MENTAL HEALTH PROFESSIONALS’ KNOWLEDGE OF APHASIA A thesis presented to the faculty of the Graduate School of Western Carolina University in partial fulfillment of the requirements for the degree of Masters of Science in Communication Sciences and Disorders. By Chandler Kirsten Barnes Director: Dr. K. Leigh Odom Associate Professor of Communication Science and Disorders Communication Sciences and Disorders Department Committee Members: Dr. Billy Ogletree, Communication Sciences and Disorders Dr. Valerie Schwiebert, Human Services March 2016 ACKNOWLEDGEMENTS I would to give tremendous thanks to my thesis committee, Leigh Odom, Ph.D., CCC- SLP, Billy Ogletree, Ph.D., CCC-SLP, and Valerie Schwiebert, Ph.D., NCLPC, NCC, NCGC, CRC for taking the time to advise me during these last two years. I would also like to extend my deepest gratitude to Yanju Li, Ph.D. for assisting Dr. Odom and I in analyzing our data. We couldn’t have done it without your unrelenting guidance. To my thesis director and advisor, Dr. Odom, without your constant confidence in me as a person, student, and professional, I would not be submitting this thesis. I would also like to thank those that participated in my thesis. I could not be more grateful to you for taking the time out of your busy lives to help shed light on such an important topic. Finally, to my friends and family, I could not have done this without your persistent love and support, especially, my husband, mom and dad. I cannot express how much you all mean to me and how much I love you. Thank you for always being there for me. Also, Elizabeth Rose, Lysandra Sykes, and Meredith Hubbard, I want to thank you three for being my biggest cheerleaders throughout this process. I couldn’t ask for better friends. ii TABLE OF CONTENTS Page List of Tables ................................................................................................................................. iv List of Abbreviations ...................................................................................................................... v Abstract .......................................................................................................................................... vi Chapter One: Introduction .............................................................................................................. 1 Mental Health, Mental Disorders and Quality of Life ........................................................ 1 Stroke and Aphasia ............................................................................................................. 3 Mental Health in Stroke and Aphasia ................................................................................. 5 Mental Health Service Providers ........................................................................................ 6 Managing Mental Disorders Post-Stroke ............................................................................ 8 Barriers to Counseling ...................................................................................................... 10 Statement of Purpose ........................................................................................................ 12 Chapter Two: Methods ................................................................................................................. 15 Participants ........................................................................................................................ 15 Survey ............................................................................................................................... 15 Procedure .......................................................................................................................... 17 Data Analysis .................................................................................................................... 17 Chapter Three: Results .................................................................................................................. 19 Mental Health Professionals’ Demographics .................................................................... 19 Knowledge of Aphasia ...................................................................................................... 22 Service Provision .............................................................................................................. 27 Learning about Aphasia .................................................................................................... 29 Continuing Education Opportunities Completed .............................................................. 31 Confidence in Providing Ethical Services to Persons with Aphasia ................................. 32 Chapter Four: Discussion .............................................................................................................. 38 Conclusions and Implications ........................................................................................... 38 Mental Health Professionals Knowledge of Aphasia ....................................................... 38 Experience Providing Services to Persons with Aphasia ................................................. 40 Aphasia Training for Mental Health Providers ................................................................. 43 Confidence in Providing Mental Health Services to Persons with Aphasia ..................... 44 Future Directions .............................................................................................................. 45 Limitations ........................................................................................................................ 45 Conclusions ....................................................................................................................... 46 Chapter Five: References .............................................................................................................. 47 Appendices .................................................................................................................................... 54 Appendix A: Survey ......................................................................................................... 54 Appendix B: Recruitment Email ....................................................................................... 59 iii LIST OF TABLES Table 3.1 Number of Participants by Discipline and Specialty .................................................... 20 Table 3.2 Demographic Data of Participants ................................................................................ 21 Table 3.3 Participants by Profession Having Heard of Aphasia ................................................... 22 Table 3.4 Definition of Aphasia Chosen by Profession ................................................................ 24 Table 3.5 Professionals’ Confidence (Very Confident, VC; Somewhat Confident, SC; Only Guessing, OG) in Chosen Definitions of Aphasia ............................................................ 27 Table 3.6 Provision of Services to Person with Aphasia by Profession ....................................... 28 Table 3.7 Initial Opportunity to Learn about Aphasia (Academic Coursework, AC; Clinical Practice, CP; Personal Experience, PE; Media Source, MS; Continuing Education, CE; Never Heard of Aphasia, NA; Other, O) by Profession ................................................... 30 Table 3.8 Professions Participation in Continuing Education Opportunities ............................... 32 Table 3.9 Professionals’ Confidence Providing Services to Persons with Aphasia ..................... 33 Table 3.10 Highest Degree Earned and Participants’ Confidence (Very Confident, VC; Somewhat Confident, SC; Neither Confident Nor Doubtful, NCND; Somewhat Doubtful, SD, Very Doubtful, VD) Providing Services to Persons with Aphasia ............................ 35 Table 3.11 Years of Clinical Practice (YCP) and Confidence (Very Confident, VC; Somewhat Confident, SC; Neither Confident Nor Doubtful, NCND; Somewhat Doubtful, SD, Very Doubtful, VD) in Providing Services ............................................................................... 36 Table 3.12 Confidence of Service (Very Confident, VC; Somewhat Confident, SC; Neither Confident Nor Doubtful, NCND; Somewhat Doubtful, SD, Very Doubtful, VD) and Definition of Aphasia ........................................................................................................ 37 iv LIST OF ABBREVIATIONS AMHCA .............................................................. American Mental Health Counselors Association ASHA ................................................................. American Speech-Language-Hearing Association CBT ................................................................................................... Cognitive Behavioral Therapy DSM ........................................................... Diagnostic and Statistical Manual of Mental Disorders HRQOL ............................................................................................ Health-Related Quality of Life NAMI ....................................................................................... National Alliance on Mental Illness NHIS ........................................................................................... National Health Interview Survey NSDUH ............................................................................ National Survey of Drug Use and Health PTSD ..............................................................................................