Telehealth delivery of memory rehabilitation following stroke.

Making the Most of Your Memory The Making the Most of your Memory is a manualised six-week memory skills program. It has been designed for small rehabilitation groups and validated for people with stable neurological disorders and everyday memory complaints. For the purposes of this project, the program has been adapted for delivery to participants on an individual basis, as well as delivery via internet videoconferencing (i.e. software programs such as Skype or Zoom). Participants will attend one memory skills training session per week for a six week period. The sessions will be up to two hours in duration, based on the needs of the participant and level of interaction. Sessions will be administered by Provisional Psychologists on Clinical Psychology or Neuropsychology placement at the Monash Psychology Centre (MPC), supervised by Dr Dana Wong. Participants will engage with the program either via group delivery at the MPC, individually face-to-face at the MPC, or individually via internet videoconferencing. Therefore there will be four arms to the study: group face-to-face, individual face-to-face, individual internet delivery, and a wait-list control. Sessions will cover psychoeducation regarding the impact of stroke on memory and the contributions from lifestyle factors such as diet, exercise, sleep, and stress. Participants will also be provided with comprehensive training in a range of internal strategies, use of external tools, and environmental adjustments designed to support everyday memory functioning. The program also includes exercises to be discussed and carried out either in-session or as homework between sessions, designed to encourage practise and generalisation of skills. Adherence to the requirements of the program will be monitored by shared spreadsheets and calendars accessible by related clinicians and the researcher, in order to register session attendance. A booster session will be offered to participants on a randomised allocation, at a follow-up point approximately 6 weeks following completion of the program. The booster session will run for up to 2 hours (based on the needs of the participant and level of interaction) and will follow the same format as the participant's earlier sessions (i.e. group face-to-face, individual face-to-face, or individual internet delivery). The booster session will be less structured than the earlier sessions, and will focus on goals and strategies that will have been highlighted through discussion as most relevant to the participant. A single session will also be offered to a close friend or family member during the process, in order to provide additional support to the participant at home. This session will run for approximately 1.5 hours, and will follow the same format as their close-other (i.e. group/individual face-to-face, or individual internet delivery). The session will comprise a condensed summary of the psychoeducation, lifestyle factors, internal memory strategies and environmental adjustment sections of the memory skills program. All participants will also be asked to complete a range of objective and subjective assessment tasks designed to measure memory functioning immediately prior to the rehabilitation, immediately following the rehabilitation, and at six-week and twelve-week follow up points.