Post‐stroke depression: the case for augmented, individually tailored cognitive behavioural therapy

Broomfield, Niall M.; Laidlaw, Ken; Hickabottom, Emma; Murray, Marion F.; Pendrey, Rachel; Whittick, Janice E.; Gillespie, David C.

doi:10.1002/cpp.711

Cited by 99Stroke Rehabilitation and RecoveryAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesCancer survivorship and care

Post‐stroke depression: the case for augmented, individually tailored cognitive behavioural therapy

Broomfield, Niall M., Laidlaw, Ken, Hickabottom, Emma, Murray, Marion F., Pendrey, Rachel, Whittick, Janice E., Gillespie, David C.·2011·Clinical Psychology & Psychotherapy

DOI 10.1002/cpp.711

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Abstract

In this review, we begin by considering why post‐stroke depression (PSD) is so prevalent. We then examine the current evidence base to support cognitive behavioural therapy (CBT) as a treatment approach for the condition. While there is limited evidence currently, we demonstrate that much remains to be established with regard to PSD and the efficacy of CBT. We argue there is every reason to believe CBT should be an effective treatment, but that clinicians must augment and individually tailor this approach to ensure effectiveness. We set out our rationale for a novel augmented, individually tailored CBT protocol, and describe five key components that we believe once incorporated, and tested using randomized controlled methods, should enhance treatment outcome of PSD. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioner Message: • Depression is a common consequence of stroke. • Despite a lack of clear evidence, there is reason to believe cognitive behavioural therapy (CBT) for post‐stroke depression should be effective, if it is adapted and tailored to the specific needs of stroke survivors. • Augmented and individually tailored therapy using motivational interviewing techniques, grief resolution, selection optimization compensation, cognitive deficits adaptations and executive skills training is recommended. • It is important to individualize augmented CBT, based on principles of case formulation.

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Based on a literature review, several alterations of psychotherapy were identified: memory aids, simplified tasks, emphasis on behavioural techniques, repetition of content, structured sessions, incorporating breaks, use of concrete examples, involving relatives in therapy or homework tasks, one-on-one face-to-face sessions, adjusting the number of sessions and the duration of the sessions, and包括
“Based on a literature review, several alterations of psychotherapy were identified: memory aids (visual resources, workbook, session summaries, written notes), simplified tasks, emphasis on behavioural techniques, repetition of content, structured sessions, incorporating breaks, use of concrete examples, involving relatives in therapy or homework tasks, one-on-one face-to-face sessions, adjusting”
From Acceptance and commitment therapy for people with acquired brain injury: Rationale and description of the BrainACT treatment. (2023) · cites this paper as [28]
The acceptance and commitment therapy treatment protocol was adapted to the needs and possible cognitive deficits of patients with brain injury, based on suggestions made in previous literature and knowledge gained in clinical practice.
“Fourth, the ACT treatment protocol was adapted to the needs and possible cognitive deficits of patients with brain injury. These adaptations were based on suggestions made in previous literature and knowledge gained in clinical practice.”
From The BrainACT study: acceptance and commitment therapy for depressive and anxiety symptoms following acquired brain injury: study protocol for a randomized controlled trial. (2019) · cites this paper as [46]

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Post-Stroke Fatigue: Epidemiology, Clinical Characteristics and Treatment
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Post stroke depression: the sequelae of cerebral stroke
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Anxiety After Stroke: The Importance of Subtyping
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Positive Psychology and Brain Injury Rehabilitation
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“It has been argued that CBT can and should be adapted for the particular circumstances and needs of people with ABI; for example, modified treatment frameworks have been described for the stroke population (Broomfield et al., 2011; Kneebone, 2015).”
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Association Between Stress and Tinnitus—New Aspects
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Classifying Major Depressive Disorder Using fNIRS During Motor Rehabilitation
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Literature and Art Therapy in Post-Stroke Psychological Disorders
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Augmented Cognitive Behavioral Therapy for Poststroke Depressive Symptoms: A Randomized Controlled Trial
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A Framework to Support Cognitive Behavior Therapy for Emotional Disorder After Stroke
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Post-stroke emotional adjustment: A modified social cognitive transition model
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AIDE–Acute Illness and Depression in Elderly Patients. Cognitive Behavioral Group Psychotherapy in Geriatric Patients With Comorbid Depression: A Randomized, Controlled Trial
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Is Pain Associated With Suicidality in Stroke?
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Development of a novel positive psychology-based intervention for couples post-stroke.
Terrill, A. L., Reblin, M., MacKenzie, J. J., Cardell, B., Einerson, J., Berg, C. A., Majersik, J. J., & Richards, L. G. (2018) · Rehabilitation Psychology · doi:10.1037/rep0000181 · Cited by 39 · see citing works
Age-appropriate augmented cognitive behavior therapy to enhance treatment outcome for late-life depression and anxiety disorders
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Is Fatigue Associated With Suicidality in Stroke?
Tang, W. K., Lu, J., Mok, V., Ungvari, G. S., & Wong, K. S. (2011) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2011.02.018 · Cited by 34 · see citing works
The effects of music listening interventions on cognition and mood post-stroke: a systematic review
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Treating anxiety after stroke using cognitive-behaviour therapy: Two cases
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Acceptance and commitment therapy for individuals with depressive and anxiety symptoms following acquired brain injury: A non-concurrent multiple baseline design across four cases.
Rauwenhoff, J. C. C., Bol, Y., Peeters, F., van den Hout, A. J. H. C., Geusgens, C. A. V., & van Heugten, C. M. (2023) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2022.2053169 · Cited by 30 · see citing works
The Relationship Between 5-Hydroxytryptamine and Its Metabolite Changes With Post-stroke Depression
Gu, S., He, Z., Xu, Q., Dong, J., Xiao, T., Liang, F., Ma, X., Wang, F., & Huang, J. H. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.871754 · Cited by 31 · see citing works
Psychological therapies for the management of co-morbid depression following a spinal cord injury: A systematic review
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Adaptation following stroke: A personal projects analysis.
Davis, C. G., Egan, M. Y., Dubouloz, C., Kubina, L.-A., & Kessler, D. (2013) · Rehabilitation Psychology · doi:10.1037/a0033400 · Cited by 29 · see citing works
Post Stroke Depression Frequently Overlooked, Undiagnosed, Untreated
Dar, S. K., Venigalla, H., Khan, A. M., Ahmed, R., Mekala, H. M., Zain, H., & Shagufta, S. (2017) · Neuropsychiatry · doi:10.4172/neuropsychiatry.1000296 · Cited by 29 · see citing works
Comparing the Symptomatology of Post-stroke Depression with Depression in the General Population: A Systematic Review
Blake, J., Gracey, F., Whitmore, S., & Broomfield, N. M. (2023) · Neuropsychology Review · doi:10.1007/s11065-023-09611-5 · Cited by 27 · see citing works
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Computerized Cognitive Behavioral Therapy to Treat Emotional Distress After Stroke: A Feasibility Randomized Controlled Trial
Simblett, S. K., Yates, M., Wagner, A. P., Watson, P., Gracey, F., Ring, H., & Bateman, A. (2017) · JMIR Mental Health · doi:10.2196/mental.6022 · Cited by 26 · see citing works
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Kootker, J. A., Fasotti, L., Rasquin, S. M. C., Heugten, C. M. V., & Geurts, A. C. H. (2012) · BMC Neurology · doi:10.1186/1471-2377-12-51 · Cited by 26 · see citing works
Traditional Chinese Acupuncture for Poststroke Depression: A Single-Blind Double-Simulated Randomized Controlled Trial
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An economic evaluation of an augmented cognitive behavioural intervention vs. computerized cognitive training for post-stroke depressive symptoms
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An augmented cognitive behavioural therapy for treating post-stroke depression: description of a treatment protocol
Kootker, J. A., Rasquin, S. M. C., Smits, P., Geurts, A. C. H., Heugten, C. M. V., & Fasotti, L. (2014) · Clinical Rehabilitation · doi:10.1177/0269215514559987 · Cited by 22 · see citing works
Emotional adjustment post-stroke: A qualitative study of an online stroke community
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Patients with Severe Poststroke Fatigue Show a Psychosocial Profile Comparable to Patients with Other Chronic Disease: Implications for Diagnosis and Treatment
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Updated Approach to Stroke Rehabilitation
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A randomised controlled trial of expressive arts-based intervention for young stroke survivors
Chan, C. K. P., Lo, T. L. T., Wan, A. H. Y., Leung, P. P. Y., Pang, M. Y. C., & Ho, R. (2021) · BMC Complementary Medicine and Therapies · doi:10.1186/s12906-020-03161-6 · Cited by 19 · see citing works
A Deficit in Psychotherapeutic Care for Older People with Depression and Anxiety
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Aphasia and stroke therapeutic alliance measure (A-STAM): Development and preliminary psychometric evaluation
Lawton, M., Conroy, P., Sage, K., & Haddock, G. (2019) · International Journal of Speech-Language Pathology · doi:10.1080/17549507.2019.1648551 · Cited by 17 · see citing works
Acceptance and commitment therapy for people with acquired brain injury: Rationale and description of the BrainACT treatment.
Rauwenhoff, J. C., Bol, Y., van Heugten, C. M., Batink, T., Geusgens, C. A., van den Hout, A. J., Smits, P., Verwegen, C. R., Visser, A., & Peeters, F. (2023) · Clinical Rehabilitation · doi:10.1177/02692155231154124 · Cited by 15 · see citing works
Selective optimization with compensation (SOC) competencies in depression
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Anticipated and imagined futures: prospective cognition and depressed mood following brain injury
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Longitudinal relationships between depressive symptoms and cognitive function after stroke: A cross-lagged panel design
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Post-stroke emotionalism: Diagnosis, pathophysiology, and treatment
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Aphasia Depression and Psychological Therapy (ADaPT): Perspectives of People with Post-Stroke Aphasia on Participating in a Modified Cognitive Behavioral Therapy
Baker, C., Thomas, S., Tjokrowijoto, P., Ryan, B., Kneebone, I., & Stolwyk, R. J. (2024) · Healthcare · doi:10.3390/healthcare12070771 · Cited by 13 · see citing works
Clinical Translation of Cognitive Behavioural Therapy for Anxiety and Depression: Adapted for Brain Injury (CBT-ABI): How Do We Train Competent Clinicians?
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Skype Supervised, Individualized, Home-Based Rehabilitation Programs for Individuals With Rett Syndrome and Their Families – Parental Satisfaction and Point of View
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Unravelling the complex interactions between self-awareness, cognitive change, and mood at 6-months post-stroke using the Y-shaped model
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Associations between the Brief Memory and Executive Test (BMET), Activities of Daily Living, and Quality of Life in Patients with Cerebral Small Vessel Disease
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Beyond persuasion: Improving conversational quality around high-stakes interpersonal disagreementsPreprint
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Diagnosis and etiology of poststroke depression: A review
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An integration of third wave cognitive behavioural interventions following stroke: a case study
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Discovery of Neuroprotective Antioxidants for the Management of Ischemic Brain Stroke
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The Effectiveness of Cognitive Behavioral Therapy for People with Depression Following Stroke: A Systematic Review and Meta-Analysis
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Psychotherapy of anxious and depressive states in patients with stroke
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Anxiety Disturbances in Stroke Patients
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MODULATION OF TOTAL CHOLESTEROL AND TRIGLYCERIDE IN PLASMODIUM BERGHEI INFECTED MICE BY AQUEOUS CRUDE EXTRACT OF ANDROGRAPHIS PANICULATA
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COGNITIVE BEHAVIOURAL THERAPY TO REDUCE DEPRESSION IN POST STROKE PATIENTS: A SCOPING REVIEW
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Lapadatu, I. L. (2015) · ORCA Online Research @Cardiff (Cardiff University) · Cited by 2 · see citing works
The efficacy of mindfulness-based interventions and cognitive rehabilitation on emotional and executive functioning problems after acquired brain injury
Higgins, L. (2019) · UEA Digital Repository (University of East Anglia) · Cited by 2 · see citing works
Single Case Experimental Design Examining Cognitive Behavioural Therapy for Post-Stroke Depression
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Evaluation of the Wisdom Enhancement Timeline approach for post-stroke depression using a single-case experimental design
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“I wanna just not go, because maybe I’m sad” – views on depression from the perspective of people with aphasia, their care partners, and speech-language pathologists
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Urgent and Emergent Psychiatric Disorders
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ACT and CBT in Older Age
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Possibilities of Using Cognitive Behavioral Therapy for the Treatment of Depression and Anxiety after Stroke
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Cognitive Behavioral Therapy in Late Life
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Accidents ischémiques et dépression
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The feasibility of delivering motivational interviewing to those with communication difficulties following a stroke
Holland, E.-J. (2015) · CLOK (University of Central Lancashire) · Cited by 1 · see citing works
Finding meaning after stroke : an analysis of older people's stroke narratives
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The psychological sequelae of transient ischaemic attack: the development of a preliminary screening tool
Spurgeon, L. C. (2013) · University of Birmingham Institutional Research Archive (University of Birmingham)
Psychotherapy as Treatment for Depression in an Aging Population
Buchholz, K. (2013) · Language arts journal of Michigan
Depression in Older People: Cognitive Behavior Therapy, Evidence and Practice
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Exploring the acceptability and effectiveness of psychosocial interventions for stroke patients experiencing depression
Cathers, R. (2014) · ERA
Comorbid Neurological Illness
Wint, D. P., & Cummings, J. L. (2013) · Oxford University Press eBooks · doi:10.1093/med/9780199796816.003.0017
Re-purposing my self: a grounded theory study of young adults’ experiences of living with haemorrhagic stroke.
Murphy, M. H. (2019) · Arrow@dit (Dublin Institute of Technology)
A Qualitative Study of the Efficacy of the STEPSS Program for Stroke Survivors
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Severity of Post-Stroke Cognitive Impairment Moderates the Relationship Between Cognitive Change and Emotional Distress in the Months Following StrokePreprint
Wheeler, M., Williams, O., Johns, L., Chiu, G., Slavkova, E. D., & Demeyere, N. (2021) · doi:10.31234/osf.io/sxv52
Anxiety and depression in people with acquired brain injury
Rauwenhoff, J. C. C. (2022) · doi:10.26481/dis.20221130jr
The assessment of mood in people with severe cognitive and communication impairments following brain injury: a survey of UK-based professionals
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Delivering Psychological Intervention for Patients With Poststroke Depression: Can Short Treatment Help During Inpatient Rehabilitation?
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Authors: Broomfield, N. M., Laidlaw, K., Hickabottom, E., Murray, M. F., Pendrey, R., Whittick, J. E., & Gillespie, D. C.
Affiliations: Western Infirmary (GB)
University of Edinburgh (GB)
Stratheden Hospital (GB)
Astley Ainslie Hospital (GB)
Corresponding author: Broomfield, Niall M.
ORCID: Broomfield, Niall M.
Laidlaw, Ken
Gillespie, David C.
Venue: Clinical Psychology & Psychotherapy
Publisher: Wiley
Published: 2011-05
Volume: 18
Issue: 3
Pages: 202-217
ISSN: 1063-3995 (ISSN-L)
1099-0879
DOI: 10.1002/cpp.711
OpenAlex: W2027121757
Cited by: 99
References: 110
Citations by year: 2026: 5 · 2025: 6 · 2024: 5 · 2023: 5 · 2022: 5 · 2021: 5 · 2020: 7 · 2019: 8 · 2018: 6 · 2017: 3 · 2016: 8 · 2015: 9 · 2014: 6 · 2013: 10 · 2012: 5
FWCI: 1.11
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Clinical Psychology & Psychotherapy (publishedVersion)
PubMed (publishedVersion)
ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
Topics: Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords: post-stroke depression, cognitive behavioral therapy, personalized treatment, motivational interviewing, grief resolution, cognitive impairment, case formulation, stroke survivors
MeSH terms: Depressive Disorder, Humans, Cognitive Behavioral Therapy, Stroke

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Post‐stroke depression: the case for augmented, individually tailored cognitive behavioural therapy

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