WHAT CAN COACHES AND CONSULTANTS LEARN FROM SPEACH AND LANGUAGE THERAPISTS

WHAT CAN COACHES AND CONSULTANTS LEARN FROM SPEACH AND LANGUAGE THERAPISTS
Improved communication when not talking.

We all know how important communication is. For a human infant it is a life and death situation. Without the ability to communicate with sounds and behaviours they are unable to communicate need, hunger, fear, discomfort. Communication is our key to connection with colleagues, communities, cultures even countries.

So what if you cannot talk?

As a consultant and coach I am always aware of the opportunity to learn from different fields and am really interested in Speech and Language Therapy (for example helping stroke patients to communicate) and what it might teach us about every-day communication.

I am indebted to a number of people for the notes below and have included links and references in an efforts to ensure appropriate acknowledgements and references for my observations and speculations. I am not a clinician or a neuroscientist so I apologise if I have misinterpreted the journals and would invite more informed readers to make corrections or clarifications in the comments.  

CONTEXT

“All rehabilitation at its heart, concerns changing behaviour.” For some stroke victims the rehabilitation is a collaboration between them and their partner with both having to make adjustments. Interestingly not everyone understands this at first.

1. There are some cases in a partnership where they work brilliantly as a team to use signs, signals, sounds, gestures, writing, pointing etc., to make-up the short-fall in speech and as a result communicate very well.

2. There are some cases in a partnership where one partner is trying to help correct, improve, guide, challenge the other into getting it right; much as you would do with teaching a child. The problem is that although well intended this may be future because of the damage caused by the stroke and may just create frustration and confusion and actually undermine communication. For example if you know B.. B.. B.. means ball, you've got the meaning why challenge them further my making them say the whole word perfectly?

3. There are some people who fail to appreciate their role, importance and partnership thinking that they do not have to make big changes because it is not them with the stroke. They do not immediately realise that the rehabilitation is for them too, because they have been affected.

A STUDY

I have read of studies (links below) that describe how speech and language therapists use a structured approach based around Behaviour Change Techniques (BCTs) and Behaviour Change Wheel to guide both participants (the stroke victim and their partners) through the challenges, problems, barriers, opportunities and possibilities for better communication.

This is interesting for anyone interested in communication and change. Remember the most significant model in Business Change today is the Kublar Ross Change Curve which came from a Health context. Maybe the next breakthrough in Communication and Motivation exists in neuroscience and Speech and Language Therapy.

SUMMARY OF APPROACH TAKEN

Coaches, consultants and project managers all love  structure, tools, templates and lists to guide process. So these models were really interesting even if the reality is that they are simply a model to provoke thinking rather than a strict prescription of what works in exact doses.

See Table 2. Structure, aims, and activities within better conversations with aphasia.
https://www.tandfonline.com/action/showCitFormats?doi=10.1080/09638288.2019.1703147

The above table/link is the "recipe" that the speech and language therapists followed with the stroke victim and their partners. I am interested as a consultant and coach whether a similar approach is useful in other circumstances.

CONUNDRUM

Some things appear to work better than others

See Table 3. Reliably agreed BCTs identified in Better Conversations with Aphasia.
https://www.tandfonline.com/action/showCitFormats?doi=10.1080/09638288.2019.1703147

The above table/link shows which Behaviour Change Techniques (BCTs) worked

It seems that sometimes the "recipe" works, sometimes it doesn't and it not always obvious why. A possible reason is that it is not the "recipe" but maybe the ingredients (participants) or the chef (therapist/coach) that makes the difference.

Everyone's stroke is different, just as every person and personality is different. So perhaps some 'tools' suit different situations better than others. After all a hammer and a drill are both DIY tools useful to shelves but they are not interchangeable!

See pages 47 to 68 of this PDF for The taxonomy of behaviour change techniques
https://discovery.ucl.ac.uk/id/eprint/1400691/1/Michie_et%20al.%20(in%20press)%20-%20BCT%20Taxonomy%20v1%20development%20paper.pdf

 

As a consultant and coach I was interested, but do not know from the information available.

1. Was the personality (assumptions, beliefs, values) of either the stroke victim or their partners a factor?
2. Was the education, age, social background a factor?
3. Is being intrinsically (from within) motivated versus extrinsically motivated (to appear to others) a factor?
4. Is an internal locus of control (I manage my life) versus external locus of control (Life happens to me) a factor?

However it does seem possible that the step-by-step the "recipe"  may impact, influence or change some of these factors to the extent that stroke victim or their partners change their belief, assumptions, accountability, and thus their behaviour, and thus improve their approach to communication which is more about meaning and understanding than about the ability to talk.

Maybe for some people the the "recipe"  unlocked something for the stroke victim or their partners that for others was left untouched. It would be really interesting to examine all the combinations but possibly a difficult task without an infinite amount of time to accommodate all combinations or some super Artificial Intelligence which can do the modelling for us.

Do do feel there is much to learn from Behaviour Change Techniques (BCTs) taxonomy, if only as a guide of options for coaches and consultant conversations. I certainly welcome any comments from Speech and Language Therapists on their experience of what works and what doesn't in conversations that are geared towards communication, understanding, and change.

We are after all able to communicate meaning and understanding with our offspring well before they are able to talk, so there is no reason that should stop if they loose the ability to talk.

TimHJRogers
Consultant Mentor Coach
Helping people and organisations get things done:
http://www.adaptconsultingcompany.com/coaching/

Adapt Consulting Company
Consult CoCreate Deliver
@AdaptCCompany +447797762051


Behaviour Change Wheel
https://link.springer.com/article/10.1186/1748-5908-6-42

The taxonomy of behaviour change techniques to a conversation therapy for aphasia
https://www.tandfonline.com/doi/full/10.1080/09638288.2019.1703147

Behaviour Change Techniques (BCTs)
See  Table 3. Reliably agreed BCTs identified in Better Conversations with Aphasia.
https://www.tandfonline.com/doi/full/10.1080/09638288.2019.1703147

Also Electronic Supplementary Materials Table 3. BCT Taxonomy (v1): 93 hierarchically-clustered techniques
https://discovery.ucl.ac.uk/id/eprint/1400691/1/Michie_et%20al.%20(in%20press)%20-%20BCT%20Taxonomy%20v1%20development%20paper.pdf

Also
https://www.ncbi.nlm.nih.gov/books/NBK327624/table/table4/?report=objectonly