STRICTLy CFT: A Feasibility Randomised Control Trial of a Compassion Focussed Therapy Intervention to Aid Recovery Post-stroke

Stroke Stroke is a type of acquired brain injury (ABI) and is a heterogeneous term used to describe both ruptures to large blood vessels in the brain causing flooding with blood, and occlusions of tiny vessels in a part of the brain that is vital for functioning.

In the UK stroke is the second leading cause of death and disability, second only to coronary heart disease. Approximately 110, 000 strokes occur each year in England with prevalence rates estimated to be 7.20/1000.

Strokes can lead to changes in functioning in a variety of areas of life. As a result, individuals can often experience a range of emotional difficulties. For example, there is a high prevalence of mental health difficulties in stroke survivors; the most commonly reported are depression and anxiety disorders. Prevalence rates of distress vary between studies; however, it is estimated that the prevalence of post-stroke depression is approximately 31%, and post-stroke anxiety is estimated to be 18%. High levels of depression and anxiety can augment the functional impairments experienced as a result of a stroke. Depression in particularly is associated with reduced functioning outcomes and increased mortality rates.

In addition, studies have found high levels of self-criticism post-stroke as individuals realise they are no longer able to do things which they used to be able to. Studies have found higher rates of depression in individuals who continue to pursue what have now become unachievable life goals. It is postulated that this could be one of the reasons for the high prevalence rate of depression post-stroke, particularly if individuals do not re-evaluate their life goals to realign with any changes in cognitive capacity and functional deficits as a result of the stroke.

National Institute for Health and Care Excellence Guidance has suggested that individuals who have had a stroke should have access to psychological therapy to help with difficulties adjusting to life post-stroke. One such therapy is Compassion Focussed Therapy (CFT) which aims to reduce self-criticism by increasing self-compassion. CFT may be particularly effective in this population due to the specific challenges faced. For example, they have to adjust to the loss of previous functioning (both cognitively and otherwise) alongside managing the threat that a stroke may reoccur and the gradual and often frustrating nature of recovery which may be conditional on clinical input. The picture can then be complicated further by an individual's self-criticism tendencies which, as described above, can compound any challenges the individual is already facing. Therefore, CFT, which aims to reduce self-criticism and foster adjustment through self-compassion, would appear to be a well-suited intervention in this population.