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Transdiagnostic approaches and supported-bibliotherapy for psychological problems after stroke.

Gladwyn-Khan, Misbah 2019. Transdiagnostic approaches and supported-bibliotherapy for psychological problems after stroke. ClinPsy Thesis, Cardiff University.
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Stroke leads to high levels of disability, with up to a third of stroke survivors failing to regain function. Consequently, psychological distress in this group is common, and a third of stroke survivors experience depression, whilst a quarter experience an anxiety related difficulty. A high proportion of stroke survivors report that their psychological distress wasn’t addressed by services. The following papers present potential stepped-care options for the provision of psychological care in stroke services. Paper one Paper one presents a systematic review of brief, transdiagnostic psychological approaches. The review considers both treatment and prevention of psychological difficulties. Prevention and treatment are both important because the rate of psychological difficulties in the stroke population is known to be reliably high. Prevention may also help target the high level of multimorbidity in this population since stroke more commonly occurs at chronologically higher ages. The systematic review focussed on transdiagnostic approaches. Transdiagnostic approaches target a common psychological mechanism across a range of difficulties. The benefit of transdiagnostic approaches is that they potentially result in increased clinical utility by reducing the requirement for training in a large number of approaches. The results showed that transdiagnostic approaches, such as Motivational interviewing (MI), Problem-solving therapy (PST), acceptance and commitment therapy (ACT) are helpful for psychological difficulties after stroke. Paper two Paper two presents a study of bibliotherapy using a stroke-specific book that was developed collaboratively by stroke clinicians and stroke survivors. The book is called ‘Rebuilding your life after stroke’ and contains material to address psychological difficulties after stroke with an acceptance and commitment therapy model. The study used a multiple baseline design and reported results on a general health questionnaire (GHQ-12) and a satisfaction with life questionnaire (SWLQ). Sixteen stroke participants were recruited from clinical services and third sector organisations with expertise in stroke. The results showed that moderate-to-large effect sizes were obtained for a high proportion of the sample on both measures. The results are discussed in the context of using bibliotherapy and ACT materials to enhance provision of psychological care in stroke services. Paper 3 Paper three is a reflective paper which considers the strengths and limitations of both papers one and two. Paper three presents a discussion of the difficulties of reviewing the evidence base for transdiagnostic approaches as studies more commonly investigated therapies using single-diagnostic criteria. Paper three also discusses the strengths and challenges of conducting multiple baseline design studies and the issues of recruitment encountered during the study.

Item Type: Thesis (DClinPsy)
Date Type: Completion
Status: Unpublished
Schools: Psychology
Subjects: H Social Sciences > H Social Sciences (General)
Funders: DClinPsy Programme
Date of First Compliant Deposit: 26 September 2019
Last Modified: 26 Sep 2019 12:56

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