Background
Understanding cognitive-communicative disorders is an essential component of goal setting and therapy planning in group interventions. It is important to identify social communication skills problems associated with community integration and satisfaction with life. La Trobe Communication Questionnaire can be used to evaluate communicative abilities and gather the information of individual experiences with real life social situations. A follow up study of the perceived communication skills after TBI was carried out in Finland during 2004-2007. The results show that communicative abilities were severely impaired after TBI, seemed to be persistent and were perceived very similarly by the patients themselves and their close-others. Therefore we came to the conclusion that the following intervention is essential.

Intervention
The main goal in our group interventions is to support the participation and social integration.
Since 2007 we have carried out several group intervention periods with 10-20 group meetings including few individual meetings for guidance. These group meetings can also be multidisciplinary with speech-language pathologist and neuropsychologist. They include education, reflection and practicing. The aspects of nonverbal communication, peer discussions and finding compensation skills for challenging social situations are also important to include in intervention. Cognitive-communication disorders of the participants have varied from mild to moderate.

Conclusions
According to clinical observations the main remarks after the intervention are: increased quantity of turn taking and comments, increased coherence in discussion, increased relation to the topic, better identification and understanding the aspects of nonverbal communication. The patients themselves report: increased encouragement, more positive relation to social participation, new activities and compensation skills, and decreased loneliness. It seems that group intervention is an important link between cognitive-communication rehabilitation and real life.

Back to social participation – a group intervention for TBI patients