Aaron Rothbart, McKay Moore Sohlberg, Samantha Shune, John Seeley, Elliot Berkman, Jim Wright
{"title":"靶向工作联盟治疗成分是否能改善获得性脑损伤患者的认知康复表现？","authors":"Aaron Rothbart, McKay Moore Sohlberg, Samantha Shune, John Seeley, Elliot Berkman, Jim Wright","doi":"10.1044/2024_AJSLP-24-00347","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to experimentally evaluate the potential impact of clinician-driven therapy ingredients hypothesized to enhance working alliance (WA) and promote patient engagement during cognitive rehabilitation sessions. It was hypothesized that when the clinician introduced evidence-backed alliance enhancing ingredients, there would be a corresponding improvement in participants' (a) performance on attention drills paired with a metacognitive strategy, (b) learning the steps to use a phone application, and (c) adherence to a home exercise program. It was also hypothesized that patients would show perceptual shifts toward stronger alliance.</p><p><strong>Method: </strong>Four adult participants who sustained moderate to severe acquired brain injuries with chronic cognitive deficits participated in the study. The study used a concurrent multiple-baseline design with randomization. Both visual and quantitative analyses were used to compare potential differences in performance on cognitive rehabilitation tasks when specific alliance enhancing behaviors were integrated into sessions.</p><p><strong>Results: </strong>Findings showed a strong effect for increased performance on attention span tasks when the clinician added the alliance enhancing treatment ingredients. Participants also learned more steps in the phone application task and either maintained or improved homework adherence in the experimental phase when the treatment ingredients were applied. The findings provided mixed results on participant perceptions of WA, as measured by a modified version of the Working Alliance Inventory.</p><p><strong>Conclusions: </strong>This study provides some of the first experimental data demonstrating that alliance enhancing treatment ingredients can have a significant influence on patient performance during cognitive rehabilitation sessions. The article offers recommendations for building on this important line of study.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.28727006.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":"34 3","pages":"1023-1040"},"PeriodicalIF":2.3000,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Do Treatment Ingredients Targeting Working Alliance Improve Cognitive Rehabilitation Session Performance in Patients With Acquired Brain Injury?\",\"authors\":\"Aaron Rothbart, McKay Moore Sohlberg, Samantha Shune, John Seeley, Elliot Berkman, Jim Wright\",\"doi\":\"10.1044/2024_AJSLP-24-00347\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The purpose of this study was to experimentally evaluate the potential impact of clinician-driven therapy ingredients hypothesized to enhance working alliance (WA) and promote patient engagement during cognitive rehabilitation sessions. 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Both visual and quantitative analyses were used to compare potential differences in performance on cognitive rehabilitation tasks when specific alliance enhancing behaviors were integrated into sessions.</p><p><strong>Results: </strong>Findings showed a strong effect for increased performance on attention span tasks when the clinician added the alliance enhancing treatment ingredients. Participants also learned more steps in the phone application task and either maintained or improved homework adherence in the experimental phase when the treatment ingredients were applied. The findings provided mixed results on participant perceptions of WA, as measured by a modified version of the Working Alliance Inventory.</p><p><strong>Conclusions: </strong>This study provides some of the first experimental data demonstrating that alliance enhancing treatment ingredients can have a significant influence on patient performance during cognitive rehabilitation sessions. 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Do Treatment Ingredients Targeting Working Alliance Improve Cognitive Rehabilitation Session Performance in Patients With Acquired Brain Injury?
Purpose: The purpose of this study was to experimentally evaluate the potential impact of clinician-driven therapy ingredients hypothesized to enhance working alliance (WA) and promote patient engagement during cognitive rehabilitation sessions. It was hypothesized that when the clinician introduced evidence-backed alliance enhancing ingredients, there would be a corresponding improvement in participants' (a) performance on attention drills paired with a metacognitive strategy, (b) learning the steps to use a phone application, and (c) adherence to a home exercise program. It was also hypothesized that patients would show perceptual shifts toward stronger alliance.
Method: Four adult participants who sustained moderate to severe acquired brain injuries with chronic cognitive deficits participated in the study. The study used a concurrent multiple-baseline design with randomization. Both visual and quantitative analyses were used to compare potential differences in performance on cognitive rehabilitation tasks when specific alliance enhancing behaviors were integrated into sessions.
Results: Findings showed a strong effect for increased performance on attention span tasks when the clinician added the alliance enhancing treatment ingredients. Participants also learned more steps in the phone application task and either maintained or improved homework adherence in the experimental phase when the treatment ingredients were applied. The findings provided mixed results on participant perceptions of WA, as measured by a modified version of the Working Alliance Inventory.
Conclusions: This study provides some of the first experimental data demonstrating that alliance enhancing treatment ingredients can have a significant influence on patient performance during cognitive rehabilitation sessions. The article offers recommendations for building on this important line of study.
期刊介绍：
Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work.
Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.
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