Scientific title:
Development and feasibility trial of an Acceptance and Commitment Therapy (ACT) group intervention to address psychological distress in life after stroke: the Wellbeing After Stroke (WAterS) study
University of Manchester
Principal investigator:
Dr Emma Patchwood
Grant value:
Research ID:
SA PDF 18\100024
Research area:
Start date:
Monday 11 March 2019
End date:
Saturday 30 September 2023
3 years 6 months
Year awarded:

Why is this research needed?

Up to 75% of stroke survivors report issues such as depression, anxiety and general distress. Supporting people to come to terms with persisting disability and adjust to ‘life after stroke’ is a high priority, but there is a lack of options for treatment and not enough clinical psychologists to deliver support.

Acceptance and Commitment Therapy (ACT) has been used successfully in NHS services as group-based psychological support. It includes mindfulness exercises and support to identify important personal values and goals. With some adaptations, ACT workshops may be helpful to improve adjustment and wellbeing for stroke survivors.

Stroke Association staff often come from non-clinical backgrounds but are experienced in delivering support to stroke survivors. They may be an ideal workforce to increase the reach of psychological care. In addition, the COVID-19 pandemic has caused disruption to health services and remote technologies may be required more and more to deliver support.

What is the research aiming to do?

The Wellbeing After Stroke (WAterS) study aims to:

  • Develop an Acceptance and Commitment therapy group workshop and a comparison support group workshop specifically for stroke survivors, to be delivered using video calling.
  • Develop a staff training and supervision programme for Stroke Association staff to deliver the workshops in a research study.
  • Test whether the workshops can be successfully delivered remotely to stroke survivors; whether they are valued by stroke survivors; and how to carry out a large-scale research study to test if they really can improve wellbeing in a cost-effective way.

The research has two main stages:

Development stage

  • We will collaborate with healthcare professionals and stroke survivors to adapt psychological support workshops for stroke, including Acceptance and Commitment Therapy.
  • This includes developing a workbook to support attendance, and making course content suitable for stroke survivors with difficulties in thinking and communicating.
  • We will also train Stroke Association staff to deliver workshops in a research study

Early testing stage (known as a ‘feasibility trial’)

  • Using a novel research design, find stroke survivors to participate.
  • Participants will be split into groups at random to receive the different workshops.
  • Psychological well-being will be measured before and after support, and again three months later.
  • Participants will also be interviewed to understand their experiences and learn how to improve the workshops and study design.

What benefits could this have for people affected by stroke?

This research could produce psychological support workshops to improve wellbeing in life-after-stroke. The workshops would be tailored for stroke survivors and deliverable by a readily available workforce to improve the potential reach of support.

The testing phase will produce the information needed to seek more funding for a large-scale research study to test clinical and cost-effectiveness.

About the researcher

Dr Emma Patchwood has a neuropsychology background and achieved her PhD in 2015. She has worked as an applied healthcare researcher in stroke since 2005.

Emma was previously funded by the Stroke Association for her PhD and postdoctoral work that involved patient-centred care and measurement, optimising post-stroke reviews of unmet needs, and supporting carers of stroke survivors.

The current Wellbeing After Stroke (WAterS) study involves collaboration with a wide team of experts, including Clinical Psychologists and stroke survivors themselves. Emma feels strongly about the benefits of involving users in research and aims to conduct research that has the potential to make a real difference to the quality of life of people with stroke and their families.