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ACT-group for Stroke Survivors (Pilot Study)

Not Applicable
Recruiting
Conditions
Depressive Symptoms
Anxiety
Stroke
Stress
Intracerebral Hemorrhage
Interventions
Behavioral: Group Therapy
Registration Number
NCT06282029
Lead Sponsor
Bielefeld University
Brief Summary

The goal of this clinical pilot trial is to test the feasibility, acceptance and preliminary efficacy of an adapted group psychotherapy manual in stroke survivors with psychological stress. The main questions it aims to answer are:

* Is the group therapy feasible?

* Is the group therapy accepted by stroke survivors and therapists?

* Are there first indications on the efficacy of the group therapy to improve mental health?

Participants will take part in 8 weekly group therapy sessions of 90 minutes each.

Detailed Description

This trail aims to investigate the feasibility, acceptance and preliminary efficacy of a group therapy manual based on Acceptance and Commitment Therapy. The manual is an adaptation of "Living Well with Neurological Conditions" (Hill et al., 2017), which was conducted in groups with acquired brain injury in general. The manual was translated to German and adapted to the needs of stroke survivors who are often older, have more comorbidities and specific neurological impairments. Session length was reduced from 165 minutes to 90 minutes. The program includes 8 weekly sessions. In addition, outcome questionnaires were translated to German and all measures are translated into plain language to increase accessibility.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
12
Inclusion Criteria
  • Value above a cut-off on one of the DASS-21 subscales (depression > 10, anxiety > 6, and stress > 10)
  • Sufficient cognition and language ability (clinical rating)
  • Sufficient therapy motivation (clinical rating)
Exclusion Criteria
  • Behavioral disorders (e.g., high irritability or apathy in clinical rating)
  • Other severe mental disorder (dementia, psychosis, personality disorders, intellectual disability)
  • Parallel psychotherapy or neuropsychological therapy

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Intervention armGroup TherapyGroup therapy
Primary Outcome Measures
NameTimeMethod
Treatment fidelityUntil end of last session, presumably 8 weeks

Treatment fidelity ≥ 80% in each group. Two randomly selected sessions are video-recorded. A research assistant then applies self-developed checklists for the respective sessions to assess if therapists adhere to manual instructions and contents. Treatment fidelity is one indicator of feasibility.

Homework completionUntil end of last session, presumably 8 weeks

Mean rate of participants completing homework ≥ 50% in each group. Mean rate of participants attending sessions ≥ 80% in each group. Homework completion is assessed each session and averaged over all 8 sessions. Homework completion is one indicator of feasibility.

Drop-out rateUntil end of last session, presumably 8 weeks

Rate of participants discontinuing the group therapy ≤ 20% in each group. Drop-out rate is one indicator of feasibility.

Session adherenceUntil end of last session, presumably 8 weeks

Mean rate of participants attending sessions ≥ 80% in each group. Attendance is assessed each session and averaged over all 8 sessions. Session adherence is one indicator of feasibility.

Group therapy session questionnaire - therapists (Zoubek, 2013; Plain German)Until end of last session, presumably 8 weeks

Therapists rate acceptance for each session and the whole group therapy.

Acceptance and Action Questionnaire-Acquired Brain Injury (Sylvester, 2011; Plain German)Before first and after last session, presumably 8 weeks

Measure of psychological flexibility to investigate efficacy. Scores range from 0 to 36 with higher values indicating higher inflexibility.

Completion of outcome measuresBefore first and after last session (time frame = 8 weeks)

Mean rate of completed outcome measures ≥ 80% in each group. Rate is calculated based on number of completed items in all questionnaires. Completion of outcome measures is one indicator of feasibility.

Group therapy session questionnaire - patients (Zoubek, 2013; Plain German)Until end of last session, presumably 8 weeks

Patients rate acceptance for each session and the whole group therapy.

Depression and Anxiety Stress Scales-21 (Lovibond, 1995; Plain German)Before first and after last session, presumably 8 weeks

Measure of psychological burden to investigate efficacy. Scores range from 0 to 63 with higher values indicating higher burden.

Secondary Outcome Measures
NameTimeMethod
Self-as-context scale (Zettle, 2018; Plain German)Before first and after last session, presumably 8 weeks

Measure of self as context to investigate efficacy. Scores range from 10 to 70 with higher values indicating a perspective closer to self-as-context.

Patient Health Questionnaire-9 (Kroenke, 2001; Plain German)Before first and after last session, presumably 8 weeks

Measure of depressive symptoms to investigate efficacy. Scores range from 0 to 27 with higher values indicating more severe depressive symptoms.

Generalized Anxiety Disorder-7 (Spitzer, 2006; Plain German)Before first and after last session, presumably 8 weeks

Measure of anxiety symptoms to investigate efficacy. Scores range from 0 to 21 with higher values indicating more severe anxiety symptoms.

Valuing Questionnaire (Smout, 2014; Plain German)Before first and after last session, presumably 8 weeks

Measure of valued living to investigate efficacy. Scores range from 0 to 60 with higher values indicating higher value-congruent living.

Trial Locations

Locations (1)

University Neuropsychological Outpatient Clinic

🇩🇪

Bielefeld, Germany

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