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This investigation examined how the interpretive practices of a speech–language pathologist (SLP) contributed to the construction of identity among adults with traumatic brain injury (TBI) during group therapy in a hospital setting. Six group therapy sessions were video-recorded and transcribed (yielding a total of 8,056 utterances). Attention was paid to patient expressions of identity and ability, the communicative functions of these expressions, and the manner in which these expressions were evaluated by the SLP. The SLP was also interviewed regarding the nature of therapy practice. Analysis revealed that the interpretive voice of the SLP dominated in ascribing a patient identity of self as damaged goods. Implications are discussed in terms of how the institutional setting, the perceived nature of TBI, the agenda of the SLP, and the interactional substrate combined to motivate such interpretive practices on the part of the SLP.

The construction of identity during group therapy among adults with traumatic brain injury