Optimising mental health and wellbeing after post-stroke aphasia

Aphasia and communication support with self-selection of 1 of 3 psychological therapies: behavioural activiation; problem-solving therapy; or relaxation therapy. The therapy will include the following: Participants will be provided with therapy worksheets for use in therapy session and home practice. Intervention providers will be provided with a therapy manual which includes instructions and therapy content for each therapy session. Procedures include: Behavioural activation: 7 x individual therapy sessions (in person or via telerehabilitation for people living in regional/rural areas) covering following themes: -Identifying meaningful activities -Structuring and scheduling activities -Consistent daily activation -Overcoming barriers Problem-solving therapy: 7 x individual therapy sessions (in person or via telerehabilitation for people living in regional/rural areas) covering following themes: -Identifying problems -Listing solutions -Potential consequences -Best strategies -Plan actions, implement plan and review results Relaxation therapy: 7 x individual therapy sessions (preferably face to face with clinician or via phone/telehealth with clinician if unable to attend in person for up to two sessions) covering following themes: -Explaining the relaxation response -How & when to use relaxation exercises -Practice of strategies (e.g., breathing & how to tense and relax muscles throughout the body) -Planning to do relaxation exercises regularly and independently - each of the procedures, activities, and/or processes used, including any enabling or support activities; Intervention provider will be a qualified stroke health professional (Grade 1,2 or 3 clinician and experience with managing at least one person with aphasia in past 12 months). They will be trained by the research team in supported conversation for adults with aphasia (SCA) and all therapy types (behavioural activation; problem solving; relaxation therapy). Supervision will be available from senior allied health team members/managers and/or medical staff in the clinical setting as required. The research team will offer regular supervision and support to the intervention providers as required (composed of psychologists and speech pathologists). Mode of delivery: individual sessions and in person or via telerehabilitation for people living in regional/rural areas. Intervention will be delivered 1 x session per week (30-60 mins) for 7-8 week duration. The intervention will occur at community centre or participant's home (if in person) or via telerehabilitation for those living in regional/rural areas. Intervention providers will keep a therapy log sheet and video-record up to 2 therapy sessions per participant to monitor intervention fidelity. 'Attention' control arm will include stroke health information (choice of 6 out of 9 topics e.g., high blood pressure, cholesterol, physical activity and nutrition). The content will be presented by a stroke allied health professional using study-specific videos and written information using aphasia-friendly format (content acknowledges Stroke Foundation for information from their website as source of information adapted for this study https://strokefoundation.org.au/). The videos and written information aren't available to share publicly due to the need to test acceptability in this research. All aspects of the attention control sessions will be similar in conditions as the intervention arm (except for the content). That is, the following will apply to the attention control group: Mode of delivery of sessions: 7 individual sessions in person / via telerehabilitation for people living in regional / rural areas Frequency of sessions: 1 x session per week (30-60 mins) for 7 weeks, final session summarises the 6 previous sessions Location of the sessions: via telerehab from home or in person at clinic in health network Monitor of adherence/fidelity: Intervention providers will keep a therapy log sheet (planned versus implemented components of session) and liaise with primary researcher if any issues in facilitating sessions via meetings (phone, videoconference). Aspects of the 'attention' control arm are similar to the intervention, however content will involve stroke information provision not psychological therapy.