Conversation Therapy: Interaction as Intervention

Abstract

This chapter presents an overview of the history, principles and clinical practice that might be labelled “Conversation Therapy” (henceforth, CT) in the context of aural rehabilitation (AR) for adults who have post-lingual hearing impairment (HI). Conversation is recog-nised as the major activity limitation/participation re-striction arising from HI and as such, the therapy, as out-lined in this chapter, is designed primarily to address the everyday conversation difficulties of adults who have HI. The focus on post-lingual HI implies that clients pres-ent with normal adult speech, language and conversa-tional abilities limited only by the reduction in ease of speech reception as a consequence of their HI. While the AR work outlined here is by no means limited to this population, it is designed with the view that the individ-ual had normal adult everyday spoken communication skills prior to the onset of their HI. The hallmarks of the clinical activities included in CT are: (a) their focus on interaction rather than on speech reception, (b) the incorporation of the full range of structural linguistic, interactional, environmental and interpersonal context cues, (c) the incorporation of units of speech (or more appropriately, “talk”) larger or longer than the syllable, word, phrase or sentence, (d) the use of tasks which can be designed with the client’s situation specific difficulties in mind and (e) the increased atten-tion paid to the role of the conversation partner in the resolution of conversational difficulties arising from the post-lingual HI. This chapter makes no claim that CT is a new ther-apy in AR, nor that it has been developed in a concerted or coordinated fashion. Rather, the term is applied retro-spectively, grouping certain existing therapy activities by their focus on conversational or interactional conse-quences of post-lingual HI, including therapies such as environmental and hearing tactics (Kaplan, Bally, & Garretson, 1985) as well as communication therapy (Er-ber, 1996, 2002; Erber, & Lind, 1994) and psychosocial intervention (Pedley, Giles, & Hogan, 2005).