Counselling training for speech–language therapists working with people affected by post‐stroke aphasia: a systematic review

Abstract

Background Speech–language therapists use counselling to address the psychological well‐being of people affected by post‐stroke aphasia. Speech–language therapists report low counselling knowledge, skill and confidence for working in post‐stroke aphasia which may be related to a lack of counselling training specific to the needs of this client group. Aims To identify current training in counselling for speech–language therapists to address psychological well‐being in people affected by post‐stroke aphasia. Specifically, the intent was to establish the objectives, content, amount, teaching methods and outcomes of counselling training provided to speech–language therapists working with people affected by post‐stroke aphasia. Methods & Procedures Eleven databases were searched from inception to January 2018 using terms relating to counselling, psychological well‐being, speech–language therapy, stroke, aphasia and training. Studies using any research methodology and design were included. Nine studies were critically appraised and synthesized as a systematic review using the Search, AppraisaL, Synthesis and Analysis (SALSA) framework. Main Contribution Information on counselling training came from the UK, United States and Australia. Student speech–language therapists received training in goal‐setting and generic counselling skills. After qualification, speech–language therapists received counselling training from mental health professionals within stroke workplaces, from external providers and further education. A range of teaching techniques and counselling approaches were described. Self‐report and themes from qualitative data were the primary measures of counselling training outcomes. Moderate correlations were reported between counselling training and levels of speech–language therapists’ knowledge, comfort, confidence and preparedness to counsel people affected by post‐stroke aphasia. Conclusions Research in counselling training for speech–language therapists working in post‐stroke aphasia is limited, with a small number of primarily low‐quality studies available. Training in generic counselling skills and brief psychological approaches with support from mental health professionals in the stroke workplace enabled speech–language therapists to feel knowledgeable, skilled and confident to address the psychological well‐being of people affected by post‐stroke aphasia. Evidence about the effectiveness of counselling training on speech–language therapists’ confidence and competence in practice and on client outcomes in psychological well‐being in post‐stroke aphasia is required.

Speech language therapists’ experiences with subjective well‐being in people with aphasia

“…In Cruice and ten Kate (2019), for example, five of the 19 participating SLTs referred to QOL 'in affective terms of joy/ enjoyment, happiness, and pleasure (two of whom also referred to satisfaction)' ( 11), terms that are related to SWB much more than HQOL. Most participants (n = 15) felt they would like more teaching on the concept of, in this case, QOL, a finding in line with a recent systematic review showing that SLTs lack training addressing well-being to support PWA in coping with their aphasia (Sekhon et al 2019). Previous research identifies several barriers that British SLTs experience when addressing the patients' psychological well-being (Sekhon et al 2019, Northcott et al 2018.…”

“…Most participants (n = 15) felt they would like more teaching on the concept of, in this case, QOL, a finding in line with a recent systematic review showing that SLTs lack training addressing well-being to support PWA in coping with their aphasia (Sekhon et al 2019). Previous research identifies several barriers that British SLTs experience when addressing the patients' psychological well-being (Sekhon et al 2019, Northcott et al 2018. SLTs acknowledge their role in providing psychological support to their patients, but feel the boundaries between their services and mental healthcare professionals' services are unclear (Northcott et al 2018).…”

Emotional and Psychological Effects of Dysphagia: Validation of the Jugendwerk Dysphagia Emotion and Family Assessment (JDEFA)

“…Concerning family functionality, there also are several studies showing influences and dependencies reviewed in [15], but to our knowledge no setting put it into context with the CFAM/CFIM. However, the need for counseling training in speech and language therapists is well known on the side of therapists giving support to patients [37,38]. On the other side, we could not find literature about well-being and mental health of the therapists themselves, especially on our finding of high stress levels for making mistakes in food recommendations-possibly resulting in aspiration, choking, and death of patients.…”

Prevalence of Behavioral Health Problems Among Adults With and Without Communication Disabilities

“…32,44,[48][49][50] Another opportunity for addressing these needs is the addition of speech-language pathologists as part of the primary care and behavioral health team. 51 Such providers are specifically trained in addressing CDs and can work with both the patient and providers to improve communication and understanding of symptoms and treatment effects.…”