Brief group‐based acceptance and commitment therapy for stroke survivors

Abstract

<jats:sec><jats:title>Objectives</jats:title><jats:p>To date, the efficacy of acceptance and commitment therapy (<jats:styled-content style="fixed-case">ACT</jats:styled-content>) for stroke survivors has not been established. The aim of this study was to evaluate the efficacy of group‐based <jats:styled-content style="fixed-case">ACT</jats:styled-content> for stroke survivors in comparison with treatment as usual (<jats:styled-content style="fixed-case">TAU</jats:styled-content>) controls.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Fifty‐three participants were randomly assigned either to group‐based <jats:styled-content style="fixed-case">ACT</jats:styled-content> (<jats:styled-content style="fixed-case">ACT</jats:styled-content>ivate Your Life after Stroke) or to a <jats:styled-content style="fixed-case">TAU</jats:styled-content> control group (60% male; mean age: 63 years). The <jats:styled-content style="fixed-case">ACT</jats:styled-content> intervention consisted of four weekly 2‐hr didactic group sessions. Therapeutic effects were measured by examining changes in depression (primary outcome), anxiety, hope, health‐related quality of life, self‐rated health status, and mental well‐being. Measures were completed at pre‐treatment, post‐treatment, and 2‐month follow‐up. A mixed‐design repeated‐measures multivariate <jats:styled-content style="fixed-case">ANOVA</jats:styled-content> was conducted to analyse the findings.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Analysis based on intention to treat found that compared to participants in the <jats:styled-content style="fixed-case">TAU</jats:styled-content> control, group‐based <jats:styled-content style="fixed-case">ACT</jats:styled-content> significantly reduced depression and increased self‐rated health status and hopefulness in stroke survivors, with medium effect sizes. Significantly more participants reached clinically significant change of depression in the <jats:styled-content style="fixed-case">ACT</jats:styled-content> intervention in comparison with the control group.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The results correspond with previous studies of group‐based <jats:styled-content style="fixed-case">ACT</jats:styled-content> with other long‐term conditions. The findings from this current study suggest group‐based <jats:styled-content style="fixed-case">ACT</jats:styled-content> may have promising utility and could offer a suitable low‐intensity psychological intervention for stroke survivors. However, further large‐scale research is required.</jats:p></jats:sec><jats:sec><jats:title>Practitioner points</jats:title><jats:p> <jats:list list-type="bullet">

<jats:list-item><jats:p>Acceptance and commitment therapy (<jats:styled-content style="fixed-case">ACT</jats:styled-content>), delivered didactically to groups of stroke survivors, proved feasible and acceptable.</jats:p></jats:list-item>

<jats:list-item><jats:p><jats:styled-content style="fixed-case">ACT</jats:styled-content> had benefits, relative to treatment as usual, for depression, health status, and hope.</jats:p></jats:list-item>

<jats:list-item><jats:p>Several secondary outcome variables did not show dependable benefit for <jats:styled-content style="fixed-case">ACT</jats:styled-content>: anxiety; health‐related quality of life; and mental well‐being.</jats:p></jats:list-item>

<jats:list-item><jats:p>Results should be treated as preliminary as the sample size was small, blinding was not possible, concomitant treatments were not monitored, and there was no attention control condition.</jats:p></jats:list-item>

<jats:list-item><jats:p>Despite these limitations, group‐based <jats:styled-content style="fixed-case">ACT</jats:styled-content> merits further study as a potentially effective intervention.</jats:p></jats:list-item> </jats:list> </jats:p></jats:sec>