TeleCPT: Delivery of a Better Conversations Approach to Communication Partner Training During a Global Pandemic and Beyond

Abstract

Purpose: This case report provides an overview of telehealth delivery of our Better Conversations approach to communication partner training (CPT) for people with primary progressive aphasia (PPA) and their communication partner (CP). The purpose is to advance the knowledge of speech and language therapists/pathologists (SLTs) on this type of CPT and empower them to deliver teleCPT as part of their clinical practice. Method: We provide a case report describing therapy delivery, outcomes, and self-reflections from our clinical practice, which represents a collaboration between a UK National Health Service CPT clinic and the Better Conversations Research Lab at University College London, UK. A man with PPA and his CP (a dyad) video-recorded everyday conversations at home using a video conferencing platform. These formed the basis of an evaluation of conversation barriers and facilitators, which led to four weekly 1-hr therapy sessions covering the mechanics of conversation, identification of barriers and facilitators, goal setting, and practice of positive conversation strategies. Results: Dyad self-rating of goal attainment revealed that three of four conversation strategies were achieved much more than expected, a positive outcome given the progressive nature of F.F.'s condition. SLT access to the dyad at home via teleCPT facilitated the carryover of strategies from the session to everyday conversations in the home environment. TeleCPT was acceptable to this couple during a global pandemic, with benefits including no travel, ease of therapy scheduling around the CP's work and family commitments, and access to a specialist CPT clinic outside their geographical area. Conclusions: TeleCPT is feasible and acceptable to clients, improving access to therapy in a way that should not just be the preserve of service delivery during a global pandemic. SLTs can enable clients and their families to have better conversations despite communication difficulties by offering teleCPT. We have shared practical suggestions for delivering teleCPT.

Better conversations: a language and communication intervention for aphasia in posterior cortical atrophy

“…Another limitation of this study was that due to the restrictions of the Covid-19 pandemic this intervention had to be delivered remotely, via teleconferencing. Yet, the sparse evidence on remotely delivered speech and language interventions has demonstrated equitable outcomes to in lexical word retrieval interventions for people with PPA (Dial et al, 2019 ), and exploration of remote delivery of communication partner training interventions for PPA are emerging (Beeke et al, 2021 ). Thus, this paper adds to the developing literature demonstrating that speech and language interventions can be delivered to people with dementia remotely, specifically people with PCA.…”

“…They were provided with a handout to support them to identify a possible topic, a coproduced resource available as part of the BCPPA intervention. To inform intervention delivery, this video was analyzed by the speech and language therapist using the Better Conversation Observation Checklist (Beeke et al, 2021 ). This involves the speech and language therapist watching the video recording, often repeatedly, and making notes about behaviors or ‘practices’ that are facilitators (that enhance the flow) and barriers (that result in conversation breakdown).…”

A Communication Partner Training Program Delivered via Telehealth for People Living With Parkinson's (Better Conversations With Parkinson's): Protocol for a Feasibility Study

“…If the dyad requires it, a list of conversation topics will be provided to support this process. This form of remote data collection replicates methods used in previous teleCPT and Better Conversations research [ 29 ] and is designed to facilitate ease of data collection and security of data transfer. The timescales of sample video recordings are shown in Table 1 .…”

“…Better Conversations, and CPT in general, has been adapted to a telehealth form of delivery. Beeke et al [ 29 ] introduced the term “teleCPT” to mean CPT delivered via videoconferencing technology. In this case study of a person living with primary progressive aphasia and his partner, the authors demonstrate that Better Conversations delivered via videoconferencing is effective, acceptable, and feasible to deliver.…”

“…In this case study of a person living with primary progressive aphasia and his partner, the authors demonstrate that Better Conversations delivered via videoconferencing is effective, acceptable, and feasible to deliver. Furthermore, teleCPT can maximize the ecological validity and convenience of therapy [ 29 ]. Theodoros et al [ 30 ] suggest that telerehabilitation has particular potential to improve services for people with Parkinson’s: it allows ready access to treatment, it supports the development of self-management skills, and people with Parkinson’s express overall satisfaction with and support for telerehabilitation.…”