Gaining consensus on core intervention components of Communication Partner Training (CPT) in aphasia: A European perspective
1st supervisor: Dr Madeline Cruice
2nd supervisor: Dr Suzanne Beeke (External Examiner UCL)
Communication Partner Training (CPT) is a complex behaviour change intervention in post-stroke aphasia rehabilitation, delivered by speech and language therapists, that has a substantial evidence base (Simmons-Mackie et al., 2010; 2016). CPT targets communication partners of people with aphasia, and can be family members, friends, healthcare staff or students, and volunteers. Review of the reporting of CPT interventions in these two systematic reviews, using the TIDieR, highlighted inadequate reporting for replication in research or implementation in clinical practice, and limited attention to what constitutes core components of CPT intervention. It is unsurprising then that CPT, within the broader field of conversation therapy, is so variably delivered in local practice, with aphasia clinicians uncertain of its value in rehabilitation. As improved conversation with family members and communication with others (including healthcare professionals) is an outcome prioritised internationally by people with aphasia, family members, aphasia clinicians and managers, urgent attention to core intervention components of CPT, and their effectiveness in changing others’ communication behaviours, is needed to move this field forward.
PhD Proposal: This doctoral research will examine this need drawing on all key stakeholders (researchers; aphasia clinicians; clients; others – family members, healthcare professionals) involved, taking a European* perspective. Methods: (1) Identification of core components via review of CPT intervention manuals in aphasia, published and/or translated into the English language, and accessible via hard copy or in electronic format; identified through literature searching at CATs network*. This study will build on the work of recent research6, and will include analysis of CPT interventions for familiar and unfamiliar communication partners, and intervention study designs representing a range of levels of evidence. (2) Studies 2, 3 and 4 are a trilogy of stakeholder investigations, and examine core components from the perspectives of researchers who have developed and evaluated CPT (study 2); aphasia clinicians who have experience of delivering CPT (study 3); and others who have experience of receiving CPT/ engaging in CPT in rehabilitation, e.g. family members, healthcare professionals, volunteers, and patients/ clients (study 4). Methods will utilise established protocols for international e-Delphi studies for studies 2 and 3, and nominal group technique methods for study 4. Core components will be linked to theory of behaviour change, and considered from the perspective of what is presumed to make them effective at changing others’ communication behaviours. Core components from across the studies will be synthesized to draft a prototype CPT intervention for further post-doctoral testing.
Supervision team: This doctoral research benefits from a cross-institution supervision team, with complimentary expertise and experience from both supervisors. Dr Beeke is the PI on the design and evaluation of the CPT intervention Better Conversations with Aphasia, further translated into a free online resource with more than 5,800 registered users worldwide, with expertise in the application of behaviour change theory to CPT and links to the UCL Centre for Behaviour Change. The candidate will be supported by a broader Advisory Panel, essential for international research of this kind, and will include Associate Professor Emma Power based in Australia, an internationally leading researcher in CPT in traumatic brain injury, Dr Jytte Isaksen, a leading aphasia researcher in Denmark currently engaged in outcome assessment in this field, and Dr Fiona Johnson, a UK speech and language therapist with expertise in behaviour change theory and methods in aphasia.
Potential field of strong candidates: LCS Aphasia Team has a reputation for attracting high calibre PhD students. Recent graduates, clinicians studying their Masters at City or UCL, and RA staff at both institutions are likely candidates applying for this proposal.
This project aligns with the research agenda and priority of the Societal Impact and Reintegration Research Group within the international Collaboration of Aphasia Trialists (CATs) https://www.aphasiatrials.org/. Cruice, Isaksen, Beeke and Power are members. Several other members in this research group are active CPT researchers in different countries, and will support this project to engage with researchers, clinicians and CPT interventions in other languages.
If you would like to have an informal discussion please contact M.Cruice@city.ac.uk.