The efficacy of therapist-supported acceptance and commitment therapy-based bibliotherapy for psychological distress after stroke: A single-case multiple-baseline study

Gladwyn-Khan, Misbah and Morris, Reg ORCID: https://orcid.org/0000-0002-8250-9315 2023. The efficacy of therapist-supported acceptance and commitment therapy-based bibliotherapy for psychological distress after stroke: A single-case multiple-baseline study. Behavioural and Cognitive Psychotherapy 51 (1) , pp. 87-104. 10.1017/S135246582200042X

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Abstract

Background: Psychological distress is common after stroke, and affects recovery. However, there are few evidence-based psychological treatments. This study evaluates a bibliotherapy-based approach to its amelioration. Aims: To investigate a stroke-specific self-management book, based on acceptance and commitment therapy (ACT), as a therapist-supported intervention for psychological distress after stroke. Method: The design was a single case, randomised non-concurrent multiple-baseline design (MBD). Sixteen stroke survivors, eight males and eight females (mean age 60.6 years), participated in an MBD with three phases: A (randomised-duration baseline); B (intervention); and follow-up (at 3 weeks). During the baseline, participants received therapist contact only. In the bibliotherapy intervention, participants received bi-weekly therapist support. The primary measures of psychological distress (General Health Questionaire-12; GHQ-12) and quality of life (Satisfaction with Life Scale; SWLS) were completed weekly. Secondary measures of mood, wellbeing and illness impact were completed pre- and post-intervention. Results: Omnibus whole-group TAU-U analysis was statistically significant for each primary measure with a moderate effect size on both (0.6 and 0.3 for GHQ-12 and SWLS, respectively). Individual TAU-U analyses demonstrated that the majority of individuals exhibited positive change. All the secondary measures showed significant pre–post improvements. Eighty-one per cent of participants reported the book was helpful and 81% also found the ACT-based sections helpful. Relative risk calculations showed finding the book helpful was associated with improvement in GHQ-12 and SWLS scores. Conclusions: ACT-based bibliotherapy, with therapist support, is a promising intervention for psychological difficulties after stroke.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Psychology
Publisher:	Cambridge University Press
ISSN:	1352-4658
Date of First Compliant Deposit:	14 December 2023
Date of Acceptance:	18 August 2022
Last Modified:	18 Dec 2023 14:45
URI:	https://orca.cardiff.ac.uk/id/eprint/164825

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