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Title: A systematic review of the effect of group based mindfulness interventions for acquired brain injury survivors and an empirical study exploring stroke survivors' views and experiences of using 'Rebuilding Your Life After Stroke' as a rehabilitation tool
Author: Williams, Kathleen
ISNI:       0000 0004 9354 2238
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2020
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Advances in acute medical intervention has resulted in an increase of survival rates for those experiencing an acquired brain injury (ABI). ABI such as stroke and traumatic brain injury (TBI) are leading causes of disability and post injury. ABI survivors experience a range of physical, emotional and cognitive difficulties, some of which result in a permanent change in survivors’ ability to function. Subsequently, ABI survivors have to adjust to their new way of life, managing with these residual effects and disabilities. Therefore, it is unsurprising that incidence of psychological difficulties such as anxiety or depression are higher in ABI survivors and that they use health services at a higher rate. Additionally, the effective treatment of psychological difficulties by conventional methods such as Cognitive Behavioural Therapy (CBT) is limited. Survivors’ cognitive deficits make engaging with approaches such as CBT more challenging and ABI survivors report high levels of unmet needs. Acceptance and Commitment Therapy (ACT) is a relatively new therapy that has shown promise in helping stroke survivors to better manage their difficulties and mindfulness is a method inherent within the ACT approach. With the increase in effective acute intervention and aging population, the number of ABI survivors is set to increase in the coming years. It is anticipated that demand for help will continue to be greater than services will be able to offer, especially as it is likely that healthcare funding will not increase in accordance with the amount of people surviving. Therefore, the quest for the cost-effective dissemination of psychological information and delivery of interventions to reduce the psychological difficulties associated with ABI has burgeoned. The facilitation of group based interventions and development of a condition specific self-help book could be a solution. Paper 1 presents a systematic review of group-based mindfulness interventions for adults with traumatic brain injury, brain haemorrhage or stroke. PsychInfo, MEDLINE, EMBASE, Web of Science and Scopus databases were electronically searched, the reference lists and author websites of included studies were handsearched and eleven studies met inclusion criteria. Studies investigated the effect of group based mindfulness on a range of psychological outcomes from anxiety and depression to survivors’ abilities to integrate into the community after their ABI. All the outcomes were summarised in the review and studies were quality assessed. As the studies included were of varying quality, it is difficult to draw firm conclusions. However, generally it can be concluded that group based mindfulness can be beneficial across a range of outcomes, particularly in relation to the management of emotional difficulties post injury. The paper concludes with recommendations for future research. Paper 2 presents a qualitative exploration of stroke survivors’ views and experiences of using the ‘Rebuilding Your Life After Stroke’ book. Thirteen participants were interviewed and transcripts were analysed using Inductive Thematic Analysis. Three themes emerged 1) Active Process: participants have to actively engage in their rehabilitation, which is improved with professional support. 2) Tailor Made Intervention: the book is flexible and allows survivors to assess and understand their difficulties and gives them choice and control over their rehabilitation. This allows survivors to use strategies to overcome the effects of stroke that would otherwise make rehabilitation difficult. 3) Outcomes: outcomes include an improved understanding, acceptance, the development of new skills and feelings of hope. Participants in this study felt that ‘Rebuilding Your Life After Stroke’ was an accessible, effective and reliable resource, which suggests that the book is suitable for the target audience. Professionals in stroke services or third sector organisations (e.g. charities) can have confidence in the use of the book as a resource. Moreover, the book is also versatile as it can be read independently in its use as a self-help book or can form the basis of interventions such as guided self-help or bibliotherapy.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: BF Psychology