Scientific title:
HEADS:UP (Helping Ease Anxiety and Depression following Stroke) psychological self-management intervention: non-randomised pilot study followed by a 3-arm randomised controlled pilot trial.
Glasgow Caledonian University
Principal investigator:
Professor Maggie Lawrence
Grant value:
Research ID:
SA PPA 18\100011
Research area:
Start date:
Monday 3 June 2019
End date:
Tuesday 31 January 2023
3 years 6 months
Year awarded:


Anxiety and depression are common after stroke. As many as a third of stroke survivors may suffer from depression, and psychological problems are common amongst carers. However, there are currently few long-term family-centred treatment options to help people manage the psychological consequences of stroke.

Mindfulness is the practice of being aware of your body, mind, and feelings in the present moment. It's an increasingly popular technique to help people manage their psychological health. Mindfulness Based Stress Reduction (MBSR) courses use meditation to increase people’s levels of mindfulness and teach skills to help self-manage anxiety and depression. Although some people find MBSR helpful, research has shown that many do not complete a full course.

The research team have already worked with people affected by stroke to make changes to the MBSR course that might help people affected by stroke follow the whole course. One change they have made is to train stroke survivors and family members/peers together so that they can support one another through the course.

What is the research aiming to do?

This study will test the new course, called HEADS: UP, with more people affected by stroke. They'll use this to improve the course and plan a larger study to find out if HEADS: UP helps people to self-manage anxiety and depression long-term.

The study was designed in two parts. In part 1 (June 2019 to June 2020) the researchers recruited a small number of people affected by stroke to take part in the face-to-face HEADS: UP course.

  • This part of the study helped the research team to understand if they needed to make any more changes to the course before testing it in a larger group of people.

The researchers had then planned to compare people affected by stroke attending the course face-to-face, with those that didn’t do the course, to understand the effect the course may have on psychological well-being.

Changes to the research due to the COVID-19 pandemic

The COVID-19 pandemic meant that the researchers couldn't test the HEADS:UP with stroke survivors face-to-face, so the researchers changed the study and now plan to test the course online.

Now, the researchers will divide the study into three parts:

  • Part 1 (June 2019 - June 2020) has been completed.
  • In part 2, people affected by stroke will take part in the course to understand how it can be changed from face-to-face to online. 
  • In part 3, the researchers aim to find out what difference the online course can make by testing it in more people affected by stroke. Two different groups will be compared - some will have attended the course online delivered by a trainer, and some will have followed the online course on their own, and some will have not attended the HEADS: UP online course. Everyone will be asked to complete online questionnaires and invited to take part in at least one focus group. 

Lead researcher Professor Maggie Lawrence said: “Making these changes wasn’t easy. It took a whole team of researchers to be flexible, creative and think on their feet.

But by changing our study to develop and test HEADS: UP online, we consider we’ll be 'ahead of the curve'. This study can improve our understanding of treatment for psychological problems after a stroke that could offer greater inclusivity, more immediately than would have been achieved following our original plans. It can also save the NHS money if high-quality and effective psychological support can be offered in this way.”