A systematic review of the effectiveness of group-based Acceptance and Commitment Therapy for neurological conditions and an empirical study of staff perceptions of a stroke specific self-management book

Lewis-Dunford, Hannah 2020. A systematic review of the effectiveness of group-based Acceptance and Commitment Therapy for neurological conditions and an empirical study of staff perceptions of a stroke specific self-management book. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

This thesis comprises of two papers; a systematic review and an empirical study. The systematic review explored the effectiveness of group-based Acceptance and Commitment Therapy interventions for those with a diagnosed neurological condition. Individuals with a neurological condition have the lowest health related quality of life of any long-term health condition with around one quarter being diagnosed with a co-morbid mental health condition. Acceptance and commitment therapy (ACT) is effective for those with long-term health conditions with a growing evidence base. However, reviews of effectiveness in those with neurological conditions are lacking. The systematic review aimed to evaluate effectiveness and quality of studies of group-based ACT for adults with neurological conditions. Searches for peer-reviewed articles were carried out using Psych Info, Ovid MEDLINE and EMBASE. Two reviewers independently screened and rated all relevant studies. Twelve studies were included: eight were randomised controlled trials, one used a randomised design with repeated measures, one used a quasi-experimental design with pre-post measures and two used pre-post designs with no control group. The neurological conditions which were covered by the included studies were Multiple Sclerosis, Epilepsy, Fibromyalgia, Stroke and Chronic Headache. Interventions were targeted at a number of outcomes including Quality of Life, distress and the processes of ACT. The results of the review generally supported the finding that group-based ACT seems to be as effective as other active treatments and more effective than Treatment as Usual or Waiting list controls. Improvements as a result of ACT were found in all studies which examined the level of pain related disability, the impact of the neurological condition, frequency of seizures, secondary fatigue, and the core processes of ACT. The empirical paper was a qualitative study of a stroke specific self-management book. The study was thought to be beneficial to the evidence base for stroke as despite pressure to deliver psychological interventions to those who have experienced a stroke, there continues to be a lack of psychological resources available for this patient group. Depressive symptoms have also been found to be reduced in stroke survivors when they are provided with information post-stroke, thus emphasising the potential role for self-help resources in this area. The aim of the paper was therefore to gain insight into staff working within stroke services experiences of using a stroke specific self-management book in their practice. Interviews with fifteen staff members working within stroke services who had used the ‘Rebuilding your life after stroke’ (Morris et al., 2017) self-management book were conducted and analysed using a thematic analysis approach. Staff members varied in their role, training, age and length of service working with a stroke population. All participants appeared to believe that the book was a welcome addition to the resources available within stroke services. The book appeared to be considered as a form of peer support and was felt to be accessible from a practical point of view. Professional role and level of training appeared to influence the views of interviewees, how they used the book in practice and how user-friendly they felt certain ACT concepts were for themselves and the stroke survivors they work with. The main conclusion of the current study was that in general ‘Rebuilding your life after stroke’ (Morris et al, 2017) had been positively received and welcomed by those staff interviewed. All participants agreed that the book had in some way supplemented their practice with most remarking on the benefits of having such a resource available both for themselves and the stroke survivors they work with. The study did however find that staff without knowledge of psychological concepts such as ACT may find training around the book useful in order to gain the most benefit from it within their practice. This therefore outlines a potential role for psychologists within the area of staff training and upskilling of the workforce working within stroke services.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	24 September 2020
Last Modified:	24 Sep 2021 01:30
URI:	https://orca.cardiff.ac.uk/id/eprint/135079

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