None listed
Conditions
Brief summary
Although stroke in young adults (18-65) is rare, studies have demonstrated that stroke in this age group is becoming increasingly more common. In younger adults stroke occurs in a life stage where they have an active social life, are starting to form new families (or are responsible for young children), and have active careers. Previous studies have found that young stroke survivors perceive assessments, interventions, and rehabilitation developed around older stroke survivors to be inadequate in dealing with the problems they experience. Previous research has identified a number of unmet needs and problems expressed by younger stroke survivors during the rehabilitation period, including: Caring for younger children, relationships with spouse, sexuality, invisible cognitive disabilities, fatigue that affects engagement in age appropriate activities, loss of employment, reduced intellectual fulfilment, and financial problems. The current study aims to evaluate the efficacy of psychotherapy with younger stroke survivors who are experiencing symptoms of depression and anxiety, as this is an area that has been neglected in previous research. This study also aims to collect information regarding young stroke survivors problem solving abilities and their quality of life. This study will include two groups: Problem Solving Therapy, which will be compared with a waitlist control group. The therapy sessions will run for 6 weeks and will consist of one hour weekly sessions. Measures of depression, anxiety, quality of life and problem solving ability will be taken at base line, at the end of the treatment sessions and at a three month follow up session. It is hypothesised that scores on the depression and anxiety measures will decrease slightly in the waitlist control group, however the decrease on these measures will be significantly greater for the problem solving therapy group. It is also hypothesised that participants in the problem solving therapy group will show a significant increase in more effective problem solving strategies and a significant decrease in ineffective problem solving strategies. It is hypothesised that participants in the problem solving therapy group will show a significantly greater improvement on measures of quality of life than the control group.
Interventions
1.Problem Solving Treatment (PST): Participants in this group will be offered the brief psychological therapy, which will aim to teach them how to use their own skills to cope with their everyday life problems in a systematic way. The therapy comprises seven stages: (1) Explanation and rationale, (2) Clarification and definition of the problems, (3) Establishing achievable goals, (4) Generating solutions, (5) Selective preferred solution, (6) Implementing solution, (7) Evaluation of progress. Th
1.Problem Solving Treatment (PST): Participants in this group will be offered the brief psychological therapy, which will aim to teach them how to use their own skills to cope with their everyday life problems in a systematic way. The therapy comprises seven stages: (1) Explanation and rationale, (2) Clarification and definition of the problems, (3) Establishing achievable goals, (4) Generating solutions, (5) Selective preferred solution, (6) Implementing solution, (7) Evaluation of progress. The intervention will be made up of six group sessions of one hour a week. The programme will specifically target problems resulting from their stroke. Throughout the sessions the participants will receive psycho-education on post stroke depression and anxiety in general and learn specifically about the mechanics of PST and why it is effective. Therapists will guide patients to generate a list of problems that they are currently experiencing in their lives and select and clearly define a moderately challenging one to focus on. Patients will then identify a goal, related to that problem, that they would like to achieve and brainstorm strategies to meet the goal, producing as many solutions as possible. Following this, patients assess the pros and cons of each solution they have created and choose one or more to implement. They then generate an action plan containing steps by which to carry out this solution. The action plan will be reviewed and the success (or lack of success) at achieving the goal is discussed and a new solution will be developed if necessary. The principal investigator (myself, Charlotte Wainwright, a clinical psychology trainee) will run the Problem Solving Therapy Sessions with a co facilitator (another clinical psychology trainee). The principal investigator will always have access to a registered clinical psychologist during sessions as the sessions will be run at the Massey University Psychology clinic. The principal investigator will attend supervision after each therapy session. The sessions will be run in group format of six to eight participants. A register of attendance will be taken at the beginning of each session.
Sponsors
Charlotte Wainwright
Study design
Allocation
Non-randomised trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Inclusion criteria for participants will be a diagnosis of stroke within the previous six months to two years of the current study. Participants will be between the ages of 18 and 65 and will be able to get to and partake in therapy sessions. Participants will also be experiencing symptoms of depression and anxiety.
Exclusion criteria
Participants will be excluded from the study if they suffer from severe aphasia or are unable to give informed consent and therefore can not take part in therapy sessions or complete assessment measures.
Outcome results
None listed