ACQ Vol 12 No 2 2010

Power, & Rietdijk, 2009). Each person with TBI and their communication partner attends a two and a half hour group session with 3–4 other pairs. Each pair then also attends their own weekly one-hour session without other group members. Here each pair can focus on their own specific needs related to the week’s topic and review home practice tasks that have been recorded onto supplied tape recorders. An overview of the 10-week program is provided in box A. The sessions incorporate a mix of role plays and conversational practice with peer feedback. Session handouts are also provided. A morning tea break each week allows people to socialise with and obtain support from other group members.

Box A: The 10-week partner training program Session Title Contents number

Session 1 Introductions

Members are introduced to each other. Aims of training, group guidelines and home practice expectations are established.

Session 2 Brain Injury and Educational component on TBI and communication communication

Session

Effective

Communication roles and rules in

3-4

communication society. Barriers and facilitators to 1 and 2 good communication in everyday life. General communication strategies.

Figure 1 Example of TBI express toolkit whereas the much less investigated method described above is to train communication partners. While both approaches clearly have potential, to date, no study has compared the two methods. Our study aims to determine whether training people with TBI only or training communication partners of people with TBI jointly is beneficial in improving communication interactions compared to people who do not receive training (delayed treatment controls). We also want to establish whether one treatment is more effective than the other. To investigate these questions, over the last 18 months we have been conducting a non-randomised clinical trial (Togher et al., 2009) funded by the National Health and Medical Research Council and administered by the University of Sydney and University of NSW. Forty-four people with severe TBI and their chosen communication partners have been recruited from brain injury units at Liverpool and Westmead Hospitals and the Royal Rehabilitation Centre Sydney. The people with TBI range from 18 to 62 years old and are 1–25 years post injury (average of 8 years). Based on communication partner availability, pairs were allocated to one of the three groups: the TBI only group, where only the person with TBI was trained, the JOINT group where both the communication partner and person with TBI were trained together, and a delayed treatment control condition. Tests, questionnaires and ratings of video conversations will be used to evaluate outcomes for communication, as well as measures of social skills, carer burden and self esteem. Currently, data collection and analysis are being finalised and we hope to provide readers with results next year. Preliminary results have been positive and participants have been given the opportunity to report on strategies they found useful and on any benefits of the program from their own point of view. Conclusion Training communication partners of people with brain injury, particularly their family members, is a promising way to enhance interactions and build personal relationships, which

Session 5 Collaboration Techniques for communication partners to make conversations a

collaborative process where both the “feel” and information exchange are more equal, shared and organised. Techniques for communication partners to organise and link conversational topics to support longer and more interesting conversations questions to start and keep conversations going. Includes how to avoid negative or ‘testing’ questions and focus on a positive questioning style. Use of appropriate and helpful

Session 6 Elaboration

Session 7 Asking

questions

Sessions

Improving skill

Revision and practice of information

8–10

and confidence and techniques learnt in previous sessions using the Communication Partner Communication Strategies Toolkit (figure 1). Celebration lunch for group members’ achievements.

The program teaches communication partners how to help the person with TBI actively engage in conversations in everyday life and so the strategies are immediately applicable in everyday situations. Some examples of the key messages that the training program participants receive are presented in box B, along with quotes from participants themselves or specific examples to illustrate the message. Research update To improve interactions for people with TBI, two approaches have been suggested as helpful. The most commonly researched approach has been to train the person with TBI to improve their social skills (e.g., Dahlberg et al., 2007),

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ACQ Volume 12, Number 2 2010

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