Table 3

Fidelity criteria for treatment delivery within the treatment modules

Active ingredientBehaviourFidelity componentExperimental treatmentAttention control treatment
Principles of supported conversationUsed appropriate level of communication strategies to support the person with aphasia’s (PWA) receptive language skills
For example, adapted resources, writing, gesture, drawing, repetition
CompetenceEssential criteriaEssential criteria
Principles of supported conversationUsed appropriate level of communication strategies to support the PWA’s expressive language skills
For example, suggested using drawing, writing, pointing, gesture, verification
CompetenceEssential criteriaEssential criteria
Behaviour change
The therapist delivered only the target treatment as described in the manual and in training sessions
For example, spent the majority of the session discussing topics related to the study treatment; for queries/discussions not related to the study treatment, therapist dealt appropriately or sign-posted to an appropriate source of information or advice
ContentEssential criteriaEssential criteria
Collaborative learningExplained the rationale for the module
For example, how the treatment module relates to the participant’s (and family member’s) goals
ContentDesirable criteriaDesirable criteria
Collaborative learningDemonstrated an appropriate level of engagement, rapport and warmth, in line with their familiarity with the PWA (and family member)
For example, warm tone of voice; appropriate use of humour; avoidance of criticism; encouragement of communication attempts; identified what information the PWA (and family member) already had access to in relation to the study treatment and the gaps in information/understanding
CompetenceDesirable criteriaDesirable criteria
Collaborative learningEvidence of therapeutic alliance
For example, seeks agreement; avoid dominating the discussion; active listening; adapts approach to engage the PWA (and family member)
CompetenceDesirable criteriaDesirable criteria
Behaviour changeReviewed homework from the previous module and explored reasons for non-completion of homework—experimental treatment only ContentDesirable criteriaNot targeted
Behaviour change
Targeted behavioural change—experimental treatment only
For example, asked questions to gain a better understanding of the PWA (and family member); asked questions to prompt the PWA (and family member) to explore the topic or to make it personally relevant to them; used the written materials as a platform to generate further discussion; discussed challenges to achieving the goal for the specific module and worked with the participant to problem-solve; prompted the PWA (and family member) to keep a written note of any activities they wanted to action as ‘homework’
CompetenceEssential criteriaNot targeted
Behaviour change
Person-centred approach
Effectively engaged the PWA (and family member) in the practical activities—experimental treatment only
For example, gave accurate feedback on practical activities; agreed an appropriate homework
CompetenceDesirable criteriaNot targeted
Experimental treatment Total score (max 9, min 7.2)
Essential behaviours score (min 4)
Attention control treatment Total score (max 6, min 4.8)
Essential behaviours score (min 3)