ACQ Vol 12 No 2 2010

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ACQ Volume 12, Number 2 2010 83
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.
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.
Session 6 Elaboration Techniques for communication
partners to organise and link
conversational topics to support
longer and more interesting
conversations
Session 7 Asking Use of appropriate and helpful
questions questions to start and keep
conversations going. Includes how to
avoid negative or ‘testing’ questions
and focus on a positive questioning
style.
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),
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