title: Group cognitive behavioural therapy for stroke survivors with depression and their carers.
abstract: Depression in stroke survivors is common, leads to poorer outcomes and often not treated. A group cognitive behavioural therapy (CBT) program (Brainstorm) for stroke survivors with depression, and their carers has been running as part of usual care since 2007.
  
  
  
  To evaluate the implementation and acceptability of Brainstorm, a closed group intervention consisting of up to 10 sessions of education, activity planning, problem solving and thought challenging.
  
  
  
  Participating stroke survivors and their carers complete assessment measures at baseline, post-treatment and 1-month and 6-months follow-up. A mixed models for repeated measures data was conducted with depression and anxiety scores for stroke survivors (Beck Depression Inventory-II; Hospital Anxiety and Depression Scale) and the assessment of depression, anxiety and carer burden for carers. Acceptability was assessed by session attendance and written and open participant feedback upon completion of the program.
  
  
  
  Forty-eight community dwelling stroke survivors and 34 carers attended Brainstorm, with a median attendance of 88% of sessions. Follow-up assessments were completed by 77% (post-treatment), 46% (1-month) and 38% (6-month) of stroke survivors. Stroke survivors' depression scores decreased from baseline to post-treatment (p<.001); maintained at 1-month (p<.001) but not at 6-month (p=.056). Anxiety scores decreased between baseline and 1-month (p=.013). Carer burden, depression and anxiety scores at 1-month and 6-month follow-up, for carers, were all reduced when compared with baseline (p<.05).
  
  
  
  The Brainstorm group intervention for depression in stroke survivors appears to have been effectively implemented and is acceptable to stroke survivors and carers.
authors.affiliation: a School of Psychology, Faculty of Science and Information Technology , University of Newcastle , Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: K Ward
authors.affiliation: b School of Medicine and Public Health , University of Newcastle , Australia.|c IMPACT SRC, School of Medicine , Deakin University , Australia.|d Department of Psychiatry, School of Medicine , University of Melbourne , Australia.
authors.forename: Alyna
authors.initials: A
authors.lastname: Turner
authors.affiliation: e Liaison Psychiatry Department , John Hunter Hospital , Newcastle , Australia.
authors.forename: John
authors.initials: J
authors.lastname: A Hambridge
authors.affiliation: a School of Psychology, Faculty of Science and Information Technology , University of Newcastle , Australia.
authors.forename: Sean
authors.initials: S
authors.lastname: A Halpin
authors.affiliation: f School of Mathematical and Physical Sciences, Faculty of Science and Information Technology , University of Newcastle , Australia.
authors.forename: Megan
authors.initials: M
authors.lastname: E Valentine
authors.affiliation: g Community Stroke Team , Hunter New England Local Health District , Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: L Sweetapple
authors.affiliation: h Hunter Medical Research Institute and Hunter Stroke Service , John Hunter Hospital , Newcastle , Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: H White
authors.affiliation: i Neurological and Mental Health, The George Institute for Global Health , The University of Sydney , Australia.|j The School of Health , The University of Central Lancashire , Preston , UK.
authors.forename: Maree L
authors.initials: ML
authors.lastname: Hackett
mesh_terms: D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000209:etiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011615:Psychotherapy, Group / Q000379:methods*; D020521:Stroke / Q000150:complications / Q000523:psychology*; D017741:Survivors
keywords: Cognitive behaviour therapy; anxiety; carers; depression; group therapy; stroke