The efficacy of problem solving therapy to reduce post stroke emotional distress in younger (18–65) stroke survivors

Abstract

Purpose: To investigate the efficacy of problem solving therapy for reducing the emotional distress experienced by younger stroke survivors.

Method: A non-randomized waitlist controlled design was used to compare outcome measures for the treatment group and a waitlist control group at baseline and post-waitlist/post-therapy. After the waitlist group received problem solving therapy an analysis was completed on the pooled outcome measures at baseline, post-treatment, and three-month follow-up.

Results: Changes on outcome measures between baseline and post-treatment (n = 13) were not significantly different between the two groups, treatment (n = 13), and the waitlist control group (n = 16) (between-subject design). The pooled data (n = 28) indicated that receiving problem solving therapy significantly reduced participants levels of depression and anxiety and increased quality of life levels from baseline to follow up (within-subject design), however, methodological limitations, such as the lack of a control group reduce the validity of this finding.

Conclusion: The between-subject results suggest that there was no significant difference between those that received problem solving therapy and a waitlist control group between baseline and post-waitlist/post-therapy. The within-subject design suggests that problem solving therapy may be beneficial for younger stroke survivors when they are given some time to learn and implement the skills into their day to day life. However, additional research with a control group is required to investigate this further. This study provides limited evidence for the provision of support groups for younger stroke survivors post stroke, however, it remains unclear about what type of support this should be.

Implications for Rehabilitation

• Problem solving therapy is no more effective for reducing post stroke distress than a wait-list control group.

• Problem solving therapy may be perceived as helpful and enjoyable by younger stroke survivors.

• Younger stroke survivors may use the skills learnt from problem solving therapy to solve problems in their day to day lives.

• Younger stroke survivors may benefit from age appropriate psychological support; however, future research is needed to determine what type of support this should be.

Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12615000840583.

Keywords:

• Stroke
• younger people
• depression
• anxiety
• problem solving
• therapy
• perceived support

Acknowledgements

The authors are grateful to the younger stroke survivors who shared their unique experiences and to the Stroke Foundation of New Zealand who assisted with the circulation of the survey.

Disclosure statement

The authors report no conflict of interest.

Funding

The authors would like to acknowledge the Ryoichi Sasakawa Young Leaders’ Fellowship Fund for assisting with the funding of this study.