Introduction. Researchers from the University of Sydney and La Trobe University in Australia conducted a survey to investigate the practices of speech-language pathologists (SLPs) regarding working with traumatic brain injury (TBI) survivors who were their friends. The goals were to understand the motivations of SLPs who had chosen to work with friends following TBI, the frequency of such arrangements, the barriers that SLPs encounter as service providers to friends following TBI, and perceptions of successful friendships post-TBI.

Methods. Seventy-eight SLPs whose caseload included persons with TBI were recruited to fill out an online questionnaire via Survey Monkey. The survey contained 37 items – 27 closed questions and 10 open-ended questions, and covered four areas: (i) demographics, (ii) current work practices regarding friends; (iii) barriers to working with friends; and (iv) perceptions regarding success of friendships. Responses were analyzed using a mixed methods approach: descriptive statistics were used to analyze quantitative data, and inductive content analysis methods were used for responses to open-ended questions.

Results. Sixty-eight of these questionnaires (87.2%) contained the completed sections required for data analysis. Of the 68, only a minority of the clinicians – 27 (39.7%) – reported including friends in their clinical activities, either directly or indirectly; the majority – (60.3%) – reported not including friends. Most of the SLPs who work with friends participate in multidisciplinary clinical teams, and the non-SLP team member most frequently consulted regarding service delivery to friends was the occupational therapist. The most common purposes of such consultations were: (i) to educate friends ‘about TBI and assistance provision’; and (ii) to problem-solve ‘behind the scenes in tricky cases.’ The most commonly cited reason for working with friends was ‘to prevent negative psychosocial outcomes in persons with TBI.’ The two most common barriers to maintaining friendships with TBI survivors were ‘inability to access the friends’ (76.9%), and ‘time constraints’ (53.9%).

Conclusions. The authors note scope for improvement. Specifically, they recommend the development of targeted communication partner education and training materials, the better to support the inclusion of friends in rehabilitation.

For further reading:   T. Bertram, E. Power, J. Douglas, L. Togher.  2020.  Friendships after severe traumatic brain injury: a survey of current speech pathology practice.  Brain Injury, 34(8): 1020–1030,

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