Motivating Stroke Survivors with a therapy sandwich

How caregivers can challenge speech-language survivors during treatment, without discouraging them.

Start by helping the patient choose the goal: after all it's their therapy. But some patients start at an over-challenging level and quickly become frustrated.  Or they stay at an easy level & avoid challenge (which is necessary to make progress.)  In those cases, communicate with the survivor about how they are feeling and what their goal is.  Let them know you are not judging them and are just helping them navigate those feelings.

This three step method warms up the patient with success, then challenges them (this is the meat of the treatment), and then finishes with something easier so they finish with success. 

"It really is a good way to do it so you don't get flustered."

- Shirlene Cooper, stroke-survivor

1. WARMUP : Find a level that they can succeed at (90-100% accuracy* ). This gets them comfortable with the exercise and how it works. It also gives them some emotional momentum and confidence.
   They'll need that for step 2.
   
   *90-100% is a guideline. The goal is that they feel successful.
   
   How to modify the goal if your Survivor is easily frustrated

   Adjust them  to your survivor's motivation an frustration level. If 90% doesn't feel like success to them, but 100%does then 100% Correct should be the target for the easy Level for the Warmup (and for step 3, below)
   Some survivors push themselves too hard and get frustrated. Others are under confident and don't want to risk failure.
   I provide a range (and even that is just a guide).
   
    What I mean by 90-100% accuracy

   X% accuracy means they got the correct answer on their first attempt X% of the time.
   So if I showed them 10 photos and had them name them and they named 5 correctly in their first guess, but took more than one try for the other ones they'd be at 50% accuracy.

2. CHALLENGE: Work at a level that is a challenge for them (something around 60-90% accuracy). This is the meat of our Therapy Sandwich and I suggest spending most of the session time at this level. This is where you strain the brain. No strain, not gain. We want to challenge them.
3. FINISH WITH SUCCESS: Go back to the level in #1. 

The idea here is that they are more likely to remember the success of step 1 and 3 than the challenge of Step 2.

Now that you know how to make Therapy Fun,
ready for some free therapy materials?