Counselling training for speech-language therapists working with people affected by post-stroke aphasia: a systematic review

Abstract

Background: Speech-language therapists use counselling to address the psychological well-being of people affected by post-stroke aphasia. Speech-language therapists report low counselling knowledge, skill and confidence for working in post-stroke aphasia which may be related to a lack of counselling training specific to the needs of this client group.

Aims: To identify current training in counselling for speech-language therapists to address psychological well-being in people affected by post-stroke aphasia. Specifically, the intent was to establish the objectives, content, amount, teaching methods and outcomes of counselling training provided to speech-language therapists working with people affected by post-stroke aphasia.

Methods & procedures: Eleven databases were searched from inception to January 2018 using terms relating to counselling, psychological well-being, speech-language therapy, stroke, aphasia and training. Studies using any research methodology and design were included. Nine studies were critically appraised and synthesized as a systematic review using the Search, AppraisaL, Synthesis and Analysis (SALSA) framework.

Main contribution: Information on counselling training came from the UK, United States and Australia. Student speech-language therapists received training in goal-setting and generic counselling skills. After qualification, speech-language therapists received counselling training from mental health professionals within stroke workplaces, from external providers and further education. A range of teaching techniques and counselling approaches were described. Self-report and themes from qualitative data were the primary measures of counselling training outcomes. Moderate correlations were reported between counselling training and levels of speech-language therapists' knowledge, comfort, confidence and preparedness to counsel people affected by post-stroke aphasia.

Conclusions: Research in counselling training for speech-language therapists working in post-stroke aphasia is limited, with a small number of primarily low-quality studies available. Training in generic counselling skills and brief psychological approaches with support from mental health professionals in the stroke workplace enabled speech-language therapists to feel knowledgeable, skilled and confident to address the psychological well-being of people affected by post-stroke aphasia. Evidence about the effectiveness of counselling training on speech-language therapists' confidence and competence in practice and on client outcomes in psychological well-being in post-stroke aphasia is required.

Keywords: aphasia; counselling; psychological well-being; speech-language therapy; stroke; training.