ALHT106 Assessment 2

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Australian Catholic University *

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106

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Psychology

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Oct 30, 2023

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Question 1: Psychology is the study of human behaviour and mental processes. This discipline aims to understand and analyse how individuals think, feel, and behave in various contexts (Burton et al., 2023). An understanding of psychology is essential as a speech pathologist, as it provides valuable insight into the psychological impact of communication and swallowing disorders on individuals, families, and the wider community. In addition, speech pathologists often work in a multidisciplinary team, partnering with other allied health professionals (including psychologists) to achieve the best possible outcomes for clients (Speech Pathology Australia, 2020). Speech pathologists will often work alongside psychologists to gain a more holistic understanding of the patient and to accommodate specific needs (Allied Health Professions Australia, 2023). A background in psychology allows speech pathologists to advise and implement strategies that promote positive behavioural and psychological management in all aspects of a client's life (SPA, 2023). Cognitive psychology investigates how individuals perceive, process, and remember information (Burton et al., 2023). Knowledge of cognitive psychology is vital in speech pathology when assessing and treating individuals with cognitive-communication disorders, such as those resulting from traumatic brain injuries or neurogenerative diseases (Short et al., 2014). Speech pathologists need to have a comprehensive understanding of the cognition level of a client when developing treatment plans and therapy goals that focus on cognitive functions, such as attention, memory and problem-solving (Lanzi et al., 2021). Another perspective of psychology that is relevant to speech pathology is developmental psychology. Developmental psychology studies the development of an individual's cognition, emotions, and behaviours across the lifespan. Speech pathologists work with clients at various developmental stages whose needs are influenced by their stage of life. For example, a speech pathologist with paediatrics may work with clients with language delays. In contrast, a speech pathologist who works with older persons may have clients whose primary concern is their inability to communicate effectively and swallow safely due to a brain injury (Speech Pathology Australia, 2020). By understanding the principles of developmental psychology, speech pathologists can assess and address their client's needs in a developmentally appropriate manner, ensuring that clients receive the best possible care. Social psychology explores how social interactions and relationships influence individuals' thoughts, feelings, and behaviours. Speech pathologists frequently work with clients who experience social communication difficulties, such as individuals with autism spectrum disorder, clients who stutter or individuals with aphasia. Communication difficulties can hinder social interactions, leaving individuals feeling excluded, isolated, and misunderstood. (SPA, 2023). By drawing on social psychology principles, speech pathologists can assist clients in developing practical social communication skills and navigating social situations. For example, the allied health therapy centre "Kidsfirst" runs a social skills program for children who struggle with social communication disorders. Speech pathologists lead these classes and draw on various psychological concepts to build social competence (Kidsfirst, 2023). Knowledge of psychological concepts gives speech pathologists a better understanding of the emotional impact of communication and swallowing disorders on an individual's well-being (SPA, 2020). The mental health guidelines outlined by Speech Pathology Australia (2010) recognise the relationship between speech pathology and mental health, stating that "speech

pathologists play a crucial role in mental health services given the high correlation between mental health disorders and communication and swallowing disorders". For example, speech pathologists may work in organisations that have a high rate of communication disorders and poor mental health. These organisations could include youth justice and detention centres, child protective services or asylum seeker centres. Clients in these clinical settings have often been subjected to trauma, neglect or abuse and may be suspicious of or unwilling to work with allied health professionals. Understanding mental health and the broader psychological domains is essential for speech pathologists to connect and build trust with clients (SPA, 2010). Furthermore, Speech Pathology Australia's Code of Ethics emphasises the need for speech pathologists to consider the psychological well-being of their clients, maintain confidentiality, and respect clients' autonomy and dignity in line. These ethical principles align with the broader understanding that psychological factors are integral to assessing, diagnosing, and treating communication disorders (SPA, 2018). Question 2: Motivation is a psychological concept that refers to the internal and external processes that drive determination and goal-orientated behaviour. Motivation is comprised of two main components, the goal that the individual wishes to achieve and the level of intensity that drives them to achieve it. Motivation plays a vital role in setting and working towards goals as it determines the level of engagement and persistence an individual puts forth (Burton et al., 2023). In the case of Mr B, his motivation to set and work towards goals has been impacted by several factors. Firstly, his experience of a stroke and the resulting disability has likely caused a decrease in his self-efficacy or his belief in his ability to accomplish tasks and reach desired outcomes. This decreased self-efficacy can directly impact his motivation, as feelings of self- doubt and helplessness can make it difficult for him to find the drive and purpose to continue working towards his goals. Additionally, Mr B's physical limitations may also lead to decreased motivation, as the tasks he needs to complete may be more challenging. Mr B may suffer from negative emotions, such as anxiety or guilt. These feelings can harm his self- worth and overall well-being, making him incapable of setting and working towards his goals. Lastly, the perceived fear of not being able to return to a "normal" state may cause Mr B to feel overwhelmed and discouraged at the thought of therapy. The cognitive perspective emphasises the role of cognitive processes, such as beliefs, expectations, and self-perception, in motivation (Burton et al., 2023). Mr B's negative thoughts and concerns about not being able to return to his everyday life can shape his motivation. Self-Determination Theory (SDT) is a valuable framework for understanding Mr B's poor motivation and inability to set and work towards goals. SDT suggests that the degree of motivation is directly influenced by an individual's level of competence and sense of autonomy (Deci et al., 2015). In Mr B's case, the stroke has impacted both elements. Newfound physical limitations have left Mr B with less control over his body and reliance on others for assistance. Furthermore, difficulties with slurred speech may make Mr B feel less confident in his ability to communicate and feel incompetent in social situations. The cognitive approach also considers the impact that goal setting can have on an individual's motivation. Goal-setting theory suggests that setting specific and attainable goals can increase an individual's motivation and likelihood of achieving goals (Burton et al., 2023). Mr B's

stroke has created barriers that make setting and pursuing specific goals difficult. His balance is impaired, making engaging in activities such as returning to work or playing golf challenging. Furthermore, his slurred speech also makes it difficult to engage in social situations and conversations surrounding goal setting. As a result of these challenges, Mr B may feel as though there is a lack of clarify and feasibility in regard to the goals he can achieve. From a humanistic perspective, it is possible to understand Mr B's lack of motivation by examining his experiences and needs within the framework of Maslow's Hierarchy of Needs. Maslow's Hierarchy of Needs theory proposes that humans are motivated by five levels of needs: physiological, safety, love or belongingness, esteem, and self-actualisation (Burton et al., 2023). Mr B can still meet most of his physiological needs and is surrounded by a safe and supportive environment; however, his self-esteem and sense of fulfilment have declined due to the stroke. Mr B views himself as a burden to his family, suggesting he struggles with a poor sense of self-worth. Mr B's inability to return to work and golf may have also led to a loss of identity and sense of self, resulting in poor self-esteem and avoidance of setting goals or working to achieve them. In addition to this, Mr B may be struggling to meet his self- actualisation needs. Self-actualisation refers to fulfilling one's potential and searching for personal growth and meaning (Burton et al., 2023). Mr B's stroke has likely caused him to experience a lost sense of control, autonomy, and direction within his life. These negative feelings and Mr B's new circumstances may mean that it has been difficult for him to feel motivated and prioritise goal setting. Question 3: A speech pathologist may employ many strategies to help combat Mr B's low motivation and encourage goal-setting behaviours. Two specific examples include: 1. Goal setting: Sherratt et al. (2011) states that goal setting is a crucial part of rehabilitation and fundamental to achieving a client-centred approach. A speech pathologist can work alongside Mr B to create meaningful and achievable goals to help improve his communication abilities. By involving Mr B in goal setting, he can regain control and empowerment over his rehabilitation process. Additionally, by incorporating Mr B in the creation of therapy goals, the goals can be tailored towards things that provide him enjoyment and meaning; the goals become more engaging and intrinsically motivating. This strategy provides a structured framework that can be assessed and adjusted by a speech pathologist based on Mr B's progress and needs. A speech pathologist may split the larger overall goal into smaller, more achievable goals. These smaller goals would allow Mr B to reach milestones and experience a sense of accomplishment throughout the rehabilitation journey. This process aligns with motivation as it relies on Mr B's internal drive for competence, relatedness, and autonomy. A study by Fishman et al. (2021) found that goal setting improved cognitive function, working memory, and learning after a stroke, leading to increased motivation and drive to achieve goals. 2. Positive reinforcement: A speech pathologist could aid Mr B's motivation by providing positive reinforcement and encouragement. Reinforcement could be achieved by acknowledging and praising his efforts, progress, and achievements. Oyake (2020) suggests that praise can induce a positive outlook for clients, boost self-

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esteem and increase overall motivation. Positive reinforcement may also include providing Mr B with success stories from other clients to help reassure him that he can "get back to his normal self". Through positive reinforcement, a speech pathologist can utilise an individual's innate motivation to strengthen belief in their abilities and produce a sense of pride and satisfaction. This strategy helps create a positive therapeutic environment in which Mr B can feel supported and motivated to reach his goals. Positive reinforcement helps establish trust and rapport between the client and the speech pathologist, which provides the base for collaboration and open communication about goals. Stroke rehabilitation may sometimes be discouraging and frustrating, so the treating speech pathologist must employ positive reinforcement to reassure clients that a desired outcome is possible. This ongoing encouragement from a health professional would help clients like Mr B to feel as though their efforts are worthwhile, which in turn helps to motivate them to continue working towards their goals.

References: Allied Health Professions Australia (2023). Speech Pathology. https://ahpa.com.au/allied- health-professions/speech-pathology/ Burton, L., Westen, D., & Kowalski, R. (2023). Psychology. (Australian and New Zealand 6th ed.) . Wiley Deci, E. L., & Ryan, R. M. (2000). The" what" and" why" of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11 (4), 227-268. Fisherman, K.N., Ashbaugh, A.R., & Swartz, R.H. (2021). Goal Setting Improves Cognitive Performance in a Randomized Trial of Chronic Stroke Survivors. Stoke, 52 (2), 458-470. https://doi.org/10.1161/STROKEAHA.120.032131 Kidsfirst (2021). Social Skills Groups. https://kids-first.com.au/social-skills-groups/ Lanzi, A. M., Ellison, J. M., & Cohen, M.L. (2021). The “Counselling” Roles of the Speech- Language Pathologist Serving Older Adults with Mild Cognitive Impairment and Dementia From Alzheimer's Disease . Perspectives of the ASHA Special Interest Groups, 6 (5), 987- 1102. https://doi.org/10.1044/2021_PERSP-20-00295 Oyake, K., Suzuki, M., Otaka, Y., & Tanaka, S. (2020). Motivational Strategies for Stoke Rehabilitation: A Descriptive Cross-Sectional Study. Frontiers in Neurology, 11 (553). https://doi.10.3389/fneur.2020.00553 Sherratt, S., Worrall, L., Pearson, C., Howe, T., Hersh, D., & Davidson, B. (2011). "Well it has to be language-related": speech-language pathologists' goals for people with aphasia and their families. International journal of speech-language pathology , 13 (4), 317–328. https://doi.org/10.3109/17549507.2011.584632 Short, J., McCormack, J., & Copley, A. (2014). The current practices of speech-language pathologists in providing information to clients with traumatic brain injury. International journal of speech-language pathology , 16 (3), 219–230. https://doi.org/10.3109/17549507.2014.882413 Speech Pathology Australia. (2018). Code of Ethics. https://www.speechpathologyaustralia.org.au/SPAweb/Members/Professional_resources/Code _of_Ethics/SPAweb/Resources/Professional_resources/Code_of_Ethics.aspx Speech Pathology Australia (2023). Impacts of a Disability. https://www.speechpathologyaustralia.org.au/Communication_Hub/Impacts_of_disability/So cial_Impacts.aspx Speech Pathology Australia. (2010). Mental Health Clinical Guideline. https://www.speechpathologyaustralia.org.au/SPAweb/Members/Position_Statements/spaweb /Members/Position_Statements/Position_Statements.aspx?hkey=dedc1a49-75de-474a-8bcb- bfbd2ac078b7

Speech Pathology Australia (2020). Professional Standards for Speech Pathology in Australia . https://speechpathologyaustralia.cld.bz/Speech-Pathology-Australia-Professional- Standards-2020

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