“Challenges and practical solutions for implementing online groups – Portuguese Institute of Aphasia (IPA)‘s experience”

Background The shift to online service delivery during the COVID-19 pandemic introduced both opportunities and challenges for group-based interventions involving people with aphasia (PWA).Aims To explore the experiences of PWA and speech and language therapists (SLTs) at the Portuguese Institute of Aphasia (IPA) in initiating and participating in online group sessions, during and after the COVID-19 pandemic.Method and Procedures A qualitative exploratory study was conducted using online focus groups with PWA (n = 10) and SLTs (n = 4). Participants included PWA attending IPA online groups and IPA SLTs delivering telepractice. Two focus groups were conducted with PWA (organized by severity) and one with SLTs, using semi-structured guides. Aphasia-friendly strategies (e.g. simplified language, visual supports, multimodal communication) were used to facilitate PWA participation. All focus groups were conducted via Zoom, recorded, transcribed verbatim, and analysed using reflexive thematic analysis.Outcomes and Results Four themes were identified: (1) access to technology and digital literacy, (2) communication and interaction, (3) perceived advantages and limitations, and (4) strategies facilitating participation. Initial challenges reported included connectivity issues, platform use, and managing interactional dynamics (e.g. delays, overlapping speech), particularly for individuals with more severe aphasia, who often required caregiver support. Over time, participants described adapting with multimodal strategies and clinician facilitation. Participants viewed online groups as valuable for social interaction and accessibility. Hybrid delivery models were frequently preferred.Conclusions Online group therapy is a viable and meaningful intervention for PWA beyond the pandemic context. PWA participation in online groups is shaped by the interaction of individual, environmental, and therapeutic factors, highlighting the importance of clinician-led scaffolding and supporting the integration of flexible, hybrid models of care.