Why is this research needed?
Around one-quarter of stroke survivors have aphasia, which means they have difficulty communicating. This can be difficulties with talking, understanding, reading or writing. Stroke survivors with aphasia are at risk higher risk than others of having problems with their mental well-being such as depression and isolation.
However, due to their communication difficulties they are often locked out of current treatments. They are also often excluded from research exploring new treatments to support mental well-being, so there is little information about what could help.
Solution Focused Brief Therapy (SFBT) is an existing therapy that shows promise for supporting mental well-being. But it’s not know if it can be used with stroke survivors with aphasia. This research will find out if it can be adapted, tested and helpful to this group of stroke survivors that are currently at risk of suffering from mental ill health
There is also little information about how people affected by stroke, speech and language therapists (SLTs) and mental health professionals can best work together to support mental-well-being in life after stroke. This research can help to change this.
About Solution Focused Brief Therapy (SFBT)
SFBT focuses on what a person can do. It encourages people to talk about, reflect on and explore their personal strengths and resilience to build positive change in their lives.
Stroke changes a person’s physical and mental abilities in an instant. This can be traumatic and put people at risk of having problems with their mental well-being. SFBT could help stroke survivors recover and avoid severe problems with their mental well-being.
What is this research aiming to do?
This research will find out if SFBT can be adapted for stroke survivors with aphasia and whether they find it helpful. It will lay the foundations for a large-scale trial in the future.
Before, during and three months after receiving up to six SFBT sessions over three months, participants will be asked about:
- how their aphasia affects their mood, well-being and social participation using questionnaires
- their experience of the therapy in interviews
Another group of stroke survivors with aphasia that have not yet received the therapy will be asked similar questions. The groups can then be compared to understand if the therapy could make a difference to mental-wellbeing, mood and social participation. This group will be offered the therapy later on.
What happened?
SFBT was adapted for speech and language therapists (SLTs) to use with stroke survivors with aphasia. A therapy manual was created and used to support SLTs. As well as the manual, the SLTs received initial training in the approach, as well as regular supervision. They really valued having the manual, the training, and also the ongoing support.
32 stroke survivors with aphasia took part. The research successfully showed that SFBT could be tested as a new treatment as it was found that:
- the treatment, and the way research could assess the effects of the treatment, were acceptable to this group of patients.
- this group of patients could, and wanted to take part in research into the treatment. They were positive about receiving the therapy, and felt it worked well for people with aphasia.
"It make you somebody, hey… oh it good, good, good, good, and so, it give me courage, courage, courage… Now, now I am myself." – Stroke survivor with aphasia describing the therapy
- SLTs could work with this group of patients using SFBT.
"it was just amazing, to persevere with it and to see that even, even with people with severe aphasia you could still use it… all the participants seemed to really enjoy the sessions." – Speech and language therapist talking about the therapy
This research also helped to understand why SFBT could be helpful to stroke survivors with aphasia, and what experience they have of the care they would normally receive.
Sarah said "I’m excited to share the findings that it’s possible to adapt SFBT for stroke survivors with aphasia, even very severe aphasia – and that the therapy is valued.
"It’s very common for people with aphasia to lose confidence and become anxious or depressed. Yet too often they’re not able to access high quality psychological support due to their language difficulties. I hope our research can help mental health professionals to work closely with SLTs to improve psychological support for stroke survivors with aphasia."
You can find out more at http://bit.ly/SOFIAblog
Next steps
Sarah is planning to share results of this research widely with people affected by stroke, professionals in stroke, and mental health practitioners. This includes through online events, videos and social media.
She is working with stroke survivors with aphasia and professionals in stroke to consider the best step forward with this research. This might be a larger trial to prove the difference the therapy can make, and how much it costs. They may look to further adapt the therapy, for example, for use online or alongside other speech and language therapies.
Meet the researcher
Our charity’s funding for Sarah allowed her to develop skills to become a leader in stroke research. She excelled at this and secured a permanent position as a Senior Lecturer at City, University of London.
Sarah hopes to continue her work with researchers across the UK, Europe, Australia and the United States of America. She hopes to support SLTs to get involved in research and use the findings of research in their treatment and care for stroke survivors with aphasia.
She said “I will continue to listen closely to the views of people living with stroke, as well as others in the stroke community, and together build a successful programme of stroke research. I hope to be a research leader within the field and that my research has a genuine impact on stroke services and clinical practice, and so improve the quality of life of people with living with stroke and aphasia.”
Award Title - Stroke Association Jack and Averil (Mansfield) Bradley Fellowship Award