An Investigation of the Manifestations of and Changes to Social Cohesiveness as a Result of Conversational Group Therapy in Aphasia.

摘要

This dissertation focused on how the affiliation and engagement practices that contribute to social cohesiveness result in changes to conversation for three individuals with aphasia that were part of group therapy that targeted improved communication through conversation. It revealed how those changes were made manifest by employing a qualitative research design which allowed the researcher to discover how social cohesiveness is demonstrated in conversation. This design included the administration of aphasia batteries that are widely used in the area of aphasiology and were administered prior to and subsequent to the period of conversation treatment. The design further included medical and clinic records that informed the researcher of the participant's physical and communicative abilities. The primary research tool was Conversation Analysis which by virtue of its dual characteristics of being context-sensitive yet context-free allowed the researcher to examine behaviors in an authentic context and observe patterns within and across participants. Additionally, post-semester interviews served as a lamination tool that, along with the primary and other secondary data sources, would verify or refute the patterns of conversation changes.;The resulting data were then analyzed for patterns of conversation change and formed three areas of interest; patterns of conversation changes that revealed the member's growing orientation toward group cohesiveness, patterns of changing compensatory strategy use, and changing patterns of turn-taking. The results of this study demonstrate the importance of social cohesiveness as an integral part of group conversation treatment and its effect, as a catalyst, upon improving conversation ability. Additionally, it illustrates group cohesiveness as a multi-dimensional construct that involves an orientation to task and interpersonal cohesiveness. Further, it explicates the relationship between an individual's functioning, personal factors, and context as influencers of the aphasic's demonstration of social cohesiveness. This study proffers important implications concerning the value of a qualitative research design for studying communication changes in aphasia and the essential employment of constructivist approaches to communication therapy for individuals with aphasia. These clinical implications shape the assessment and intervention practices of clinicians who recognize the transformative power of a constructivist approach that requires the situation of treatment in an authentic context.