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Communication and Medicine

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The construction of identity during group therapy among adults with traumatic brain injury

Dana Kovarsky / Allan Shaw / Maureen Adingono-Smith
Published Online: 2007-08-22 | DOI: https://doi.org/10.1515/CAM.2007.029


This investigation examined how the interpretive practices of a speech–language pathologist (SLP) contributed to the construction of identity among adults with traumatic brain injury (TBI) during group therapy in a hospital setting. Six group therapy sessions were video-recorded and transcribed (yielding a total of 8,056 utterances). Attention was paid to patient expressions of identity and ability, the communicative functions of these expressions, and the manner in which these expressions were evaluated by the SLP. The SLP was also interviewed regarding the nature of therapy practice. Analysis revealed that the interpretive voice of the SLP dominated in ascribing a patient identity of self as damaged goods. Implications are discussed in terms of how the institutional setting, the perceived nature of TBI, the agenda of the SLP, and the interactional substrate combined to motivate such interpretive practices on the part of the SLP.

Keywords: language and identity; clinical discourse; traumatic brain injury; selfhood; stigma

About the article

Dana Kovarsky

Dr. Dana Kovarsky is currently an Associate Professor in the Department of Communicative Disorders at the University of Rhode Island. As an ethnographer of communication disorders, his research has focused on the analysis of speech–language therapy interaction, the communicative practices of audiologists, and other communicative activities relevant to the study of clinical discourse such as the diagnostic talk of physicians in a pediatric intensive care unit.

Allan Shaw

Allan Shaw and Maureen Adingono-Smith received their Master's degrees in the Department of Communicative Disorders at the University of Rhode Island. Their research interests are in the management of adults and children with communication impairments.

*Address for correspondence: Department of Communicative Disorders, Independence Square, University of Rhode Island, Kingston, RI, 02881.

Published Online: 2007-08-22

Published in Print: 2007-05-29

Citation Information: Communication, Volume 4, Issue 1, Pages 53–66, ISSN (Online) 1613-4087, ISSN (Print) 0341-2059, DOI: https://doi.org/10.1515/CAM.2007.029.

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