This week I reviewed a webinar given by Gail Ludwig M.A., CCC-SLP about incorporating RDI (Relationship Development Intervention) into speech therapy sessions.

gail lud

When we care for people with brain injuries it is important to not only care for them, but show them how to care for themselves.

She reminds us that one great thing about using RDI, is the increased empowerment that it gives to the caregivers. They are instructed to mentor instead of just care for the person. People with brain injuries can regress over the years if they are not using their brains in a way to aid neurological functioning.

Mindful Guidance

RDI goes beyond the behavior and addresses the thought process. For example, behavior the patient is exhibiting is that they are not getting ready for the day. The support you give, is figuring out why they have decided not to (get ready), then guiding them to a solution.

A few examples of things to look for when you are addressing the thought process:

  1. Perspective taking
  2. Problem solving
  3. Memory
  4. Self awareness

After you have assessed if and how these issues are inhibiting, you ask them a question highlighting what is expected from them; For example, “I see that you are not ready yet” instead of a direct command like “Go brush your teeth”, this gives the person being treated chance to think and feel more competent.

Spotlighting

Once they have made the decision to get ready, it is time for you to highlight their decision.

For example “I see that you are getting ready, I am so glad you decided to do what you needed to do.” This spotlights the success of the client, supporting motivation by developing memories of successful tasks. To support memories of success you can say something like “I remember yesterday you decided to get ready on time, I know you can make the same decision today.”

Shared Communication the people that are caring for the client should care about them sketch of man people caring

One aspect of shared communication is sharing things about yourself and experiences. This can help the client understand others’ perspectives and makes the experience of caring for them a joint experience. Another way to promote a shared experience is to create a scenario for interaction, then go back and spotlight those memories. A great way to do this is by taking pictures, organize a cooking project, take pictures during the project, and then jointly review them after.

Many caregivers do not give the care receiver an opportunity for self reflection, especially for the severely disabled.

Support

Caregivers need to find the right amount of support to give and then gradually fade the support by:

  1. Demonstrating
  2. Giving feedback
  3. Gradually letting them do the task by themselves

If the care recipient is overwhelmed it is better to use nonverbal communication. Moving the body by going for a walk can be helpful.

Many times when caring for people with disabilities it seems natural to want to do everything for them. We have discovered is that this is not always helpful. If we incorporate these different techniques into our everyday professional routine, not only will  behavior start to improve, but you will enjoy a more meaningful mentoring experience.

From Gail: My RDI and Speech Therapy series is based on my personal experience combining my knowledge of RDI with 30 years of working as a Speech/Language Pathologist. I started out my career working with adults with brain injuries and now work with individuals with all types of disabilities and all ages. I use an approach that is first focused on trust and engagement and is activity based. I demonstrate for family members and get them involved whenever possible. Through the therapy, I give my clients the opportunity to build relationships and communicate in natural, authentic ways. My series includes my work with young children, school age clients, school consultations, expanding to different populations and long distance support.

To see this three part series, Join the RDI Learning Community

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