Neurogenic Communication Disorders and the Life Participation Approach: The Social Imperative in Supporting Individuals and Families by Audrey L. Holland;Roberta J. Elman;

Author:Audrey L. Holland;Roberta J. Elman; [Holland, Audrey L.]
Language: eng
Format: epub
Publisher: Plural Publishing Inc.
Published: 2020-10-21T20:00:00+00:00

We encourage you to consider how to support the exploration of stories with families and friends within and beyond the walls (or confines) of therapy sessions. Being open to receiving these stories is a first step. Once again, listening plays a major role in receiving such stories. Sometimes family and friends just need to be heard. This does not always take significant amounts of time.

Conclusions

In 2007, Shadden and Hagstrom stated that:

At its core, the premise of life participation as a primary intervention goal must encompass the role of communication in renegotiating a sense of self or identity. Life participation must address more than engagement in desired activities. It must target an individual’s ability to participate in core social interactions that allow narrative exploration of one’s life story and associated sense of self or identity. In effect, it must actively support the biographical accommodation needed to maintain a sense of a meaningful lifeline (p. 330).

More than a decade later, this statement of social imperative remains relevant. Narrative is indeed one of the most fundamental life concerns of humans, not in the restricted sense of telling a story with good organization, but more broadly, in terms of framing and supporting one’s life story and identity.

Questions remain about the role of relationships in the treatment paradigm, as well as the degree of personal engagement or disengagement appropriate for the clinician. It is our premise that SLPs are uniquely posed to understand and support the stories of life with aphasia, and in doing so, facilitate fuller life participation with aphasia. Clinicians can choose to focus primarily on providing an environment for sharing everyday personal narratives, or more purposefully, they can elicit and support illness narratives or create more structured interventions targeting life stories.

How should SLPs approach this challenge? A good starting point is learning more about why narrative is such an important part of the social fabric of our lives. We have much to learn from other disciplines. Each clinician can and should reflect on the role of story in her own life and the way that the small and big stories each of us tells provide opportunities to frame and validate our sense of who we are, our identity, as described further in Strong and Shadden (2020). Clinicians should also be more attentive to who they listen to, what they listen for, and how they listen when stories are being shared.

LPAA’s influence on how we serve people living with aphasia has been profound. At the heart of this influence is the recognition that successful living with aphasia is grounded in social interaction, and that this social grounding serves complex functions. Our title captures our message that small and big stories are the currency we use to make meaning in our lives and to continually reframe our sense of who we are and where we are going. We hope the reader will respond to our call to action to be more attentive to story in the lives of our clients and their loved ones and to join in the honor of sharing our space with their stories.

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