Group training in communication skills for carers of adults with aphasia.

This study describes a communication skills group programme for four carers of adults with aphasia that ran once a week for 6 consecutive weeks. The content of the group was based on an approach previously not described in the literature in any detail. Conversation analysis (CA) was used to guide individualized advice that was incorporated into the group by the use of written advice sheets. Intervention was motivated by the results of a newly developed assessment tool--the Conversation Analysis Profile for People with Aphasia (CAPPA)--and a quantitative and qualitative analysis of collaborative repair. The CAPPA utilizes the methodology of conversation analysis (CA) as a means of both characterizing and comparing the relationship between the carers' perception of the aphasia and what is occurring in natural conversation. During the group, accurate perceptions and strategies that minimized the disruption to the conversation were reinforced, while inaccurate perceptions and strategies that appeared to impede interaction were discouraged. The use of the CAPPA results and a quantitative/qualitative analysis of repair management to measure change pre- and post-group was explored. The post-intervention analyses examined three questions in particular: (1) did the carers demonstrate more accurate perceptions of their relatives' aphasia?; (2) did the carers report a decrease in the problem severity of the aphasia?; and (3) was there a change in the time taken to repair a trouble source and was this attributable to a change in the management of repair by the carer? The study was essentially an investigation of whether this type of approach was beneficial to the carers involved. The results suggested that focusing on individualized advice and targeting conversation management in the group setting was a useful way of providing advice to carers. Furthermore, the CAPPA and a quantitative/qualitative analysis of repair management seem to have the potential for motivating the individualized advice and measuring the effectiveness of an intervention.