In the Driver's Seat: Narrative-Based Counseling in Aphasia

People with aphasia have been shown to experience higher rates of depression and mental health issues than stroke survivors without aphasia. Narrative-based counseling approaches to therapy in communication disorders have shown promise in several areas, such as stuttering. Little is known regarding how these approaches can be implemented with individuals with aphasia. This study sought to uncover what therapeutic processes could be utilized to overcome barriers to utilizing this approach with people with aphasia. A qualitative case study design was utilized. The primary data source included audio-recorded intervention sessions of a narrative-based counseling approach. Secondary data sources included reflection journals produced by the clinician and artifacts created by the client, including letter written as a part of the therapeutic process and other documents co-constructed by the clinician and client that detailed the client's journey. Data were analyzed inductively, in which transcripts were coded by the researchers and compared across the data set until patterns were apparent in the data that were later defined as themes. Analysis of data suggests that adapting narrative counseling techniques for success with people with aphasia consists of allowing adequate time for client response, building a therapeutic alliance, reiteration and saturation of solution-focused language and narratives, and maintaining a topic of conversation centered around aphasia. This study argues for further consideration of how narrative-based counseling techniques can be adapted and flexibly used in aphasia intervention.