Beginning to teach the end: the importance of including discharge from aphasia therapy in the curriculum

Hersh, Deborah and Cruice, Madeline (2010) Beginning to teach the end: the importance of including discharge from aphasia therapy in the curriculum. International Journal of Language and Communication Disorders, 45 3: 263-274. doi:10.3109/13682820902994200

Author Hersh, Deborah
Cruice, Madeline
Title Beginning to teach the end: the importance of including discharge from aphasia therapy in the curriculum
Journal name International Journal of Language and Communication Disorders   Check publisher's open access policy
ISSN 1368-2822
Publication date 2010-05
Sub-type Article (original research)
DOI 10.3109/13682820902994200
Volume 45
Issue 3
Start page 263
End page 274
Total pages 12
Place of publication Oxford, United Kingdom
Publisher John Wiley & Sons
Collection year 2011
Language eng
Formatted abstract

Discharging clients with long-term aphasia from therapy services constitutes a challenging dilemma for practising clinicians for a multitude of reasons. Although discharge was raised and discussed as a contentious issue in the field of aphasiology ten years ago, it remains an aspect of practice which is complex and underexplored. We are only a little more enlightened now than then on how to address this issue in relation to professional education and practice.


This paper draws on a single case study of a man with aphasia, his wife, and treating clinician, taken from a substantial research study, to highlight awareness of how communication, choice and differing perceptions of goals of therapy influence the experience of the discharge process. The case serves as the context for addressing a gap in the university curriculum around teaching about discharge practice in the context of long-term aphasia.

Methods & Procedures

This paper describes how university and practice educators could include discharge issues in students' learning by teaching discharge in context, addressing it in formal university lessons as well as through work-based learning opportunities in clinical placements, and by scaffolding learning using graduated learning outcomes over the different stages of the students' programme.

Main contribution

This paper provides practical suggestions to guide the inclusion of discharge in teaching about communication disorders generally, and specifically in relation to long-term aphasia. Discharge needs to be appreciated within the context of the entire intervention process, with good practice modelled in both university and workplace settings. We propose that it is learned in association with stages of decision-making, duty of care, documentation, goal setting, continuous therapy evaluation, clinical reasoning, professional communication with clients, ethical behaviour, and evidence-based practice.

Conclusions & Implications

Bringing discharge practice from the realm of implicit knowledge to one that can be examined and discussed in an explicit manner should help reduce anxieties about discharge for new clinicians, help to clarify and improve the discharge approaches used by clinicians and lead to better discharge experiences for clients.

© Copyright 2010 Elsevier B.V.

Keyword Discharge
Aphasia therapy
Speech pathology/Speech and language therapy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Health and Rehabilitation Sciences Publications
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Citation counts: TR Web of Science Citation Count  Cited 2 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 3 times in Scopus Article | Citations
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Created: Sun, 09 May 2010, 00:04:07 EST