Yarning together: Culturally secure rehabilitation for Aboriginal & Torres Strait Islander peoples after brain injury

Yarning together: Developing a culturally secure rehabilitation approach for Aboriginal Australians after brain injury

 

Project Aim

To develop an understanding of the perceptions by Aboriginal Australians with acquired communication disorder following brain injury have of rehabilitation services and test the feasibility and acceptability of a culturally tailored model of rehabilitation delivered via one of two models: face to face or using telehealth technology.

 

Project Team:

Project leader: Associate Professor Natalie Ciccone, Associate Dean (Allied Health), School of Medical and Health Sciences, Edith Cowan University.

Administering organisation: Edith Cowan University
Project timeline: 1 May 2018—1 April 2019

 

Methodology

Using a single case, mixed methods design, the study involved 11 Aboriginal participants from the Perth metropolitan area with acquired communication disorders after brain injury. The therapy involved 16 X 1 hour treatment sessions provided twice weekly by a speech pathologist and Aboriginal co-worker incorporating a yarning framework and family involvement. Pre-therapy interviews gathered participants’ thoughts on therapy and their expectations of the therapy. Post-therapy interviews explored the participants’ views of the therapy provided. Therapists were interviewed at study completion to develop a sense of clinical acceptability.

 

Project Findings

Analysis of the results indicate that it is feasible to provide speech pathology intervention co-jointly with a speech pathologist and Aboriginal co-worker and to implement a yarning framework – a conversation-based approach following Aboriginal discourse structures (broadly based on Bessarab & Ng’andu 2010). The therapy was considered acceptable to participants, and both modes of delivery — face to face and using tele-rehabilitation technology — were also well received. Participants also reported communication improvements across the treatment period

 

Project Outcomes

Knowledge
  • The project will develop a greater understanding of the priorities and needs of Aboriginal people who have an acquired communication disability (ACD). The findings can be adapted to other programs that work with Aboriginal people with a disability.
Awareness
  • Speech pathologists’ awareness of ways to increase cultural security of therapy will increase through the presentations, workshops and publications ensuing from the project.
Behaviour
  • Speech pathologists’ behaviours related to implementation of a yarning framework in speech therapy sessions will make a significant contribution to an anticipated increase in cultural security of speech pathology sessions.
  • Recommendations for working with an Aboriginal co-worker will also influence speech pathologists and other rehabilitation specialists as they are embedded in clinical guidelines.
Skills
  • The individuals employed in this study as Aboriginal Research Assistants developed their research, interviewing and communications skills.
  • Research Assistants also attended training on brain injury, communication disorders, research processes associated with the project, yarning and methods for interviewing participants.
  • Research Assistants participated in discussions regarding the clinical management of each participant and processes involved in research.
  • One of the Aboriginal Research Assistants was invited to co-present at two conferences and a workshop.
Other
  • The treatment protocol will provide direction for rehabilitation therapists and directly contribute to the ongoing development of clinical guidelines for the management of people who have experienced ACD following brain injury in order to influence the provision of services to Aboriginal people and to promote engagement and improve quality of care.
  • It is anticipated that the speech pathology principles of practice will be generalisable to other allied health rehabilitation services and contribute to national guidelines that will reflect culturally appropriate services models for Aboriginal brain injury survivors.
 

Acknowledgement of Country

We acknowledge the traditional owners of the land across Australia and pay our respects to their Elders past, present and future. Aboriginal and Torres Strait Islander people should be aware that this website may contain images, voices and names of deceased persons.

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