Working with Families

Jenna Sargent, Natalie Brickner, Olivia Bergman

Rationale for Working with Families

Working with families...involves a collaborative counseling process in which the
family is empowered rather than a process that is driven either by the family or the
clinician (Flasher & Fogle, 2012 p. 192).
-

Best practice (Flasher & Fogle, 2012 p. 193)

Maximize opportunities for learning & enhancing communication
Generalization of skills
Safety measures
Advocacy
Support & acceptance

Flasher & Fogle (2012)

Aphasia & Working with Families

How does it affect families?
- Sudden, unexpected, and
unwanted changes
- challenges to patient and
family
- Feelings of frustration,
helplessness and hopelessness
- Communication impairments
affect ability to discuss family
problems and feelings
ASHA (n.d.)

What do family members need?

-

Information
Support
Respite
Effective mode of
communication with person
with aphasia
- Better interpersonal
relationships
Howe, Davidson, &, Worrall (2012)

Systems Therapy Model

A systems therapy model holds that the client and the clients support system
have the knowledge and capacity to create positive change. (Fox, Andrews, &
Andrews, 2013 p. 18)
-

Solution-focused therapy approach

- Self-Anchored Rating Scales (SARS)
Has been applied to aphasia treatment
- Involves clinician, client & family members

Fox (2013)

Self-Anchored Rating Scale

(SARS)
-

Function as an assessment tool

Help client and family see that
their feelings & beliefs are
important for therapy
Used to:
- Identify goals
- Track changes
- Promote further change

Fox, Andrews, & Andrews (2012)

Fox et al. (n.d.)

Principles to SARS-Based Therapy

#1 Be open to multiple perspectives

#2 Acknowledge & accept difference

Accept that each family members input is

based on their perspective of the
experience

Point out differences, dont attempt to

resolve them
Discuss what the differences may mean

Use counseling technique of clarification

Encourage open discussion

Fox (2012)

Steps in SARS-Based Therapy

Step 1: Communication after onset of aphasia
Step 2: Current communication
Step 3: Communication in the future (long-term goals)
Step 4: Small improvements in communication (short-term
goals)

Steps in SARS-Based Therapy

Step 5: Ask solution-focused questions
Step 6: Give assignments
Step 7: Discuss change

Fox (2012)

SARS-Based Therapy Outcomes

- Fosters a partnership
- Facilitates solutions from the familys beliefs
- Focused on client-centered goals
- Achieved through small, meaningful steps
- Enhances efficacy
- Promotes generalization
- As effective as other counseling methods in less time
Fox (2013)

Discussion
1. What are some advantages and disadvantages to systemic "family-based"
therapy in comparison to traditional "problem-focused" therapy?
2. Do you think the SARS approach would be applicable for your current or
previous aphasia client? Why or why not?
3. Do you think the SARS approach could be applied to other types of clients or
settings?

References
American Speech-Language-Hearing Association. (n.d.). Family Adjustment to Aphasia. Retrieved from http://www.asha.
org/public/speech/disorders/FamilyAdjustmentAphasia/
Flasher, L. V., & Fogle, P. T. (2012). Working With Families. In Counseling Skills for Speech-Language Pathologists and Audiologists (pp. 191227). Clifton Park, NY: Cengage Learning
Fox, L. E. (2012). AAC collaboration using the self-anchored rating scales (SARS): An aphasia case study. Perspectives in Augmentative and
Alternative Communication 21(4), 136-142.
Fox, L.E. (2013). SIGnatures: Family friendly. The ASHA Leader 18, 55-57. doi:10.1044/leader.SIGN.18092013.55
Fox, L. E., Andrews, M., & Andrews, J. (2012). Self-anchored rating scales: Partnering for post-aphasia change. Perspectives in
Neurophysiology and Neurogenic Speech and Language Disorders 22(1), 18-27.
Fox, L. E., Andrews, M., & Andrews, J. (n.d.). Scaling: A collaborative tool for enhanced communication and life participation. [PDF
document]. Retrieved from www.asha.org
Howe, T., Davidson, B., Worrall, L., (2012). 'You needed to rehab ... families as well': family members' own goals for aphasia rehabilitation.
International Journal Of Language & Communication Disorders, 47(5) 511-521.