SLP-administered psychosocial intervention (Schwen Blackett et al., 2025)
Purpose: Despite the high prevalence of depression and anxiety among people with aphasia (PWA), their mental health needs are often overlooked. Behavioral activation is an effective cognitive behavioral therapy technique for depression that may be well suited for PWA. The current study aimed to (a) assess the feasibility and acceptability of a speech-language pathologist (SLP)–administered psychosocial intervention that is primarily composed of behavioral activation and (b) examine preliminary effects of this intervention on depression and anxiety symptoms of PWA.
Method: Eleven participants with poststroke aphasia participated in this mixed-methods pilot study. A brief behavioral intervention was developed by an SLP and a clinical psychologist for the target population and administered to all participants by an SLP. Aphasia-friendly communication supports were created by the SLP to facilitate implementation of the intervention components. Participants were given a battery of psychosocial assessments at baseline, post-intervention, and at a 1-month follow-up. The primary outcome measures were (a) feasibility measured by retention (quantitative) and thematic interview responses (qualitative), (b) acceptability (measured qualitatively), and (c) depression and anxiety symptoms. All qualitative interviews were conducted with participants at the post-intervention session.
Results: All participants completed every session, suggesting high feasibility. Post-intervention qualitative interviews indicated that participants found the intervention acceptable and helpful. Despite low power, paired-samples t tests showed a statistically significant reduction in depression, but not anxiety, from pre- to post-intervention. Despite initial improvements from pre- to post-intervention, statistically significant reductions in depression symptoms were not maintained at the 1-month follow-up.
Conclusions: Early evidence from this pilot study suggests that this SLP-administered intervention is feasible and acceptable to PWA, but that a higher dose may be warranted to ensure durability. Fully powered research is needed to further examine the benefit of this intervention for PWA.
Supplemental Material S1. Individual scores on the primary outcome measure at each time point and post-intervention interview questions.
Schwen Blacket, D., Grubaugh, A. L., Sydlowski, D., Acierno, R., Pompon, R. H., Woodbury, M. L., Kautz, S. A., Wilmskoetter, J., McTeague, L. M. (2025). Feasibility and preliminary outcomes of speech-language pathologist–administered behavioral activation: A psychosocial intervention for people with aphasia. American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2025_AJSLP-24-00422
Publisher Note: This article is part of the Special Issue: Select Papers From the 53rd Clinical Aphasiology Conference.
Funding
This project was supported by the South Carolina Clinical & Translational Research Institute with an academic home at the Medical University of South Carolina Clinical and Translational Science Awards National Institutes of Health/National Center for Advancing Translational Sciences (Grant No. UL1 TR001450). This project was also supported by grants from the National Institute on Deafness and Other Communication Disorders (T32 DC014435, Trainee: Schwen Blackett) and the National Institute of General Medical Sciences (P20 GM109040, PI: Kautz). It was also supported by Veterans Affairs (VA) Rehabilitation R&D 1IK6RX003075 (PI: Kautz). The contents are solely the responsibility of the authors and do not necessarily represent the official views of the VA, the National Institutes of Health, or the National Center for Advancing Translational Sciences.
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