An evaluation of an open group for depressed mood on a stroke rehabilitation ward: three years of clinical data

Abstract

Purpose

An open group intervention for stroke inpatients, based on Acceptance and Commitment Therapy, is evaluated using retrospective clinical service data.

Materials and methods

Participants were included unless severely unwell or unable to provide informed consent. 117 participants attended at least two sessions in a non-controlled, repeated measures design. Two session protocols were delivered on alternating weeks by an Assistant Psychologist and Trainee Psychologist, covering values, committed action, and acceptance. Participants rated their mood each session using the Depression Intensity Scale Circles (DISCs).

Results

Attended sessions ranged from 1 to 11 (Md: 2). Significant reductions in DISCs scores with medium effect sizes were found among those scoring above the cut-off for depression at baseline, Χ²(3) = 20.87, p < .001. The likelihood of scoring below the cut-off for depression did not change between participants’ first and last sessions, X²(1, N = 117) = 1.36, p = .24. The number of sessions attended did not predict outcome, rs(117) = .09, p = .33.

Conclusions

Design limitations prevented inferences of clinical effectiveness, but the group met several clinical utility criteria by providing a flexible intervention on a rehabilitation ward with competing demands. We highlight the importance of contrasting findings of clinical trials with data from clinical services.

Implications for Rehabilitation

• In an uncontrolled, within-subjects analysis, we found that attendance of an open-group Acceptance and Commitment Therapy (ACT) based intervention was associated with reduced depressive symptoms in stroke rehabilitation inpatients

• Open-group psychological interventions may be an accessible and low-cost option for stroke clinicians on inpatient wards where flexibility is important

Keywords:

• Acceptance and commitment therapy
• mental health
• psychological intervention
• stroke
• inpatient rehabilitation

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data are collected from patients as part of Routine Outcome Monitoring. The data is confidential and the property of Norfolk Community Health and Care NHS Foundation Trust. Accordingly, we are unable to make these data publicly available.

Additional information

Funding

No external funding was provided for the purposes of this evaluation. This evaluation was completed using existing healthcare resources.