“But if you do not keep doing it, you won’t maintain”. A qualitative study on the perspectives of speech-language pathologists on maintenance of therapy gains in aphasia

Abstract

ABSTRACT Background Maintaining therapy gains in the long term is necessary for therapy to be considered successful. Yet, this topic has received limited attention in aphasia rehabilitation research. Unfortunately, for some people with chronic aphasia, maintaining the gains achieved in therapy can be difficult and many experience reduced communicative functioning over time. Understanding the perspectives of speech-language pathologists (SLPs) on maintenance is vital. As key agents in aphasia therapy, their views are crucial for understanding current practice, identifying service gaps, and informing future research on the maintenance of therapy gains. Aim The aim of this research was to explore speech-language pathologists’ perspectives on maintaining therapy gains in chronic aphasia and to understand their beliefs about the factors that influence the maintenance of gains made during aphasia rehabilitation. Methods & Procedures In-depth semi-structured interviews were conducted with seven SLPs who worked with people with chronic aphasia. Inductive thematic data analysis was used to identify themes. Outcomes & Results Six themes were identified, representing SLPs’ beliefs about maintenance and their perceptions of factors important for preserving therapy gains in aphasia rehabilitation. These were: 1) Ongoing communication activity; 2) Meaningful person-centred goals; 3) The challenge of translating functional goals to participation; 4) Individual capacity and resource availability; 5) Home support; and 6) Services. The results illustrate the complexity and interplay of factors that may both facilitate and hinder the maintenance of therapy gains. Conclusions SLPs in this study believe that aphasia rehabilitation interventions should involve meaningful, personalised, enjoyable real-life experiences to optimise maintenance of therapy gains. Moreover, they believe that maintenance must be at the centre of aphasia rehabilitation research and clinical practice, requiring new models of care for chronic aphasia. These insights may provide direction for the development of future interventions and services to enhance long-term maintenance for people with chronic aphasia.