses instruments such as the reality orientation board to improve orientation in the here-and-now situation. RO can be implemented on a 24-hour or a classroom basis: ideally the 24-hour approach and classroom RO are used in combination, the latter not being considered a sufficient intervention by itself (Jenkinson, 1992). Classroom RO is carried out in group sessions. One difficulty with the term RO is that it is used to describe a number of different techniques (Bird, 2000), and may incorporate elements of other types of intervention such as reminiscence or cognitive stimulation. Holden and Woods (1982) also...

Background: Despite evidence that Communication Partner Training (CPT) can enable health professionals to communicate more effectively with people with aphasia (PWA), an evidence-practice gap exists. To address this, a tailored implementation intervention was developed and trialled to improve health professionals' implementation of communication strategies in a subacute setting. Aims: To explore the outcomes and perceived feasibility, acceptability and potential effectiveness of an iterative CPT implementation intervention on multidisciplinary healthcare professionals' communication with PWA. Methods & Procedures: The CPT implementation intervention was delivered to two groups of healthcare professionals (n = 6 and 7) approximately 6 months apart. The intervention underwent two iterations targeting emerging barriers to implementation success, with Group 2 receiving a modified version of the Group 1 intervention. A concurrent qualitative process evaluation was conducted to understand key factors determining implementation outcomes. Quantitative outcomes were recorded at baseline and 3-month follow-up, including the Measure of Skill in Supported Communication (MSC), a customized behavioural determinants survey mapped to the Theoretical Domains Framework (TDF) and the Organizational Readiness for Change survey. Focus groups and semi-structured interviews were conducted with health professional participants and the speech-language therapist trainer to explore perceptions of feasibility, acceptability and potential effectiveness. Content analysis was used to analyse the qualitative data, with categories and themes generated.Outcomes & Results: The Group 2 implementation intervention was adapted based on feedback and reflections from Group 1 participants to incorporate more time for practice interactions and discussion during training, individual follow-up sessions and provision of accessible resources to aid communication attempts. There were greater improvements seen in the Group 2 outcomes on both the MSC and the TDF survey, suggesting that the iterative tailoring of the intervention was successful in addressing the barriers to change and led to improved implementation. The difference between the group's outcomes may also partly be explained by the impact of organizational readiness, which decreased during Group 1's implementation period. Despite similar themes emerging from the stakeholder perspectives in both groups (training factors, implementation facilitators, implementation barriers, and changes in knowledge and practice), these diverted in ways which served to explain the different implementation outcomes. Conclusions & Implications: An iteratively adapted CPT implementation intervention targeting healthcare professionals' use of supported communication strategies was feasible and acceptable for most participants. The implementation intervention was potentially effective in changing participants' communication with PWA, particularly