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  1. Kimbarow, Michael L. PhD, Issue Editors
  2. Avent, Jan PhD, Issue Editors

Article Content

The idea for this issue of Topics in Language Disorders (TLD) formed during a lunch meeting that took place approximately 3 years ago. A discussion of the benefits of group therapy in aphasia treatment (Avent & Wertz, 1996; Elman & Bernstein-Ellis, 1999) quickly led to a discussion of the value of group treatment across multiple disorders. One idea led to another and Dr. Avent proposed a workshop on this very topic. As is so often the case, the co-construction of enthusiasm for a good concept and the opportunity it afforded for the two of us to work together resulted in a 1-day conference that became the basis for our proposal to TLD.


There is a rich history behind group therapy approaches for working with individuals with communication disorders, particularly in the adult aphasia and laryngectomy literature (Avent, 1997; Elman, 1999; Kearns & Elman, 2001; Salmon & Mount, 1991; Stone & Hamilton, 1986). However, outside of the adult medical universe there is little information available on how to utilize this approach to maximum benefit with other clinical populations.


The exploration of group therapy across disorders is particularly timely. Clinicians are continually challenged to demonstrate treatment effectiveness within a context of reduced support for their services. Clinicians have come to realize that addressing a client's communication impairment without also addressing changes in his/her activity and/or participation level (World Health Organization, 2000) will lead to only partial success in improving the lives of those we serve. Group therapy is an effective strategy that recognizes the link among impairment, activity, and participation consequences of communication disorders. Consequently, this series of articles will broaden our collective understanding of the challenges and opportunities in utilizing group therapy as an important tool in therapy.


The first article in this issue by Graham and Avent offers an overview of group treatment approaches across a wide spectrum of disorders. They offer the reader an opportunity to identify the common challenges facing the clinician utilizing group therapy as an adjunct to individual therapy or as a primary treatment protocol. The authors inform us that in order to succeed with this model, we must be sensitive to issues of developing group identity and interdependency among participants. Graham and Avent also provide guidance on how one may define the communication and psychosocial goals of the group and discuss issues of accountability and methods for measuring outcomes. They acknowledge and identify the differences among the various treatment approaches addressed in this issue as they pertain to treatment settings, group size, functional communication goals, and collaborative vs. independent service delivery models.


The second article by Jan Avent reviews a unique model of group treatment for aphasia. The author has developed and refined a cooperative approach for aphasic clients participating in her program at California State University at Hayward. Avent reminds us that the cooperative model requires participants to work together to achieve shared goals and ensure communicative success of all members in stark contrast to individual therapy. The approach makes intuitive and empirical sense when one considers that most of our day-to-day communicative success is a function of cooperative strategies and co-construction of meaning. Avent discusses many of the variables leading to client success with this approach and her information serves as an important reminder that group therapy requires careful planning on the part of the clinician.


Minnie Graham takes the reader down a slightly different path of group treatment. She writes about the challenges faced by individuals experiencing the trauma and life-altering effects of a laryngectomy. Graham identifies the physical, social, and psychological sequelae of the procedure and describes how group therapy is a necessary adjunct to individual voice restoration therapy. Perhaps one of the best lessons learned from this approach is recognizing that individual treatment is advanced and nurtured in a group setting that promotes a sense of shared community among communicatively challenged clients.


The next two articles bring the reader into kindergarten and elementary schools to remind us that group therapy is an excellent method for building language and communicative success in children with language/learning disorders. Ellen Pritchard-Dodge describes an innovative program designed to promote good communication skills in her students during classroom activities. Dodge reminds us that no matter how successful we may be in treating a child's language/learning disorder, if we fail to consider the associated social and pragmatic abilities of the student we are headed toward failure.


Finally, we conclude with Bettina Larroude's article on how we can use group therapy to improve our understanding and sensitivity to an ever-growing multicultural and multilingual clinical population. Larroude describes her group treatment approach in the context of working with Spanish and bilingual Spanish-English-speaking preschool and kindergarten students in Oakland, CA. We believe this will be a valuable resource for many clinicians concerned about effective strategies to promote language and communicative success in school-based settings.


Readers are encouraged to consider how best to take the information presented in this issue and apply it in their own clinical setting. The issue editors believe that by presenting these different applications of group therapy we offer an opportunity to discover the power of this model to ensure client success on many levels. We thank the authors for their creativity and their willingness to share many years of work in developing and implementing these programs.




Avent, J. R. (1997). Manual of cooperative group treatment for aphasia. Boston: Butterworth-Heineman. [Context Link]


Avent, J. R., & Wertz, T. R. (1996). A comparison of aphasic patient's pragmatic performance in individual and group treatment. Aphasiology, 10, 253-259. [Context Link]


Elman, R. J. (Ed.). (1999). Group treatment of neurogenic communication disorders: The expert clinician's approach. Woburn, MA: Butterworth-Heineman. [Context Link]


Elman, R. J., & Bernstein-Ellis, E. (1999). The efficacy of group communication treatment in adults with chronic aphasia. Journal of Speech-Language and Hearing Research, 42, 411-419. [Context Link]


Kearns, K. P., & Elman, R. J. (2001). Group treatment for aphasia: Theoretical and practical considerations. In R. Chapey (Ed.), Language intervention strategies in aphasia and related neurogenic communication disorders (pp. 316-340). Philadelphia: Lippincott Williams & Wilkins. [Context Link]


Salmon, S. J., & Mount, K. H. (1991). Group therapy. In S. J. Salmon & K. H. Mount (Eds.), Alaryngeal speech rehabilitation: For clinicians by clinicians (pp. 93-105). Austin, TX: PRO-ED, Inc. [Context Link]


Stone, R. E., & Hamilton, R. (1986). Laryngectomee rehabilitation in a group setting. Seminars in Speech and Language, 7, 53-65. [Context Link]


World Health Organization. (2000). ICIDH-2 International classification of impairments, activities and participation. Geneva: World Health Organization. [Context Link]