Communication and Low Mood (CALM): a randomized controlled trial of behavioural therapy for stroke patients with aphasia

Thomas, Shirley A; Walker, Marion F; Macniven, Jamie A; Haworth, Helen; Lincoln, Nadina B

doi:10.1177/0269215512462227

Cited by 149Stroke Rehabilitation and RecoveryAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesDementia and Cognitive Impairment Research

Communication and Low Mood (CALM): a randomized controlled trial of behavioural therapy for stroke patients with aphasia

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Thomas, Shirley A, Walker, Marion F, Macniven, Jamie A, Haworth, Helen, Lincoln, Nadina B·2013·Clinical Rehabilitation

DOI 10.1177/0269215512462227PMC PMC3652643

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Abstract

Objective: The aim was to evaluate behavioural therapy as a treatment for low mood in people with aphasia. Design: A randomized controlled trial comparing behavioural therapy plus usual care with a usual care control. Potential participants with aphasia after stroke were screened for the presence of low mood. Those who met the criteria and gave consent were randomly allocated. Setting: Participants were recruited from hospital wards, community rehabilitation, speech and language therapy services and stroke groups. Subjects: Of 511 people with aphasia identified, 105 had low mood and were recruited. Interventions: Behavioural therapy was offered for up to three months. Outcomes were assessed three and six months after random allocation. Main measures: Stroke Aphasic Depression Questionnaire, Visual Analog Mood Scales ‘sad’ item, and Visual Analogue Self-Esteem Scale. Results: Participants were aged 29 to 94 years (mean 67.0, SD 13.5) and 66 (63%) were men. Regression analysis showed that at three months, when baseline values and communication impairment were controlled for, group allocation was a significant predictor of the Stroke Aphasic Depression Questionnaire ( P < 0.05), visual analogue ‘sad’ ( P = 0.03), and Visual Analogue Self-Esteem Scale ( P < 0.01). At six months, group alone was a significant predictor of the Stroke Aphasic Depression Questionnaire ( P < 0.05), and remained significant when baseline values were controlled for ( P = 0.02). Mean Stroke Aphasic Depression Questionnaire 10-item hospital version scores decreased from baseline to six months by six points in the intervention group as compared with an increase of 1.9 points in the control group. Conclusions: Behavioural therapy seemed to improve the mood of people with aphasia.

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Behavioural therapy, compared with TAU in an RCT, produced significant improvements in self-reported and observer-rated mood and self-esteem at 3 months in stroke survivors with aphasia and low mood.
“Behavioural therapy, compared with TAU in an RCT, produced significant improvements in self-reported and observer-rated mood and selfesteem at 3 months in stroke survivors with aphasia and low mood (Thomas, Walker, Macniven, Haworth, & Lincoln, 2013).”
From Brief group‐based acceptance and commitment therapy for stroke survivors. (2019) · cites this paper as Thomas et al., 2013

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An evaluation of treatment integrity in a randomized trial of behavioural therapy for low mood in stroke patients with aphasia
Thomas, S., Russell, C., Seed, R., Worthington, E. J., Walker, M. F., Macniven, J. A. B., & Lincoln, N. B. (2013) · Clinical Rehabilitation · doi:10.1177/0269215513489579 · Cited by 19 · see citing works
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Intensive aphasia therapy improves low mood in fluent post-stroke aphasia: Evidence from a case-controlled study
Berthier, M. L., Edelkraut, L., Mohr, B., Friedemann Pulvermüller, A., STARKSTEIN, S. E., Green, C., & Dávila, G. (2020) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2020.1809463 · Cited by 9 · see citing works
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
Self-citation
Aphasia, depression, and psychological therapy (ADaPT): A single case design evaluation of a modified cognitive behavioural therapy to treat depressive symptoms in stroke survivors with aphasia
Tjokrowijoto, P., Thomas, S., Kneebone, I., Ryan, B., & Stolwyk, R. J. (2024) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2024.2331840 · Cited by 8 · see citing works
Self-citation
Depression and aphasia after stroke
Kontou, E. (2010) · Nottingham ePrints (University of Nottingham)

Authors: Thomas, S. A., Walker, M. F., Macniven, J. A., Haworth, H., & Lincoln, N. B.
Affiliations: University of Nottingham (GB)
Nottingham University Hospitals NHS Trust (GB)
Nottinghamshire Healthcare NHS Foundation Trust (GB)
Corresponding author: Thomas, Shirley A
ORCID: Thomas, Shirley A
Walker, Marion F
Lincoln, Nadina B
Venue: Clinical Rehabilitation
Publisher: SAGE Publications
Published: 2012-10-11
Volume: 27
Issue: 5
Pages: 398-408
ISSN: 0269-2155 (ISSN-L)
1477-0873
DOI: 10.1177/0269215512462227
PMC: PMC3652643
OpenAlex: W2095758871
Cited by: 149
References: 30
Citations by year: 2026: 9 · 2025: 10 · 2024: 16 · 2023: 18 · 2022: 12 · 2021: 10 · 2020: 13 · 2019: 19 · 2018: 7 · 2017: 11 · 2016: 9 · 2015: 5 · 2014: 4 · 2013: 5
FWCI: 4.74
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Clinical Rehabilitation (publishedVersion, cc-by-nc)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Nottingham ePrints (University of Nottingham) (submittedVersion, cc-by-nc)
Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
Funders: National Institute for Health and Care Research (NF-SI-0512-10092)
Stroke Association
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 › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords: aphasia, stroke, depressive mood, behavior therapy, depression, self-esteem, communication disorders, mood
MeSH terms: Stroke Rehabilitation, Adult, Aged, Aged, 80 and over, Aphasia, Female, Humans, Male, Middle Aged, Regression Analysis, ROC Curve, Self Concept, Cognitive Behavioral Therapy, Statistics, Nonparametric, Mood Disorders, Stroke, Visual Analog Scale

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Communication and Low Mood (CALM): a randomized controlled trial of behavioural therapy for stroke patients with aphasia

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