Psychological Interventions for Post-Stroke Adjustment and Mood

Avery, Holly Grace (2026) Psychological Interventions for Post-Stroke Adjustment and Mood. Doctoral thesis, University of East Anglia.

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Abstract

Background: Difficulty adjusting after stroke is prevalent and access to psychological support in the UK remains a pertinent challenge. Group psychological therapies, particularly when delivered remotely, may alleviate some healthcare pressures and increase access to mental health support after stroke. Acceptance and Commitment Therapy (ACT) is a psychological intervention that aligns with models of adjustment in chronic health, resulting in a growing evidence base for stroke survivors.

Methods: A systematic review and meta-analysis assessed the efficacy of group-based psychological intervention on post-stroke mood (anxiety and depression). The empirical study used a concurrent multiple baseline single case experimental design to assess the preliminary efficacy of an ACT group delivered via telerehabilitation for post-stroke adjustment. Five stroke survivors completed self-report measures of psychological flexibility (PF), distress, participation, quality of life and wellbeing. Preliminary feasibility and aspects of acceptability were assessed, supported by participant feedback.

Results: A meta-analysis of eight publications found very low certainty of evidence that group-based psychological therapies impact mood post-stroke. Some concerns for risk of bias and substantial heterogeneity were noted. The empirical study found a single base effect of the intervention on PF. Increasing intervention trends indicated a cumulative effect on PF. Mixed findings of reliable and clinically significant change was noted on other psychosocial outcomes. Preliminary assessment indicated the intervention may be feasible for pilot clinical trials, and core aspects of acceptability were supported.

Conclusion: Further research is required to understand the efficacy of group-based psychological therapies for post-stroke mood, and further research of an ACT group delivered via telerehabilitation for adjustment post-stroke is warranted. Research must ensure high methodological quality of future clinical trials and consider multiple domains of psychological adjustment. Implications on research and clinical practice are considered throughout the portfolio.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Bethany Turner
Date Deposited:	04 Nov 2026 12:21
Last Modified:	04 Nov 2026 12:21
URI:	https://ueaeprints.uea.ac.uk/id/eprint/104974
DOI:

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