Sparking conversation in aphasia groups: tips to keep them talking!

“This should be easy,” the graduate student thinks as they prepare to facilitate the aphasia conversation group. After all, they’ve been watching their clinical supervisor run the group for the past few weeks, and besides, it’s just a group of adults having a conversation. How hard could it be? The truth is, likely harder than it looks.

The good news is that it is the behaviors of the group facilitators that can directly contribute to engagement in aphasia conversation groups. The bad news is, group facilitators can also exhibit behaviors that cause people to disengage from conversation.  

In this study, behaviors of graduate student aphasia group facilitators were analyzed to determine which behaviors contributed to or detracted from a group’s success.  Results can be categorized into three themes:

  • The power of turns

  • Purpose and value system

  • Managing competing needs

Check out Table 2 for some great examples that fall under each of these themes!


Among others, three main trends were noted:

First, the conversational turns taken by the facilitators influenced those that came after them (both positively and negatively).

TIP: Try moving the conversation forward by using open-ended questions and be sure to acknowledge communication turns by group members!

Secondly, the behaviors of the facilitators served to unintentionally undermine participants (causing disengagement) or, successfully minimize any existing power differential.

TIP: Create a group culture of support and encouragement early on (“foster group solidarity”)! This may be the only time your PWAs truly feel free to express themselves without judgment.

Finally, there was typically a greater focus on participants with more severe deficits, when ideally an equivalent amount of attention should be paid across all members of the group to ensure engagement across the board.

TIP: Be prepared in advance! This could include preparing multimodal communication strategies that can be used to support group members of all ability levels, so that focus isn’t spent here during the group.

Turns out it’s not quite as easy as it looks. In fact, facilitating a successful aphasia conversation group can actually be quite complex. Graduate students and novice clinicians alike will need formal training outlining the “do’s and don’ts” of managing a successful aphasia group.

Lee, J., Azios, J. (2019) Facilitator Behaviors Leading to Engagement and Disengagement in Aphasia Conversation Groups. American Journal of Speech Language Pathology.