Group Therapy: The Intangible Benefits for Acquired Brain Injury

Friendships after Acquired Brain Injury

Nancy, Felix, Ted and Alex* shared more than their acquired brain injuries. They were all isolated from friends after their acquired brain injuries. Socializing was too much work. Friends didn’t understand. Friends stopped calling. It was hard to initiate a conversation with someone new. We heard the stories again and again. They were different faces, but the same stories. They all attended group therapy to help with their communication disorders.

After Group Therapy

We heard new stories: “Group is one of my most important appointments”, “When is the next one?”, “It was really great”, “Do you have Ted’s number?”, “She inspired me because if she could do all that with all her physical problems on top of her brain injury, and with a kid, then I can do it too.”

Our clients establish a new sense-of-self linked with renewed abilities to interact successfully with peers. We have seen so many positive changes in our clients. They have developed relationships with each other outside of sessions. Clients meet before or after sessions to continue the relationships that began in the sessions. Recently Felix (an extremely shy person since his acquired brain injury) participated in a presentation that was made possible through a relationship formed through group. The other group member inspired and encouraged Felix to get involved. Ted obtained a bus pass for the first time ever, as a direct result of wanting to attend group independently. This goal was not one that Ted had ever expressed before. Alex plays in a band and now Nancy has become inspired to try to play guitar again, “Alex is really good and he learned after his brain injury”.

Group Therapy offers more than just Practice

Friendships aren’t made overnight and having an acquired brain injury can make that dynamic even harder. Group therapy helps build confidence by allowing clients to practice important skills in a safer environment, and provides emotional support by way of a client realizing that he or she is not alone. The skills to make and maintain relationships are practiced, but there is So. Much. More.

Do you need some help getting back into socializing? If so, check out our groups online, or call us to discuss your individual needs. We would love to hear your story and see which of our groups is the best fit for you.

*names and some details have been changed to protect our clients’ identities

BobiTychynskiShimoda-220Bobi Tychynski Shimoda is a Speech-Language Pathologist with more than a decade of experience working with neurological communication and swallowing disorders. She has worked in a variety of settings including inpatient rehab, acute care, community, and private practise. She is highly skilled in assessment, and innovative treatment approaches.

 

A student’s experience of our Aphasia Group

As an intern at S.L. Hunter SpeechWorks, I participated in the weekly aphasia group. Each week, I saw members given countless opportunities to participate in meaningful conversation. Within the two-hour group, members discuss current events, their families, past travels, work experience, and any other personal interests.  Communication is not limited to spoken words in this group. Instead, the use of all forms of communication are used to help members express their thoughts. I admire the work being done in this group and I hope the following blog will provide you with a glimpse into this weekly aphasia group.

The Aphasia Group Experience

As the members of S.L. Hunter’s SpeechWorks’ aphasia group gather around the table for weekly group therapy, I see Sandy, the group’s Communication Disorders Assistant (CDA) turn to a new member and say, “Congratulations on your new grandchild! Was it a girl or a boy?” The new member smiles and announces, “girl!” Each individual in the group begins to congratulate the new member. Some members offer a congratulations through spoken words and others through the exchange of a smile.  As the conversation continues with questions such as, “how many grandchildren do you have now?” I am filled with admiration for the personal and meaningful conversation that occurs in the group. I think to myself, “It is conversation that matters. This is what any person with or without aphasia would want to discuss.”

Discussion using all modes of communication

Next, a discussion regarding the week’s current events begins. Sandy begins a discussion on the CN Tower Edge Walk. She picks up a black sharpie and begins to write key words that will be used in the discussion. “The CN tower,” she says while pointing to the word “CN tower” on the sheet in front of her, “is allowing visitors to walk around the building’s very top edge.” Sandy pauses again and draws a simple sketch of the building. Next, she draws an arrow pointing to the top of her drawing to indicate the EdgeWalk occurs at the very top. Some of the members begin to chuckle. As I watch Sandy continue to unravel the discussion, I am struck by both Sandy and the group’s volunteers’ use of every mode of communication to aid each member’s understanding of the topic.

Once the summary is complete, Sandy and the volunteers begin to lead the group through discussion questions. “Would you want to participate in the CN Tower’s EdgeWalk?” the volunteer asks. She then writes the key words of the question to help each member better understand. Each member of the aphasia group is given a turn to answer. One member verbally answers “no”, another shakes her head no, and another points to the word “yes” on the answer sheet created by the volunteer. I notice how Sandy and the group’s volunteers create opportunities for each of the members to express their opinions in their preferred mode of communication.

Providing everyone with an opportunity to contribute

The final half hour of the aphasia group is spent playing a game. I notice how the game “Headbanz” is adapted to provide each member with an opportunity to play. Verbal, written, and visual support is provided to help each member take a turn in the game. For example, a volunteer writes the words “person, place, and thing” on a piece of paper. Members are provided with the opportunity to form a verbal answer or to point to one of the three words written down. Again, I notice how members are provided with the individual support they need to actively participate.

I am very privileged to have been given the opportunity to participate in this aphasia group. The members seemed to enjoy themselves and keep coming back week after week.

Grad PictureRebecca is a recent graduate from the Speech-Language Pathology Program at Calvin College in Grand Rapids, Michigan. Through her internships, she has gained experience working with toddlers, school aged children, and adults with a variety of communication disorders. While Rebecca enjoys working with kids and adults, she has a special interest in working with kids who have language disorders.

Expressing Emotions following ABI

In our blog earlier this week, the use of a feeling pie chart was described briefly. In most of the groups for ABI that I am currently running, we start with a feeling “check-in”. This is really important in a group setting as it helps for others to know what emotions other members are coming with. This can help establish rapport and cohesion in the group as members can support one another through challenging times and celebrate each other’s’ victories.

Expressing emotions following ABI can be a challenge due to survivors having trouble with word-finding and self-evaluation. These types of difficulties can lead to miscommunications. Sometimes, a survivor may not be able to identify what emotion he or she is feeling. Furthermore, if an idea of what emotion is being experienced is determined, one might have difficulty finding the word to express it.

The Feeling Wheel for Expressing Emotions Following ABI

I have found that use of specific tools that outline general feeling words (i.e. fear, anger, disgust, sadness, happiness and surprise) can help the survivor identify the “area” that his or her feeling lives.  Once the “area” is figured out, the survivor can then use the tool to determine the more specific emotion that is underlying the general one (e.g. happy à proud à confident). I have found that there are many of these sorts of tools available. The one that works best for me is the feeling wheel.  Though intended for writers, I find that clients with word-finding difficulty benefit immensely from using this for expressing emotions following ABI.

Other Applications for the Emotions Check-in Wheel

Our group members love the circular format of this tool at it allows them to move from general words to more specific words. It is simple and easy to use once the members are shown how it works. Feel free to adapt this tool for other uses whether for writing in school or work settings, or for expressing yourself verbally. I think it has applications for social work or psychotherapy as well – particularly if you are working with clients who have trouble connecting with their emotions or expressing themselves.

We offer groups for our own clients as well as those working with SLPs from other agencies. Please click here for more information on our communication groups for people who have survived ABI.

BobiTychynskiShimoda-220Bobi Tychynski Shimoda is a Speech-Language Pathologist with more than a decade of experience working with neurological communication and swallowing disorders. She has worked in a variety of settings including inpatient rehab, acute care, community, and private practise. She is highly skilled in assessment, and innovative treatment approaches.

A student’s experience of a group for acquired brain injury

As an intern at S.L. Hunter SpeechWorks, I have witnessed the powerful role group treatment can play in a person’s recovery from a brain injury.  The SpeechWorks’ group for acquired brain injury provides opportunities for members to relate to one another, receive feedback from a trusted Speech-Language Pathologist (SLP), build communicative confidence, and practice their communication goals in a safe setting. I value the work being done in these groups and I hope the following blog post will provide you with a small glimpse into a typical group therapy session at S.L Hunter SpeechWorks.

All about a Group for Acquired Brain Injury – Checking In

“Let’s begin with our check in,” Bobi, the group’s SLP announces. A circular chart filled with emotion words is passed out. “I’ll begin,” chimes a group member. The group’s attention turns towards this member. She glances at the chart and begins to state the emotions that fit her current circumstances. “I’m upset but also thankful,” she explains. As the member begins to expand on the hardships and joys of her past week, other members smile and nod in agreement as if to say, “I’ve been there too.” As the check in continues, I am struck by the comfort group members are able to bring to each other. When a member expresses concern, others are quick to relate by sharing a personal story that caused them to have the same feelings. This group for acquired brain injury is more than just a source of emotional support – it offered the members a chance to work on goals that could carry over to conversation with others.

As check in continues, another group member begins to express her feelings of frustration. I watch as the SLP listens attentively before asking, “Why do you think your brother reacted that way?” While the member considers the question, I reflect on the SLP’s ability to ask questions that require each member to carefully work through their personal goals such as the ability to take another person’s perspective. After the member responds to the question, the SLP responds with encouragement, “You did a really good job taking your brother’s perspective there.” I notice how the SLP’s encouragement provides this member with feedback specific to her goal of being able to take another person’s perspective. I am amazed by the progress I see occurring in such a natural conversation.

After the check in period concludes, the SLP leads the group through a discussion of non-verbal communications. During this time, group members share their own experience and knowledge regarding this topic. In addition to learning how to interpret non-verbal communication, I notice how each member appears to be building confidence in their communication skills. I watch as members who first appeared to be hesitant in the group begin to participate with greater ease. This group for acquired brain injury appeared to build confidence of its participants before my eyes.

A Safe and Supportive Environment

As the group begins to near an end and members fit in their final stories or discussion points for the day, I reflect on the group’s safe environment. Each member has communication goals and therefore no member needs to feel singled out by the challenges they face. Because of the safe environment, I notice how members are able to receive feedback from both the SLP and each other without any feelings of embarrassment. This group for acquired brain injury definitely offered emotional support!

Although the group has ended, I notice members are staying behind to continue their conversations. I hear laughter echoing through the hallways as I walk further away from the room. After attending just one session, I can already identify a strong sense of community within this group.

We offer groups for our own clients as well as those working with SLPs from other agencies. Please click here for more information on our communication groups for people who have survived ABI.

Grad PictureRebecca is a recent graduate from the Speech-Language Pathology Program at Calvin College in Grand Rapids, Michigan. Through her internships, she has gained experience working with toddlers, school aged children, and adults with a variety of communication disorders. While Rebecca enjoys working with kids and adults, she has a special interest in working with kids who have language disorders.