ASSBI Students

“I Still Love the World”: A Client-Led Journey of Reclaiming Identity

My name is Claudia Mazzeo, and I am a Student Speech Pathologist studying at the University of Sydney SPEECH clinic. My placement, under the supervision of Petra Avramovic, led me to meet my wonderful client, Margaret.

Margaret is a warm, social individual who loves to laugh and connect with those around her, but due to her lived experience of aphasia since 2020, her communication has made this challenging. Alongside her aphasia, she also experiences some additional cognitive changes, which together have created further obstacles in daily life. Margaret expressed that she has experienced ‘terrible’ feelings due to withdrawal from social activities. Before her health changed, Margaret was an active member of the scientific community, publishing papers on Haematology and carrying out life-saving work.

For many years since her stroke, Margaret’s therapy had focused mainly on impairment-based treatment approaches. Together, we identified that she wanted to shift towards addressing the participation impacts of her aphasia on her everyday life, and decided it was time to pursue a more meaningful, rewarding, self-fulfilling experience. This would not only help improve her positive self-identity and quality of life, but also allow her to practice her language skills in a functional way.

Project-based intervention gave Margaret a person-centred and meaningful way to work on her communication. She was able to direct her energy into creating something with purpose, a pamphlet to advocate for others living with aphasia, while also working towards her own communication goals. Researchers such as Behn and colleagues have shown that this type of approach can be especially rewarding, because it combines therapy with opportunities for self-expression and contribution. It also reflects the principles of the Life Participation Approach to Aphasia, which encourages people to take part in the activities that matter most to them. By doing so, therapy not only supports communication but also builds confidence, identity, and connection. Project-based work can also draw on elements of evidence-based techniques like script training and supported conversation, helping with word-finding, sentence building, and comprehension in a way that feels real and relevant to everyday life.

Margaret chose to create an advocacy pamphlet sharing her life story and providing advice on how to support people with aphasia. Within each session, it was rewarding to see her experience laughter, smiles and enthusiasm as she discussed photos and life achievements. Upon greeting her in the waiting room each session, her face would light up with happiness and eagerness to re-engage with her project.

I knew then her project was making a difference.

Margaret shared positive self-narratives, which were included within the pamphlet, such as “I still love the world and people”. This is a true testament to the improvements in self-identity that this intervention can bring. Margaret built a strong therapeutic bond with me as a result, ultimately sharing her diagnosis of early-stage Alzheimer's disease, which she was not initially planning to disclose. She chose to omit this from her pamphlet, reflecting the depth of autonomy and trust that is fostered through this intervention approach.

Margaret herself reviewed her success towards completing her pamphlet as “fantastic, 10 out of 10”, and shared how much she valued having a tangible, meaningful final product that she was excited to give to her friends, family and health professionals.

Witnessing Margaret’s joy, resilience, and trust throughout this journey was deeply moving and a privilege to be a part of her reclaiming a positive self-identity. I hope this inspires students and clinicians alike to prioritise project-based interventions with their clients, as it makes an everlasting change.