Early Talk Therapy May Help Stroke Patients Bounce
THURSDAY, June 23 (HealthDay News) -- After suffering a stroke,
patients who talk with a therapist about their hopes and fears
about the future are less depressed and live longer than patients
who don't, British researchers say.
In fact, 48 percent of the people who participated in these
motivational interviews within the first month after a stroke were
not depressed a year later, compared to 37.7 of the patients who
were not involved in talk therapy.
In addition, only 6.5 percent of those involved in talk therapy
died within the year, compared with 12.8 percent of patients who
didn't receive the therapy, the investigators found.
"The talk-based intervention is based on helping people to adjust to the consequences of their stroke so they are less likely to be depressed," said lead researcher Caroline Watkins, a professor of stroke and elder care at the University of Central Lancashire.
Depression is common after a stroke, affecting about 40 to 50
percent of patients. Of these, about 20 percent will suffer major
depression. Depression, which can lead to apathy, social withdrawal
and even suicide, is one of the biggest obstacles to physical and
mental recovery after a stroke, researchers say.
Watkins believes their approach is unique. "Psychological
interventions haven't been shown to be effective, although it seems
like a sensible thing," she said. "This is the first time a
talk-based therapy has been shown to be effective.
One reason, the researchers noted, is that the therapy began a
month after the stroke, earlier than other trials of psychological
counseling. They speculated that with later interventions,
depression had already set in and may have interfered with
recovery. Early therapy, Watkins has said, can help people set
realistic expectations "and avoid some of the misery of life after
The report was published in the July issue of
For the study, the researchers randomly assigned half of 411
stroke patients to see a therapist for up to four 30- to 60-minute
sessions and the other half to no visits with a therapist. All of
the patients received standard stroke care, the study authors
During the sessions, patients were asked to talk about their
future, what obstacles they thought they would have to overcome in
recovery and how confident they were about solving them.
In addition, the patients were encouraged to come up with their
own solutions to the problems they were going to face, Watkins
explained. "It's not just talking to people in any old way," she
Patients with severe communication problems were excluded from
the study because it would have been difficult for them to take
part in talk-based therapy, Watkins added.
After a year, the patients responded to a questionnaire to see
how well they were doing.
Watkins noted that the study was done only in one hospital and
only with a specific therapy. Whether this approach would be useful
in other hospitals or with other types of talk therapy isn't clear,
She and the other researchers also pointed out that although a
larger number of patients in the control group died within the year
-- suggesting a strong link between mood and death following a
stroke -- further research needed to be done to examine the cause
of the deaths.
Intriguingly, the therapists were not clinical psychologists,
but two nurses and two people with psychology degrees. They were
trained and supervised by a clinical psychologist, suggesting that
other health care settings could do the same at a low cost.
Commenting on the research, Dr. Larry B. Goldstein, a professor
of medicine and director of the Duke Stroke Center at Duke
University Medical Center, said that "this is a promising initial
However, it was limited to a selected group of patients from a
single hospital. "The study will need to be replicated and the
generalizability of the findings established with testing in a
broader range of study sites," he said.
For more information on stroke, visit the
U.S. National Library of Medicine.
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