A Biopsychosocial Intervention for Stroke Carers (BISC): development and description of the intervention

Figures & data

Figure 1. Flowchart for the development process of an intervention for stroke carers.

Table 1. Characteristics of the Biopsychosocial Intervention for Stroke Carers (BISC).

Description of the BISC intervention based on the TiDIER checklist (Hoffmann et al., 2014)
Lay title	‘Looking after your health and well-being when caring for someone who has had a stroke’
Participants	Informal carers within a year post-stroke onset willing to attend a group intervention and to provide consent. Able to communicate in English with no visual/auditory impairments that would preclude them from participating in the sessions
Facilitator	Assistant psychologist or professional with equivalent skills and competencies with background knowledge in psychology. Some experience in basic cognitive-behavioural therapy principles is recommended. Training and clinical supervision are required
Duration	Six structured two-hour sessions once weekly. Depending on group size
Method of delivery	Group format for up to five participants
Setting	Accessible location in the community
Materials	Intervention manual for participants including home practice worksheets and session summaries. Supplementary notes to guide intervention delivery for the facilitator
Tailoring/modifications	The facilitator to follow the content and structure of the intervention manual. Some flexibility in the duration of group tasks/discussions and optional relaxation practice at the end of each session. If delivered on a one-to-one basis then modified to suit individual format

Table 2. Overview of intervention sessions.

Sessions	Content	Techniques	Home practice
1. Stroke and caring	What is a stroke and its effects, caregiving role, biopsychosocial model of well-being	Introductions and getting to know each other ice-breaker task	Record of thoughts-emotions-behaviours during a caring situation
2. Adjustment and mood	Process of adjustment and normalisation	Discuss stages of adjustment	Identify what helps/gets in the way of adjusting
3. Emotions and thoughts	Dealing with difficult feelings and thoughts	Identify current and alternative strategies	Mood and activity diary
4. Dealing with problems	Learning problem-solving skills	Looking at the pros and cons when choosing a solution	Work through a particular problem
5. Stress and coping	Signs and causes of stress, coping strategies	Use the ‘stress barrel’ analogy	Try out a coping strategy identified as helpful
6. Your wellbeing action plan	Signposting and setbacks	Use ‘well-being toolbox’ analogy	Develop a personal well-being action plan

Hoffmann, T. C., Glasziou, P. P., Boutron, I., Milne, R., Perera, R., Moher, D., … Michie, S. (2014). Better reporting of interventions: Template for intervention description and replication (TIDieR) checklist and guide. BMJ : British Medical Journal, 348, g1687. doi:10.1136/bmj.g1687

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Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials.