Evaluating group therapy for aphasia: what is the evidence?

Clinical Question: For people with aphasia following a stroke, is group therapy shown to be more effective on communication outcome measures reflecting impairment, activity, and/or participation than individual therapy or no therapy? Method: Review of treatment efficacy research for group intervention in aphasia Study Sources: Cochrane Database of Systematic Reviews, Evidence-Based Medicine Reviews, PubMed, MEDLINE®, CINAHL, CSA Linguistics and Language, Behavior Abstracts, Social Sciences Citation Index (Web of Science), EMBASE, PsycINFO®, ComDisDome: Communication Sciences and Disorders Dome, and speechBITE™ Search Terms: Aphasia AND (Group therapy OR Group Intervention). Primary Results: Results from a review of the literature indicate group therapy facilitates improvements across language modalities including linguistic, pragmatic, and discourse-based outcomes. These improvements generated significant gains in activity and participation levels, as defined in the ICF framework (WHO 2001), and were associated with additional psychosocial benefits. Improvements were frequently maintained following a period of no therapy. Therapy gains did not appear to correlate with aphasia type, severity, time post onset, and age. Wide variability in individual therapy progress is noted across studies. Conclusions: Group therapy is an effective clinical strategy for improving communication impairments following stroke. Further research is required to ascertain the role of individual and group therapy to improve communication outcomes at impairment, activity and participation levels. This would enable the development of optimal therapy schedules in relation to specific patient characteristics.