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Counselling someone with severe aphasia: and explorative case study.

PURPOSE
To explore a counselling approach for a client, H.N., with a severe aphasia.


METHOD
The principles of Personal Construct Therapy were used. Therapy (six sessions) was started and finished by H.N. producing a repertory grid. Sessions were patient-led but the information from the repertory grids was used to help facilitate the process. Each session was video taped.


RESULTS
Analysis of therapy sessions revealed H.N. was following a pattern, if erratic. He used good conversational strategies to control the less structured sessions. The therapist was dominant when the repertory grids were produced. Statistical analysis of the repertory grids was mainly nonsignificant but there was a shift for the final grid to a greater variety of and more positive responses. General improvement in comprehension was also noted.


CONCLUSION
A 'counselling' approach with someone with severe aphasia is possible. Using a repertory grid was a useful tool for understanding H.N. better. It seemed to initiate H.N. to discuss things of importance. The changes seen in him could have been due to an improvement in confidence as a communicator. This study has implications for how we can enable people with limited language to adapt to their situations.