We’ve had two codesign meetings with our four speech and language therapists (SLTs) so far, and wanted to share some reflections on the process, and how valuable it is in the project. And we were hoping that other SLTs around the UK might chip in through the blog or on twitter and respond to our questions.
Real vs. ideal in SLT
In session 1, we invited our SLTs to reflect on the real and the ideal in the therapeutic process. Specifically, we asked them to comment on the following question:
From your own perspective, what does the process look like for you when deciding on, preparing, deliver, and evaluating aphasia treatment for someone with aphasia? [includes what resources and materials are used].
This led to some fascinating discussion and insights into how clinical decisions are made, which might be influenced by access to resources, expertise, trust, and setting. We had some particularly meaty discussion around how (therapy) resources are used; how personalised therapy resources could be (which is important in LUNA); and how intervention outcomes are currently being evaluated.
SLTs then considered an ideal situation (…we’re exploring some ‘blue sky’ thinking as a backdrop for LUNA…). This was especially illuminating, and with discussion covering how aphasia therapy and the rehabilitation process could be more ideal if we used standard outcome measures, could find more opportunities to incorporate therapy into everyday life, including self-directed therapy and involving family more in the client’s rehabilitation. SLTs also raised having more therapy time, more time to analyse client data, having resources to draw upon, and personalizing therapy.
LUNA would love to hear from SLTs across all settings – what does ideal aphasia therapy look like, from your perspective as a professional/ service provider?
Synthesising research for clinical practice
We then turned our attention to our scoping review-in-progress of discourse treatment research studies in aphasia and explored what makes a literature synthesis useable to clinicians.
So far, the list looks like this:
(1) the therapies/ treatments used are usefully described, or at least signposted so you can follow up and read the journal article;
(2) making sure the therapies themselves are clearly named and defined as acronyms and familiarity can lead to assumptions that others know the treatments being talked about (when this is in fact not the case!);
(3) presenting the findings in bite-sized chunks e.g. 5 minutes’ worth in recognition of busy practice and to therefore capitalize on small windows of time;
(4) highlighting if therapy manuals or resources are easily available, and whether the therapies must be carefully adhered to protocol or more flexibly delivered/ applied;
(5) grouping findings in a useful way perhaps around client profiles, or types of treatment, so it’s easy to see how and when a clinician might choose/read/ apply to a current client on caseload; and
(6) taking active steps to use it in practice such as taking one idea, trialing it, and feeding back at a team meeting or a “monthly challenge”.
LUNA would like to know: what makes a literature synthesis useful to you as a SLT?
We finished session 1 with some discussion around a model or framework that underpins LUNA, which attempts to represent the many aspects involves in telling a personal narrative/ story. There was much debate and discussion in the room around what we want a model or framework to achieve – and how we are going to share this more broadly with clinicians and researchers. There were many differing views. It’s safe to say this will be an ongoing discussion throughout our project, so we’re keeping quiet on this at the moment!
Are you interested in the LUNA model or framework? We will be looking to road-test it at some point. If you are a SLT and particularly interested in this, do get in touch with us on the LUNA email luna@city.ac.uk to volunteer yourself!