The Aphasia Center in St. Petersburg: Success Is Key for Motivation in Aphasia Therapy

Tell us more about what you do and what services you provide to persons with Aphasia

We are the only private intensive aphasia program, so we are free from prescribed goals and definitions of progress. Our programs are 1:1 individual with a Master’s or Doctoral-level aphasia therapist for 25 hours per week. Programs range from 4-8 weeks, although returning families have more options. Everyone, including staff, eats lunch together as group every day, so this is our group session. We have been operating for about 10 years.

Families with aphasia need continued guidance to keep improving, so upon discharge they are given a very specific step-by-step plan that has everything they need to continue to make progress at home. Many families then choose to continue therapy online or return for another intensive session. We provide intensive aphasia therapy, regardless of the cause of the aphasia.

What is different about your therapy approach?
Our therapy approach is always evolving to better meet the needs and challenges of our families. With my background and training in aphasia research, we tend to really break down each skill/task to make it successful with each client. Our therapies are all individualized, so even a room full of clients with the same type of aphasia will get different techniques and strategies designed for them personally. If therapy starts at a task level that’s too high, and without knowing how to scale a few steps back, the therapist declares a ‘plateau’ and the client is discharged. We quickly assess where a client’s skill level is, then work at a level slightly higher than that to ensure success.

Success is very important to performance and motivation for people with aphasia. We have found that 6 weeks of treatment tends to provide the best outcomes overall – anything less stops therapy right when the majority of clients are really starting to get up to the next level of communication.

We use evidence-based research as a concept and not as a practice. This means that the theory and language models behind treatments are used, but modified to apply to real life. You can’t expect someone to spend 100 hours of intensive therapy to just learn how to match written letters to sounds, it’s a waste of their time when there are faster and more functional ways to accomplish the same goal.

Our sessions operate year-round, with personalized start dates. We did this so that we could more immediately help clients being discharged without any follow-up plans for treatment. Only 3-4 clients are accepted at a time, so it’s a small group. This allows us to spend quality time with each client. Caregivers have enough to do, so our goal is to make intensive therapy as easy as possible. We have relaxing condos on the water that are fully-furnished. Families are involved in the creation of goals, the homework, and daily briefings. Otherwise the families are gone during the day to have some personal time. We even provide lunch because the daily lunch ordering process works on important real-life communication skills.

Every client works with every therapist every day, and each therapist works on the same goals and skills in different ways. We don’t have one person who does only reading, for example, because this isn’t integrating language. After discharge, we still work with our families for whatever support or help they need. We have discovered that the best way to continue aphasia recovery is to approach it from a long-term plan, in which intensive therapy is the first step. Then we continue a personalized step-by-step home program so they can work on important foundational skills that don’t require a therapist (we train them).

What do you like most about your work?

I enjoy meeting the families and showing them that sometimes you can make big changes with a slightly different approach. Most of the families that we encounter have lost hope and felt disconnected from their old lives. They feel powerless and lost. Sometimes the client just needs a little nudge in the right direction and the effect is immediate. It’s wonderful to help someone learn how to get 50 words when they come in with no speech at all. We get to know each family, so they become part of our family in the end and we continue to help problem-solve their issues. We also love connecting families who would otherwise have never met. I get especially excited by the more challenging and complex cases. We accept a lot of younger clients, from 21 year old to mid 50’s, which tends to be a group left without a lot of resources or support.

Tell us your favorite success story with a client

There have been so many people over the years. There’s Kory, a 43-year old father of three with global aphasia. He couldn’t say anything but “guhbuh”. After his session, he’d learned over 55 words, including saying his son’s name. Jason, who was 34 year old when he first came to us, could only say “like-a-pilike” and had been told he’d never get better. He quickly learned to speak in short sentences and use his phone to type in words he couldn’t say to communicate. Primo, an older Swiss man with Wernicke’s aphasia learned to understand when he wasn’t making sense and to correct his speech in record time. So many of these clients have only experienced frustration and negativity, so their courage and commitment to their improvement is inspiring. Many of our clients have chosen to help others with aphasia and to inspire them to keep working. It’s wonderful to see a sense of purpose dawning in this new life of theirs.

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