“Building boats and riding bikes”: one-year longitudinal study of identity and life participation following narrative co-construction in aphasia

Background Aphasia disrupts sense of self and constrains the narrative capacity essential for identity reconstruction. While narrative co-construction approaches show promise for supporting identity development in people with aphasia, little is known about whether intervention effects persist beyond the immediate post-intervention period.Aims This longitudinal qualitative study explored participants’ lived experiences one year after completing the My Story Project, a collaborative storytelling intervention, with a focus on understanding the role their co-constructed stories played in their lives in the intervening year.Methods & Procedures Three male participants with chronic aphasia (5–6 years post-stroke, ages 56–67) who had completed the My Story Project intervention participated in semi-structured follow-up interviews 12–13 months post-intervention. Interviews explored participants’ experiences with the intervention and changes over the preceding year. Data were analyzed using reflexive thematic analysis grounded in an interpretive, constructivist paradigm. The Communication Confidence Rating Scale for Aphasia was administered to assess sustained changes in communication confidence.Outcomes & Results Three themes captured the longer-term impact: Becoming and Believing (ongoing identity development, agency, and hope); Envisioning and Achieving (translation of goals into concrete achievements including boat building and adaptive cycling); and Enduring (continued story relevance). Communication confidence gains were maintained or increased (converted score changes +3 to +9). Critically, behavioral achievements emerged six to twelve months post-intervention rather than immediately. Identity work remained active and complex, with both behavioral changes and ongoing self-doubt, suggesting identity reconstruction as a continuing process rather than fixed outcome.Conclusions The sustained transformation observed – participants building boats, riding bikes, and continuing to engage with their stories – demonstrates that narrative co-construction initiates processes that remain active long after intervention concludes. Behavioral changes emerged months after intervention rather than immediately, challenging conventional expectations for rapid outcomes and highlighting the need for extended follow-up timelines when evaluating narrative interventions. Findings position narrative intervention as addressing both internal identity work and concrete life participation outcomes essential to person-centered aphasia rehabilitation.