On the tip of my tongue Series 2 Episode 3 - Dr Suzanne Beeke

Better Conversations with Aphasia: In-Depth with Dr. Suzanne Beek

In this episode, Dr. Suzanne Beek, Associate Professor of Language and Cognition at UCL, discusses her innovative therapy called Better Conversations with Aphasia. She explains how aphasia, a communication difficulty often resulting from stroke, affects conversations and the simple strategies her program employs to improve communication between people with aphasia and their loved ones. Dr. Beek also talks about the therapeutic techniques, including video feedback, that speech and language therapists use to facilitate better conversations. The conversation also highlights common communication issues, such as 'test questions,' and the need for greater awareness and support for speech and language therapy.

00:00 Introduction to Dr. Suzanne Beak and Better Conversations with Aphasia
00:13 Understanding Aphasia: Cognitive Effort and Communication Challenges
01:53 Dr. Suzanne Beak's Background and Research Focus
02:48 The Concept of Better Conversations
03:36 Implementing Better Conversations with Aphasia
05:57 The Role of Video Feedback in Therapy
07:55 Common Communication Challenges and Solutions
08:08 Addressing Test Questions in Conversations
10:37 The Emotional Impact of Aphasia
19:12 Raising Awareness and Media Representation
21:26 Different Types of Aphasia: Stroke vs. Primary Progressive Aphasia
34:09 Funding and Support for Aphasia Research
36:10 Training and Future Directions in Aphasia Therapy
41:18 Accessing Better Conversations with Aphasia
42:40 Conclusion and Final Thoughts

https://www.ucl.ac.uk/pals/research/language-and-cognition/language-and-cognition-research/better-conversations-lab

UCL Communication Clinic for people with aphasia and families
https://www.ucl.ac.uk/pals/ucl-communication-clinic

Twitter: https://x.com/BCAphasia

Transcript

Podcast s2 e3 - Dr Suzanne Beeke
===

[00:00:00] In this episode, we're talking to Dr. Suzanne Beak, Associate Professor of Language and Cognition at UCL, about her groundbreaking therapy called Better Conversations with Aphasia. For people without aphasia, one of the, maybe one of the ways they can fully understand that is to think about themselves living in another country and speaking another language.

It's that same feeling of cognitive effort and, and exhaustion. It's a question, at the end of the day, navigating your way in a language that's not your first language.

[00:01:00] 



Suzanne: My name's Dr. Suzanne Beek. I'm an Associate Professor at University College London [00:02:00] and I'm a Speech and Language Therapist by background and my research area and my teaching is in aphasia so a communication difficulty that people have as a result of stroke. I also do research in dementia and my research focus is on helping people have better conversations with their family and friends after acquiring a communication difficulty that changes the way that they talk and understand people.

Jon: Welcome Suzanne. It's, you have an interesting and wide CV, shall we say. So, but obviously we're going to, because on the tip of my tongue is about aphasia, we'll focus on that. I suppose the first question is your the current thing that you're working on now, which is the good conversation.

Perhaps you can tell us a bit more about that. [00:03:00] Yes,

Suzanne: to speech and language therapy. for a wide range of communication difficulties, which we call better conversations. So the focus is on helping people and their families and friends have conversations that are enjoyable and that flow and that work. Even though one of the people in the conversation might have difficulties with talking or with understanding.

What's said to them. So, we started our work in the world of aphasia, so stroke and aphasia, and developed Better Conversations with Aphasia, which is a speech and language therapy program that speech and language therapists can deliver to their clients with aphasia and a family member or a friend.

And it's a program that [00:04:00] helps people to understand how conversations work. Because the interesting thing about conversations is that we do them all the time, every day of our lives, pretty much, once we've mastered the skill. But we don't think about how they work. We, we do them very unconsciously, but there are lots of rules in conversation that we're all unconsciously following and that research has shown us exist.

So what our intervention does is just make people a little bit more aware of how conversations work and also how they can go wrong and the things that people can do to fix that. So to give you a very concrete example, one of the ways that conversations can go wrong for people with aphasia and their family members is that people with aphasia need more time to find the words, but family members carry on with conversations at the same [00:05:00] speed that they always did and that can cause difficulties because people with aphasia can get interrupted, they can not get to finish what they wanted to say and the conversation can move on.

Sometimes they feel like they can't even get into the conversation to begin to say anything. And we've found through our Better Conversations with Aphasia programme that giving everybody a bit more awareness that pausing in conversation and waiting for people to take their turn and finish their turn, having that awareness can really help.

As simple as that it's so often we're sharing quite simple ways in which conversations can work and get a bit stuck that family members and people with aphasia can then take away and practice and hopefully have better conversations. at home and in their social lives. So that's really what we do.

And one of the things that makes our therapy [00:06:00] distinctive is that we use video feedback. So we ask people with aphasia and their family member or friend to make video several videos maybe at home of just chatting, you know, as they would every day chat. So maybe over a cup of tea, maybe over a drink maybe at meal times.

And then the speech and language therapist will have a look at those videos to get a feel for what's working well in the conversation and what's maybe a bit more tricky. So it's a way of assessing conversation for us as speech therapists, but then we also use the videos with people with aphasia and their family members.

So we show them little clips of the video to reinforce really good things they're doing. really good strategies that are working in conversation to make it all flow. And we show one or two clips, very short clips, where we as speech therapists think maybe there's [00:07:00] something a bit tricky here or this seemed a bit challenging.

And we get people to reflect on it and think about what was going on for them. Was it challenging? What, what could they have done differently? So we find the video feedback is a really powerful way. of helping people understand how their conversations are working, both in the positive ways and in the slightly challenging ways.

And then the idea is that that makes it easier to then change your conversational behaviours, because that's quite a big thing to ask people to do. Change habits of a lifetime sometimes in the way that they talk. But we find it works. People find it very accessible, they find it quite enlightening, and sometimes one or two very simple strategies can unlock conversations for people with aphasia so that they're much, much more enjoyable. . 

@Rob: That sounds fantastic actually. what else, apart from giving people time to, [00:08:00] to speak and pause it, are there, you, you look at the videos and you see difficulties. What are the sort of typical difficulties that you find?

Suzanne: One that we see a lot is what we call a test question. So for whatever reason, and it's come, it comes from a very good supportive place, but the friends and family of people with aphasia often start asking questions they already know the answer to, because it kind of scaffolds the conversation.

You know, if you ask a question and you know what you're expecting the response to be, it makes having that conversation a bit easier if the other person can't find their words. So easily, but it's something we don't do in conversations with our peers. Teachers do it with pupils. It's a way of asking pupils to demonstrate their knowledge.

So you ask [00:09:00] them a question that you already know the answer to. So it's a, it's a very kind of classroom based interactional style. But it seems to pop up in the conversations of people with aphasia and their family members. I think simply as a way of trying to help the conversation on. Because it is tricky to know what to talk about and how best to talk about it.

But we find those test questions happening a lot, and the trouble with them is they put the person with aphasia under pressure to find a very particular word in response to that question. So actually, even though they're coming from a good place they're being done because the conversation partner thinks this will help us.

It actually makes things worse for the person with aphasia. And so that they can't use the sort of broad range of language skills that they might have left at their disposal. They've just got to find that one word to [00:10:00] answer this test question. So that's one that crops up a lot. We see that a lot in people's videos.

Thank you. And it's also a really easy one to fix, because once conversation partners realize they're doing it, they often see it on the video and think, and they say things to me, like, Oh, why am I doing that? That's like, really, I'm treating him like a child. I don't want to be doing that. What can I do instead?

@Rob: Sort of patronizing in a

Suzanne: yes. And it's not meant at all in that way. It's really just a way to try to have a conversation. But that is, it can come across that way. Yes. And I think. People with aphasia have told me that they feel frustrated by these kinds of questions and put on the spot and yes, possibly patronised. It changes the dynamic of the relationship too so we help people to find ways to avoid test questions and ask different kinds of questions, or maybe not even ask questions at all, but maybe just [00:11:00] share a little bit about something from their day.

And then it opened the conversational floor for the person with aphasia to respond in some way,

@Rob: Was going to say, you couldn't give a sort of few concrete examples of that. That's fascinating. What would a test question be typically, or perhaps there isn't a typical one, 

Suzanne: yeah, so some things I've seen in the videos that we have looked at for our research and during the therapy it would be something like what, what did you have for lunch yesterday when we went out to the pub with John and Sue?

So that kind of thing. So the person with aphasia has to list The things that they ate, but the conversation partner already knows what they ate, because they were there together. So it's those kinds of questions. Or, what did we do last weekend?

@Rob: To a child in a way.

Suzanne: Yes, that's why they are, yes, they share that kind of because when you do talk to a child like [00:12:00] that, you're You're trying to support their language and get them to talk to you.

And so, yes, that's why they're, they're quite similar, but for, for adults. With aphasia who have had perfectly you know, well functioning language and communication skills beforehand. The, the effect can be very frustrating. 

Jon: We go back to the thing that we talk about, which is that you haven't lost your intellect. You've just lost your mind. You know, the means to to communicate in one way or another. is that something that you. delve into with, on your course

Suzanne: we certainly talk about that. Yes, we talk about the fact that people, people with aphasia themselves tell us. They know what they want to say, they know what their opinions are, they just can't get them out. Or they need more time to get them out, or they need to use some other [00:13:00] strategies as well, like maybe writing something down, or you know, sketching a, a map of something, or using a range of resources they might have around them in their homes.

You know, and we all do that to a certain extent, don't we? We all go and grab the photo album or get an atlas or, or the map of the walk that we did together to remind ourselves of the places. And people with aphasia are amazingly good at working round the difficulties that they often have with finding the words or maybe putting them together into sentences.

Some people with aphasia do that really naturally and develop those strategies themselves. Other people need more help to see that as perhaps valid, a valid way of communicating. Some people worry that they're going to be judged for, for doing that kind of thing in a [00:14:00] conversation.

Jon: It's interesting that we've had a couple of people with aphasia on, on the podcast, apart from myself, and, and they've been different levels. So the, the, we I did somebody talked to somebody last week and his His speech wasn't so good and he would, he would admit that yet we had another person on with aphasia who was quite what I'd call high level, so he was able to Apart from missing the odd word was pretty, , solid to be interviewed. Rob, it's something that you've picked up on throughout doing these podcasts, is this, the whole thing about people having to find ways around doing what they do with, once you have got aphasia.

@Rob: I mean, are there kind of techniques? I often wonder with you, John, when we're talking I don't make any special thing with you and I don't know whether you feel that [00:15:00] I'm fully appreciating your condition

Jon: sometimes I have to tell you I've got aphasia, you know, I can't do this.

@Rob: You do. I never think that you do. 

Suzanne: That's interesting because those are the kind of conversations that. The better conversations with aphasia therapy unlocks and allows people to have those conversations with their family members and their friends,

which they probably haven't had before because they haven't needed to have them.

But sometimes just having that conversation about, Oh, when, when you do this thing, that really helps me. But when you do that thing, I find it really difficult. Just having that space to have that kind of conversation together can, in itself, be really therapeutic. And then just, you know, slipping a few strategies in there that we see as possible positive strategies for people, you know, using our speech and language therapy knowledge. It can be as, that can be all [00:16:00] it takes really to just unlock better conversations for people. 

Jon: I don't know whether people talk to you about this, but I find it very hard to talk to people. I mean, even this is quite hard going for me, because I'm, I'm always thinking about, am I going to get, I'm going to be is it going to be a word going to trip me up,. it's, it's quite, stressful is not the right word, but it is quite hard work. It's quite tiring.

Suzanne: I can certainly I can relate to that. So people do talk about it as. as tiring as I mean maybe another label might be. It's a, it takes a lot of cognitive effort to do something that you would have beforehand, before your stroke, before your aphasia, you would have done without thinking 

and I think for, for people without aphasia, one of the, maybe one of the ways they can fully understand that is to think about themselves. Living in another country and speaking another language. It's that same [00:17:00] feeling of cognitive effort and, and exhaustion at the end of the day, navigating your way in a language that's not your first language. 

Jon: I think that's a very good way of putting it. Yeah. And, and towards the the, the end of a day I find it more, it's more tiring to do things beginning of the day is better than the end of the day. Not always, but you know, if it's been a sort of a long day of, communicating with people.

@Rob: Also said to me that stress comes talking to strangers outside. I, I get the feeling that you're this program that you've devised, Suzanne, is, is designed for family members and and the but there is also of course, the question of going out in the world. And you've often talked to me about this, John, going into a shop

and just that sheer Terror or not much.

Is that too strong a word? But the feeling of [00:18:00] embarrassment, I suppose, that, you know, you're going to ask for something and even though you kind of rehearsed it in your head, and the fact that it's not necessarily a particularly friendly face, the other side of the counter,

you're going to be judged. It's a disability because it affects speech. It somehow is considered much more to do with your general mental capabilities. Your intelligence. It's, it's, treated much more like a kind of dementia

and I know you, you obviously deal with people with dementia as well, but it, it isn't that, is it? I mean, it is, it is purely a bit of software in the brain that isn't working very well, but the hard drive, we keep coming back to this analogy that we keep using the hard drive is there.

In dementia, you're losing your memories. You're losing your whole cognitive. It's a terrible thing, obviously, but with aphasia, you know who [00:19:00] you are. You know who these people are. You've got your, you can think, you've got your mind. You've still got your mind. It's just literally. A kind of software problem.

Suzanne: And I think, you know, there is seriously just not enough awareness of aphasia in the general population. So many. Family members say, Oh, we never knew what aphasia was until, until the husband, the father had a stroke. And then suddenly they have to, they have to learn, they have to find out because it's affecting everybody's lives.

But yes, so there is I think that's why it's really important that people like, you know, You, Jonathan, and Rob are doing these kind of podcasts because people we need to just get the message out, people need to be much more aware of what aphasia is, and I think in the media is getting better [00:20:00] at reporting about aphasia.

I've seen it. I think just seeing the stories about it coming out is something I've noticed over the last yeah, few years that has increased. But I think there is still confusion in the way that it's reported. So you've mentioned Rob, both aphasia and dementia and maybe one of the things I'd like to say is that So we use the word aphasia, which has a its root in in the Greek language and it means a loss of language But we use it for two very separate conditions and that's what causes confusion.

So we use it for The language and communication difficulties that people who have strokes experience the data tells us that one in six of us will have a stroke in our lifetime. so for every three people who have a stroke, one of those [00:21:00] people will have aphasia. This is a serious and important thing for people to understand. And this kind of aphasia can also be caused by traumatic brain injury. So maybe from, you know, a car accident, something like that. It can also be caused by some inflammation of the brain, like in encephalitis. So but stroke is the major cause.

of aphasia. We also use the word aphasia as part of another term to refer to a condition that is a very rare form of dementia.

This can be confusing for people and also it gets confusingly reported in the media.

So this is primary progressive aphasia.

Jon: this is Bruce Willis, isn't

Suzanne: Yes, so this is what Bruce Willis has. So the kind of aphasia you get after a stroke is, is what Jonathan experiences.

And also, you may have heard Emilia Clarke, the actor in Game of Thrones, talking about [00:22:00] how she had a stroke and she had aphasia. And of course she's managed to get back to her acting career, so she, she has recovered. It's a very rare form of dementia called Primary Progressive Aphasia, so the name itself gives you the clue.

So progressive, the word progressive is really important in the title. So it's, yes, it's aphasia. It's a kind of dementia that primarily begins to affect your language, so it's your language where it is the first symptom. You start to have trouble finding words. Sometimes the motor speech, so the muscles and getting the words out is also something that occurs, but it gets progressively worse.

as the dementia progresses, and people get to the point where they can't talk at all,

Jon: Which is apparently where he's at, isn't he?

Suzanne: Yes, I think I've, I've seen that reported in the media, so yes, so [00:23:00] we, we do still need to do some work so that people understand that these are two different conditions, because I think sometimes there are still So when the Bruce Willis story was originally reported, they just said he has aphasia. And I was aware in, in the aphasia community that a lot of people with aphasia were saying this is, this is not a good message to send because people are getting scared that they're going to get worse. People who'd had a stroke and had aphasia, so that different kind of aphasia, where it can be problematic because people who've had a stroke and have aphasia can think, read these stories and think suddenly, oh my goodness, I'm going to get worse, this is but that's not the case.

@Rob: Get worse with, with aphasia after a stroke. Is that what you're saying? In many ways, you can get better,

Suzanne: you can get better, yes, absolutely, and you're not going to see that progressive decline. That you see in primary progressive [00:24:00] aphasia, which is a form of dementia that's separate.

Jon: When I did my film I was filming one of the people , that was helping me, doing the background Barbara Chalk. I showed her the, we did a, a explainer., I got someone to do one for us, , a video thing. And she said, Oh, cut out the stuff about the last thing we were talking about. She said, don't put that in because that's not we, that's not what is exactly what you've said.

This is not what people want to hear.





Jon: Going back to the, the media thing.

which obviously we're all very keen on doing between us, is to, is to how do you [00:25:00] get this, everybody says, oh, we need to get the message across. , I had somebody on and did a the podcast last week and he had a car, accident. So his wasn't a stroke. It was a brain injury. He's got a group up in

@Rob: bishop Auckland.

Jon: thank you he said, well, we need to get the word out, which he's obviously, he's trying to do, but he's got, he's got 16 people on his group. And he was saying how big the, area he was living in was something like 200, 000 people. Now, even if you work out the maths, there'd be more people with aphasia in his area. let alone anywhere else. And so my point really is, you say, oh, okay, the, the media doing a better job, but it's still quite poor, isn't it really? People don't understand it, so they don't know anything about, 

Suzanne: I think, there are ways that we can all do things to raise [00:26:00] awareness. , I include speech and language therapists in that. There are two things the media could immediately do better. One of which is to always say in their article, about whether it's about aphasia or about primary progressive aphasia that the speech and language therapist is the expert who can help these people and I always get very disappointed when I see yet another article with no mention of speech and language therapy, and that happens a lot.

So I think that's a significant improvement that would would just help people to access some support. Because, you know, speech and language therapists are the healthcare professionals who get people talking again. That is what we do. It's what we train for three or four years. It's a degree level training speech and language therapists are a really important part of the team of allied health professionals who [00:27:00] work with people, with adults with communication difficulties.

And that message just needs to get out and people need to realize that they can go to their GP and ask to be referred to a speech and language therapist.

It's as simple as that.

Jon: that's what happened to me.

Suzanne: Good. Yeah.

@Rob: had, you had to wait six months, you said, John.

Suzanne: Yeah. Yes, But even so, it's a long time.

there is a problem with yes, there aren't enough speech and language therapists, , 

Jon: why is that, do you think? Is it, a profession that they don't, people don't want to go into? 

Suzanne: No, I don't think it's that. The Royal College of Speech and Language Therapists are doing some really interesting work at the moment to understand retention in the profession. So there are issues that we don't quite understand about why speech and language therapists train, work for [00:28:00] several years, but then we're losing quite a lot of people within the profession.

And I think it's, it's a range of complex factors around so that the profession is, a very high percentage of women, so who are taking career breaks to have children so there's that, that's a factor I it's not the only factor, there are also issues around working in the NHS, and Feeling that you can work up the ladder and have your skills recognised.

And sometimes that's why people leave, because they, they can't progress any further in their career.

@Rob: Is that because there's no structure there? There isn't a, I mean, you obviously are very, very high level 

Suzanne: yes, but I don't work in the NHS. I work in a university. So and for me that was a way of having, being able to do research, but also having more I suppose independence in my role and [00:29:00] roles in the NHS can be and need to be very sri circumscribed in terms of what you do from day to day.

There may or may not be opportunities to develop advanced. Skills to do research in the workplace, which is really important and needs to happen. And I think some people get to the point where they feel that they, they can't develop their skills any longer. And many of those people do end up working in the university sector because they can begin to do that research and help people.

And we are able to help in different ways. So we have a communication clinic based at University College London. where we run groups for people with aphasia, also for people with primary progressive aphasia. So we, we are able to offer intervention therapy services as well through the university. I think that also helps in terms of [00:30:00] giving more awareness.

And our students are an important resource for that. You know, it's important that we give them the skills to go out in the world and, and make people more aware as well. And also, I think as speech and language therapist, we've been a little bit nervous of talking to the media, so I do think that there are ways in which we could put ourselves forward more. And I, can I take the opportunity to also name check some, so there are amazing charity, third sector support groups in, in the aphasia world who are doing absolutely fantastic work as well. So it's not all the case that it's.

that speech therapy is happening in the NHS. There are amazing groups like Say Aphasia and Discover, Discover with a Y who offer everything from social support and connection through to speech and language therapy. In the case of Discover, they run groups for people with aphasia. And for people with primary progressive aphasia, they do the kind of [00:31:00] communication training that we've been talking about.

And there are clearly groups like your, your person in Darlington, who's, you know,

Jon: Well, he's say aphasia, he's part of Say Aphasia

Suzanne: there, Aphasia. Ah, great, yeah. So there are, and that's just two Different Strokes is another group that do great work and they have a a sort of focus on younger people. We've had strokes. Yeah, so there's some amazing third sector organizations out there doing really, really great work and also doing work to raise awareness 

Jon: but do you find though, that it's a bit fragmented? There isn't a, a, an association that's like the stroke association, for example, for aphasia.

Suzanne: I'm part of an association called the British Aphasiology Society. So they are an organization that exists to bring together speech and language therapists and researchers. who, who are all focused on stroke [00:32:00] aphasia. We have meetings and, and conferences, but we don't have we don't, there's less of an involvement of people with aphasia.

There is some involvement, and I know that the, the society are doing things to increase that, but it's it's rather a professional society at the moment and it doesn't, but It doesn't have a kind of awareness raising program. It's a great group that runs on people's people volunteering and it's, it's not centrally funded in any way.

We quite often use Parkinson's as an example because Parkinson's, I looked up how much money

in terms of funding 

I don't know what it is it's higher rated , we know people who've got it.

@Rob: It a celebrity? I mean, we talk about Bruce Willis and he doesn't have The stroke related to Aphasia is we've got this progressive thing, is it a celebrity [00:33:00] thing? Yeah, we need a few more Michael J. Fox or something

is that a trivial

Suzanne: No, I don't think it is trivial. I think, I do think it helps because I think it's an anchor for people that makes them take notice.

I do think it helps. I think, I think personally, the other factor, it's a, in this might be that, so conditions like Parkinson's are, they are medical conditions and that makes much more sense to people.

Aphasia, in comparison, is a, condition that you can get as a result of several medical conditions. So it doesn't have that same kind of you know, unified sort of persona, if you like, that Parkinson's has with, with a, you know, a very specific label. So, That's why I think more money goes into stroke in general [00:34:00] because, again, stroke is a, medical condition that people can understand and get a handle on. Whereas aphasia is a linked condition

Jon: Can I just go back to the funding thing for a minute? Did you find that harder than finding money for something else?

Suzanne: I think perhaps it's more that funding speech and language therapy research as a whole is harder than anything else. Well, I mean, sure, there are other, other sectors as well that find it difficult. to fund their research. But yeah, it's, we are successful, but it's, there's not as much money in speech and language therapy research as a whole.

I don't know that aphasia is any more or less than that. My original work on the better conversations with aphasia Intervention was funded by the Stroke Association. So those are, you know, those funding sources are out there. I have had [00:35:00] PhD students in the past funded by the Stroke Association.

And I'm involved in two current projects with colleagues in Sheffield and at St. George's City, university of London where our funding comes from the research arm of the NHS, which is called the NIHR, the Institute for Health Research. So, yeah, so there often we're looking at accessing them pots of money that are for stroke. 

And there is there is also money in in dementia research that we are able to access for our, because we do also have our better conversations. intervention for primary progressive aphasia, so that rare dementia type that we were talking about. And so we're accessing dementia funding to support that work.

Again, the NIHR funding my colleague, Dr. Anna Volkma, who's [00:36:00] leading on that work at UCL.

Jon: it's all happening, by 

Suzanne: it.

is, it is happening. Yeah,

@Rob: good ish, or how do you feel about it?

Suzanne: Yes, I think the future is looking good from, so I think the really encouraging things that I've seen since working on Better Conversations with Aphasia are that we are, we are regularly training large groups of speech and language therapists to use this intervention. We, so that's part of what we do in our Better Conversations lab.

We offer training for speech and language therapists So they can deliver the intervention and those those numbers are very healthy. So we train speech and language therapists twice a year, groups of 30 to 40 each year. I mean, remember, speech and language therapists don't all work in, even with adults, you know, a large number will work with children.

So, so those are pretty good numbers for our profession. We're [00:37:00] also seeing a lot more. Clinics being set up, if you want to call them that, or services that are particularly wanting to offer conversation training for people with aphasia and their families. And we have set up a service like that at our clinic at UCL, our communication clinic.

We're offering what we call better conversation camps. We're doing an intensive version of this training and we're also on the side, we're running a research project to see whether that works and how it works. We're doing a more intensive two week conversation training camp where both the person with aphasia and the, the chosen communication partner comes to the therapy. So, yes, I think so. I think all of those things are really positive and we train we train 60, between 62 and 65 [00:38:00] speech and language therapists graduate from UCL from our training program every year. And they all go out having had training in this intervention because that's our expertise, it's what we do.

So we make sure that they get research led training as well. So they all go out into the profession with skills to offer this kind of intervention as well. So I, I think that's all really positive. Those are the things that I want to achieve through being, being a leader of the Better Conversations Lab.

It's, for me, it's all about the impact that we can have out there in the world for people with aphasia.

@Rob: I'm only just really appreciating it now. I think this is a first, isn't it? Am I right in thinking that prior to your work, which comes out of your PhD work, I think, in conversation, better conversations with aphasia, speech and language therapists didn't have these [00:39:00] skills about analyzing conversations.

What's going wrong with conversations and how can they be improved? It was all much more about just making speech. 

Suzanne: so my work very much built on the work of my PhD supervisor, Professor Ray Wilkinson, who was a pioneer in bringing a research, a systematic scientific method for analysing conversations. to our aphasia research world. And before that it wasn't happening really.

There were, there were a few studies there'd been a couple of studies up in Newcastle, there were a few studies in the States, but it was Ray Wilkinson who really brought, so conversation analysis is the research method we use to aphasia so that we could better understand was working for in conversations with people with aphasia, but also what was [00:40:00] going wrong.

So we could understand that from a scientific standpoint. So he pioneered that work and I was very lucky to be able to do my PhD with him, which meant I could take that into the world of Speech and language therapy intervention there was a program of intervention prior to better conversations with aphasia that many speech and language therapists still, you know, have on their shelf in the clinic.

So, so I can't say I was the very first, but I think what I'm proud of is the fact that we've driven it a long way. at UCL and I think that we have been very successful in helping speech and language therapists to feel confident to deliver it as an intervention, which I don't think they did before.

So they were definitely working on communication skills between the person with aphasia and their family member before better [00:41:00] conversations with aphasia, but perhaps not in a very structured way.

Jon: you Maybe you've packaged it up

Suzanne: yes, I think we have. Yes. And I What they weren't doing before is they weren't using that video feedback method that I talked about earlier.

So that's something that we have pioneered, yes.

@Rob: And how do people access the, course, Better Conversations with Aphasia? How would John and I, for instance?

Suzanne: John would access it through a speech and language therapist. So it does need a speech and language therapist to deliver it. 

@Rob: Just something online. No.

Suzanne: We do have resources online, so and for people with aphasia that allows them to understand a bit more about how conversations work, but the therapy itself is not a self directed therapy.

It needs to be accessed through You know, having a conversation with your speech and language therapist where you say, right, I'm, I know there's this [00:42:00] intervention and, and I want it.

We're very happy to take people's queries at our communication clinic. At UCL, which if people Google it, UCL Communication Clinic, they'll find, find our webpages 

, we offer it in blocks, so it's not that every point in the year there's something going on, but we can, we can help people to fit in with what we offer in our clinic, or we can suggest other.

So I mentioned Discover, who are a third sector organisation to support people with aphasia. They also offer a very similar kind of training

Jon: Excellent.

@Rob: Well, it sounds fantastic.

Suzanne: I was going to say, just in any way that I can support you or the podcast, because I think this is a fabulous please let me know, and I will certainly be, I'll be sending the link to all our students, for example. And we're, the Better Conversations Lab is on Twitter, so I'll make sure that I I post it [00:43:00] there.

It's been a real pleasure. So, but yeah, any way that we can support you in what you do, just get in touch.

Jon: That'd be very kind. Thank you very much, 

@Rob: Yes, 

Suzanne: thank 

Jon: and we'll be in touch, no 

Suzanne: Yes, okay, all right.

Jon: thanks very 

Suzanne: Have a good rest of your day.

Jon: Thank you. Goodbye. 

@Rob: Bye bye. Bye bye.



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