Reaching Out: Conversation Partners in an Undergraduate Speech

1
Reaching Out Conversation Partners in an
Undergraduate Speech Language Therapy
Programme

• Simon Horton (University of East Anglia) Sally
  McVicker
• (Connect, the communication disability network)

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Aims of this talk

• To give an overview of
• Connect Conversation Partner Scheme
• Developing Conversation Partners in the context
  of the SLT programme at UEA
• To discuss
• Student learning
• Implications for collaborations in the local
  health economy

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Conversation Partner Project

• People with aphasia living in the community
• Poor support networks, socially and physically
  isolated

• Trained volunteers to visit people with aphasia
• supported conversation

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What do the conversation partners do?

• Open ended conversations about
• Family, sport, past (war, local history), and
  gossip!
• Watch TV
• Look at the Garden
• Italian Newspaper

• Computer type key words
• Scrapbooks
• Roll cigarettes!
• Crossword
• Listen to music
• Go out to the shops
• Newspaper / magazines
• Have dinner!

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Over 4 years
Over 100 matches in London

• People with aphasia referred
• Average age 73.5
• 55 female to 45 male
• Local
• Very severe aphasia
• Approx 50 Boston Rating of 1 or below

• Volunteers visiting as conversation partners
• Average age range 20 40 years
• Predominantly female
• From all over London
• Many aspired towards
• the Health Professions

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Feedback

• People with aphasia found
• It gave them a chance to "talk" (94)
• They felt more confident (77)
• They felt better at trying new things (60)

• 91 Service Providers reported success with
  clients showing
• Increased confidence
• Improved communication
• Improved quality of life
• Reduced isolation

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And the volunteers?

• 90 enjoyed visiting

• It was empowering, difficult and rewarding.
• I realised how resourceful it is possible to be
  in terms of finding new ways of communicating.
• Insight into aphasia Meeting new people and
  making friendships, providing a life-line to
  someone for a period of time
• A desire to do it again and do it better. The
  beginnings of an understanding of the
  complexities of a single persons life with
  multiple disabilities Excitement at the
  possibilities there are for breaking through the
  boundaries of any disability
• Expected more changes for my partner, but
  actually changed ME more than my conversation
  partner a bit more understanding just being
  there asking less
•  

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SLT at UEA

• 3 yr BSc new from Sept 2004
• Intake of 20 in 2004-5 25 in 2005-6
• Integrated approach to teaching using
  Problem-Based Learning (PBL)
• Inter-professional learning in Institute of
  Health

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Conversation Partners at UEA

• Year 1 Conversation partners
• One hour a week for 6 months with an adult
• 4-week block placement with children
• Placement assessment SLT Portfolio
• Video verbal presentation
• Summary Report of Personal Log
• Professional Discussion

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Conversation Partners collaborations in the
local community

• Referrals
• Local SLTs refer people with aphasia support
  students on 1st visit (41 referrals)
• Self-referrals Speakability and Stroke
  Association members (4 self-referrals)
• Stroke Association referrals (1 referral)

• CP skills training
• 16 people with aphasia trained at UEA to train
  students ( others)
• 8 of these collaborated in student training in
  October 2005

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Student preparation and training

• Preparatory workshops focus on
• disability equality training
• conversation partner skills training aphasia
  experts
• health safety, risk assessment and conduct in
  emergencies
• Emphasis on
• Developing awareness of own others
  communication style
• Ability to change adapt own communication style
  in a skilful way

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Conversation Partners placement process

• Prioritise referrals
• Match to student conversation partners student
  checklist, geographical location etc
• Students contact referring therapist arrange
  introductory first meeting
• Commit to visiting regularly once a week for six
  months

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Supervision and student reflection

• Support and supervision
• Fortnightly tutorial group (5-6 students tutor)
• Students complete and submit a weekly feedback
  form (reflective log)
• Students discuss issues arising
• Students show and discuss video clips of CP
  sessions
• Informal support supervision phone, email, ad
  hoc meetings

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Supervision example of issues arising

• Communication strategies e.g. accommodating
  word-finding difficulties or non-response
• Topic management
• Use of and access to resources
• Coping with emotions distress anger
• Roles and boundaries conversation partner NOT
  therapist student therapist NOT family
• Finishing the placement

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Student reflections on learning

• Communication skills
• an excellent placement, giving opportunities to
  develop my communication skills
• Development of professional competencies
• skills developed have the potential to be
  applied in clinical work later on
• it has enhanced my professional development I
  have had to contact the SLT, conduct myself
  competently, and deal with untoward events

• Insights into client experiences
• meeting my Conversation Partner has increased my
  understanding of the effects of stroke and how to
  facilitate communication this has been a
  demanding experience
• Reflective practice
• I have found it difficult to accept the positive
  role I am playing towards my Conversation
  Partner. Reflective tutorials and video have
  proven invaluable in highlighting my strengths

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People with aphasia reflections on CP programme

• How would you describe your time with your CP?
• wonderful lots of laughs
• like speaking to an old friend
• Did the CP programme meet your hopes and
  expectations?
• A chance to chat 11/12
• Company 12/12
• Ideas of things to do 2/12 yes 1/12 no
• Have things changed for you?
• Confidence 6/12 yes 2/12 no
• Better at trying new things 2/12 yes 1/12
  no
• Other comments treated as an equal speech
  improved really enjoyed her being here

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Referring clinicians reflections on CP programme

• Impact on the service
• helped to extend the service
• less frequent review needed during the
  project...time to review other clients
• Impact on the person with aphasia
• all really pleased
• reduced social isolation
• opportunity to practice skills learned in
  therapy
• very positive even those who stopped did so
  because they realised they didnt need additional
  help

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Conclusions Conversation Partners in an U/G SLT
programme

• Sound investment of money, time, effort
• Enhanced student learning and insights
• Contribution to the local health economy
• Potential for future research and knowledge about
  interventions for people with aphasia

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Collaborations in the local health economy

• Connect
• UK leader
• Resources training package
• Ongoing collaboration Reaching Out
• Future research

• People with aphasia
• Conversation partners
• Aphasia expertise

UEA SLT dept

• Students
• Enhanced reflective practice
• Responsibility and professional development
• Skills development

• SLT service
• Enhanced service
• Broadens scope of SLT practice
• Aphasia expert collaborations

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Referrals to UEA CP programme 2005-6

• Age range 35 90 yrs average age 64 yrs
• 23 male/23 female
• Aphasia severity 2/3 have BDAE rating 2 or lower

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CP feedback form example
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