Developing consensus-based clinical competencies to guide stroke clinicians in the implementation of psychological care in aphasia rehabilitation

Caroline Baker; Brooke Ryan; Miranda L. Rose; Ian Kneebone; Shirley Thomas; Dana Wong; Sarah J. Wallace

doi:10.1071/IB23091

RESEARCH ARTICLE (Open Access)

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Developing consensus-based clinical competencies to guide stroke clinicians in the implementation of psychological care in aphasia rehabilitation

Caroline Baker

^A ^B ^* , Brooke Ryan ^C , Miranda L. Rose ^B ^D , Ian Kneebone ^E , Shirley Thomas ^F , Dana Wong ^G and Sarah J. Wallace ^H ^I

+ Author Affiliations

- Author Affiliations

^A Speech Pathology Department, Monash Health Melbourne, Vic., Australia.

^B Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Vic., Australia.

^C Speech Pathology, Curtin School of Allied Health, Curtin University, Perth, WA, Australia.

^D School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Vic., Australia.

^E Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, NSW, Australia.

^F School of Medicine, University of Nottingham, UK.

^G School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia.

^H Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.

^I Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Qld, Australia.

^* Correspondence to: c.baker@latrobe.edu.au

Handling Editor: Natasha Lannin

Brain Impairment 25, IB23091 https://doi.org/10.1071/IB23091

Submitted: 29 August 2023 Accepted: 30 January 2024 Published: 28 February 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of the Australasian Society for the Study of Brain Impairment. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

People with aphasia experience depression and anxiety associated with negative outcomes across a range of time post-stroke. Stroke clinicians are well-positioned to facilitate low-intensity psychotherapeutic interventions after aphasia (e.g. mood screening, behavioural activation, problem-solving therapy, relaxation therapy); however, they self-report a lack of knowledge, skills and confidence to do so. The Theoretical Domains Framework (TDF) provides a lens through which to view and target clinician behaviours and training needs in this area of practice. The aim of this study was to develop and gain consensus on items for a rating scale of clinical competencies in facilitating individual-based, low-intensity psychotherapeutic interventions for people with aphasia.

Methods

An e-Delphi methodology using focus groups and survey rounds was used to gain consensus on clinical competencies considered important.

Results

Eight stroke clinicians (speech pathologists and psychologists), two people with aphasia and three family members participated in one of four focus groups. Four themes were derived from the data: (1) Communication support, (2) Assessment and therapy structure, (3) Interpersonal skills, and (4) Needs of the significant other (family or friend). Themes informed an initial list of 23 self-rated and observer-rated competency items. Following two rounds of e-Delphi surveys, 11 stroke clinicians (six speech pathologists and five psychologists) reached consensus (80–100%) for 19 competencies.

Conclusions

The Psychological Care in Aphasia Rehabilitation Competency scale offers a preliminary list of items to guide and train clinicians to implement low-intensity psychotherapeutic interventions for people with aphasia.

Keywords: aphasia, clinical competencies, knowledge, language/communication, mood, psychological care, skills, stroke.

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