Cited by 13Mindfulness and Compassion InterventionsStroke Rehabilitation and RecoveryArt Therapy and Mental Health

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

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Gladwyn-Khan, Misbah, Morris, Reg·2023·Behavioural and Cognitive Psychotherapy

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.

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Authors
Gladwyn-Khan, M., & Morris, R.
Affiliations
Cardiff University (GB)
Corresponding author
Morris, Reg
Venue
Behavioural and Cognitive Psychotherapy
Published
2022-10-10
Volume
51
Issue
1
Pages
87-104
ISSN
  • 1352-4658 (ISSN-L)
  • 1469-1833
OpenAlex
W4303986329
Cited by
13
References
85
Citations by year
2026: 2 · 2025: 3 · 2024: 5 · 2023: 3
FWCI
2.52
Type
journal article
Language
en
Open access
Locations
  • Behavioural and Cognitive Psychotherapy (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
  • PEARL (University of Plymouth) (submittedVersion)
Funders
Stroke Association
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Social Sciences › Arts and Humanities › Conservation › Art Therapy and Mental Health
Keywords
acceptance and commitment therapy, bibliotherapy, stroke, psychological distress, stroke survivors, quality of life, mood, well-being, disease impact
MeSH terms
Psychological Distress, Humans, Middle Aged, Quality of Life, Stroke, Acceptance and Commitment Therapy

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