Conversation Group Therapy For Patients With Mild To Moderate Cognitive Deficits In A Rehab Setting

This is a general outline that is followed by speech-language pathologists at a Geriatric

Rehabilition facility when conducting conversation group therapy for patients with mild to moderate cognitive deficits. This group therapy paradigm was developed to meet the needs of our short-term rehabilitation patients who do not fit the mold of an expressive or receptive language disorder. This population demonstrates cognitive deficits characterized by difficulties with reasoning, problem-solving, orientation, safety awareness, attention, and memory along with other mild to moderate cognitive deficits. Group therapy outline:

1. Introduction-Introductions include the patient's name, where the patient is from, why the patient is currently receiving rehabilitation services, and something useful the patient has learned through rehab services. Speech therapists introduce themselves at this time as well.

2. Discussion/Conversation Starter- A discussion topic or an inquisitive question is introduced to the group in which they are all asked to contribute their opinion. These topics and/or questions tend to fall along the lines of Dear Abby articles which elicit several opinions but are not overly sensitive or controversial topics.

3. Activity- The activities that are introduced in group need to facilitate communication amongst the patients while targeting the patient's therapeutic goals at the same time. These activities are usually completed in a team format as to keep everyone involved and contributing to the task at hand. For example, a group activity focusing on the goals of reasoning and problem-solving can include the patients working together on a Sudoku puzzle and seeing which team can find the answers to the entire puzzle first.

4. Wrap-Up- This portion is used as a "decompression" time for the patient. Patients are encouraged to talk amongst themselves. At this point, the speech therapist can try to point out similarities among clients (i.e., both patients grew up in the same area, both patients went through similar surgeries, both patients had similar occupations, etc...) and encourage the residents to continue to share their similarities outside of the conversation group. This can be done by trying to set up a lunch time between patients, organizing to have the patient's participate in physical therapy at the same time, and/or encouraging the patients to visit each other in their rooms. This time is not meant to be a structured conversation task but is designed to be a more informal conversation time to help increase functional communication in more of a community setting.

Group therapy tasks are held once a week and are ideal for groups of up to 6. The speech therapist is to set up the time and place for this group to be conducted. A list of the patients who are to participate in this group are compiled and listed in the therapy room so that other therapists can schedule their therapy times around the conversation group. Index cards can be used to make conversation group passes that can be handed out in the morning to the patients and then the patient is responsible for making it to the therapy session on their own. The ultimate goal of this group is to facilitate functional communication which will carry over into the community setting.

by: Jake Tabor

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