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Forgiveness and Freedom in terms from aphasia:
findings from WELLHEAD and SHALOM
Katharyn Mumby1, Hazel Roddam2
1Weston Area Health NHS Trust, 2University of Central Lancashire
METHODS
•The project, supported by the hospital
chaplain, involved an aphasia steering group
selecting a spiritual health assessment
(SHALOM, Fisher 2010) and shaping a
toolkit (WELLHEAD) developed by Mumby
(2017) for supporting life review, spiritual
self-assessment and goal-setting.
•Under UK NHS Ethical approval, ten
additional people discharged from speech
and language therapy with aphasia and
diverse religious backgrounds took part in
in-depth videoed interviews piloting these
materials.
•Thematic qualitative data analysis of the
interviews in NVivo was subject to cross-
checking and considered spiritual health in
accessible terms, highlighting the role of
verbalisation in processes concerning
spiritual change and growth.
REFERENCES:
Fisher, J. (2010). Development and application of a spiritual well-being questionnaire called
SHALOM. Religions, 1: 105-121.
Mumby, K., & Hobbs, E. Q. (2017). The Shape of Discipleship. The Reader, 117 (1), 16-17.
Mumby, K., & Whitworth, A. (2013). Adjustment processes in chronic aphasia after stroke:
Exploring multiple perspectives in the context of a community-based intervention.
Aphasiology, 27 (4), 462-489.
ACKNOWLEDGMENTS:
Revd. David Grace, Hospital Chaplain at Weston General Hospital for his input concerning chaplaincy
perspectives, comments on drafts and for providing safeguarding for the participants.
All the people with aphasia who formed the PPI Steering Group, including Adrian Wilmot, Eriks
Erdmanis, Marie Flood, John Hawkins and Jennifer Stephens. Hospital Volunteers Savvas Michael Joanne
Kumar and Sam Cunningham for note-taking in the groups. Harvey Dymond, R&D lead of Weston Area
Health Trust for his support with this unfunded work.
Huge thanks to the people with aphasia who shared the meaning and purpose in their lives
BACKGROUND
•Aphasia (acquired language impairment)
restricts verbalisation for communication
and for inner rationalisation, so it brings
huge challenges for resolving issues where
words are the normal currency, such as
forgiveness and reconciliation.
•This project is a collaboration with people
with aphasia working from the broad
definition of spirituality as the search for
meaning and purpose in life. The project
crosses traditional boundaries between
medical, psychosocial and spiritual models,
building on previous work in adjustment
post-stroke (Mumby and Whitworth 2013)
and a model reported in Mumby and
Hobbs (2017).
•This pioneering project establishes a
structure for spiritual assessment and a
novel intervention (WELLHEAD).
Dr Katharyn Mumby, Founder and Director: New Pathways Speech & Language Therapy
Licensed Reader, Diocese of Exeter, UK
kath@new-pathways.co.uk
RESULTS
•‘Total communication’ facilitated the use of
SHALOM and the WELLHEAD toolkit and the
results were anchored to the dimensions in
WELLHEAD of WIDE LONG HIGH and DEEP in
exploring spiritual health.
•Allowing people to explore spirituality in
their own terms and on their own terms was
crucial to the process, including insights into
forgiveness freedom and reconciliation.
CONCLUSIONS
•Simplifying the terms in use for spiritual
dialogue offers a way to promote inclusion,
positive change, and a sense of unified
purpose, illustrated in aphasia.
•The findings provide a platform for using
WELLHEAD in other settings and for wider
populations for whom verbalisation may be
challenging e.g. in those with dementia.
0
1
2
3
4
5
6
7
8
9
10
Comfortable Uncomfortable Easy questions Appropriate time Helping thinking Willingness to
continue
Definite action
plan
Participants who said 'yes’ in feedback questionnaire
(maximum is all 10 people)
www.wellheadresources.wordpress.com
Next steps:
You felt that DEEP, though well-developed (8/10) may
need to move forwards to help growth in the other areas.
Not just alone, as previously, but with others.
Needing to let go of some things –on my own.
Considering help from a more neutral person.
Helping others through my experience
Dimension
Score
/10
Key aspects
WIDE
7
Small groups are easiest for being connected.
Calm is found from the environment e.g. by the sea, or remembering that.
LONG
6
Still feels like ‘early days’. Personal story now has meaning
–it has become clearer in
the last few months (? Linked to job role).
A sense of having ‘crossed a bridge’. Tradition may mean doing things regularly.
HIGH
6
‘Unknown’ is the main word. Hope for the future is there, based on information
rather than belief or truth (needs to be realistic). A sense of searching for something
beyond.
DEEP
8
A positive sense of finding freedom, within self. Needing to deal with guilt
–painful.
May involve forgiveness (of self and others). Feels like ‘leaving the cage’.
A single case example: WELLHEAD results