Narrative-Based Practice in Speech-Language Pathology

REVIEW
This book is a remarkably honest venture into the realm of narrative-based practice in speech-language pathology. Jacqueline Hinckley argues for an appreciation of the value of story-telling in understanding, not only our clients’ experiences of communication disability, but also how stories shape us as clinicians and our therapeutic interactions. Through this book, Hinckley brings speech-language pathology into line with other areas of healthcare that have recognised the value of narrative-based approaches (Greenhalgh and Hurwitz, 1998; Hurwitz, Greenhalgh and Skultans, 2004). She explains how narrative-based practice complements evidence-based practice by integrating the individual and the exceptional of the former with the generalisable and guidelines of the latter.
It is not by accident that Hinckley opens her introduction with a personal story, one of being held at gunpoint in a lift – a highly effective way of grasping the reader as well as illustrating the power of narrative. She shows how this event, and the telling of it many times over years, affected her sense of self generally and as a clinician. She writes that story-telling is fundamental to identity and to the clinical process: “It is argued throughout this book that a first step in exploring the great plain of clinical interaction is through understanding, listening to, and telling stories” (p.x). Therefore, Hinckley includes stories within the chapters but also a number of personal insights into her experiences of being a clinician that stand alone. Her aim is to encourage the reader to think about their own stories and to share them with others.
The book is divided into four overall sections. The first contains three chapters which discuss the importance of narratives in relation to the development of identity and clinical expertise, health and healing and narrative-based practice. The second section includes three chapters which look at the fundamental of narratives. Chapter 4 considers narrative methodologies within an overview of qualitative research approaches, particularly rhetorical analysis, life narratives and autoethnography. Chapter 5 is about illness narratives and chapter 6 relates narrative to communication disorder including how it may be targeted through intervention. The third section comprises seven short “stories of a clinical life”, each with a “reflections” section to explore feelings and key issues in the accounts. This part of the book involves sharing very personal stories by the author, but the kinds of stories that all clinicians have. The final section contains two chapters. The first discusses the role of narrative in clinical interactions, in promoting reflective practice and in the training of speech-language pathologists. The second explores three examples of intervention approaches which use narrative: personal narratives, therapeutic writing and bibiotherapy. The book finishes with appendices containing further recommended reading in the areas of sociocultural variations in narrative, and personal narratives by people with communication disorders and their careers.
This book should be of interest to aphasia researchers and clinicians. First, Hinckley’s particular clinical expertise is in this area and readers familiar with her publications (for example, Hinckley, 2005; 2006) will value reading her work further. Second, this book reflects recent theoretical and clinical developments in aphasiology, for example, in relation to person-centred care and life participation (Chapey et al., 2001), identity (Shadden, 2005), clinical interactions (Horton, 2006; Simmons-Mackie and Damico, 1999), service provision (Pound et al., 2001) and the use of qualitative research approaches. In addition, this will also be useful for students and educators, particularly those employing case-based and problem-based learning on their courses. Overall, it is a book which should help clinicians to reflect on who they are, who their clients are and the role of narrative in the clinical process.

Dr Deborah Hersh Postdoctoral Research Fellow, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane

CONTENTS

• The Importance of Narrative.
• 1. To the development of the self and expertise
• 2. To healing and growth
• 3. To the practice of speech-language pathology
• Fundamentals of Narrative.
• 4. Autoethnographic narratives
• 5. Illness narratives
• 6. Psychobiology of narrative
• The Development of a Clinician: Stories from a Clinical Life.
• 7. Overheard on the bus
• 8. God and truth
• 9. Lunch hour
• 10. Being positive
• 11. Bitter memories
• 12. Aphasia group
• 13. Back to the beginning
• Using narrative to develop expertise.
• 14. The development of the clinical self
• 15. The growth of a client
• 16. Ethical considerations

1. Client Education: A Partnership Approach for Health Practitioners
   Edited by Leigh Tooth, Ph.D. and Kryss McKenna, Ph.D.
2. Counseling in Communication Disorders: A Wellness Perspective
   Audrey L. Holland, Ph.D.
3. Expert Practice:A Critical Discourse
   Alison Ferguson, Ph.D.
4. Work-Place Skills and Professional Issues in Speech and Language Pathology
   Betsy Vinson, MMedSc, CCC-SLP