Problem-Solving Therapy for Depressive Symptoms and Quality of Life in Stroke Survivor-Caregiver Dyads

Stroke Survivor-Caregiver Dyads: Feasibility of a Brief Psychosocial Intervention for Depressive Symptoms and Quality of Life

The purpose of this feasibility study is to determine whether it is practical and helpful to provide problem-solving therapy to stroke survivors and their spouses/partners (caregivers) together. It will also compare the experiences of participants who receive problem-solving therapy to those who receive stroke-related health education.

Many stroke survivors and caregivers report feeling sad or blue at some point after the stroke. These feelings can impact quality of life. Encountering problems is a part of daily life. These problems can be big or small, but sometimes they can pile up and feel overwhelming, contributing to feelings of sadness. Problem-solving therapy is a tool that teaches structured ways to address current problems or challenges in your life.

Participants who are assigned to receive problem-solving therapy will work with a research team member for six, one-hour sessions. During each session, participants will identify a problem (big or small) and create a plan to work on that problem.

Participants who are assigned to receive stroke-related health education will work with a research team member who will teach them about various topics related to stroke over six, one-hour sessions. Each session will cover information about a different topic related to stroke.

Outcomes data will be collected at approximately 4 weeks, 8 weeks, and 13 weeks from baseline.

Inclusion Criteria:

1. Both dyad participants are at least 18 years of age.
2. The stroke survivor experienced an ischemic or hemorrhagic stroke at least 3 months prior to enrollment.
3. The caregiver is a spouse/partner who provides regular, unpaid support for the survivor in activities of daily living.
4. Both dyad members are willing and able understand and comply with protocol requirements.

Exclusion Criteria:

1. The stroke survivor has severe expressive or receptive aphasia or global aphasia, as documented in the medical record by a speech pathologist or other provider.
2. Either dyad member is unable to write, as this will interfere with completion of MiniCog assessment.
3. Either dyad member has significant cognitive impairment, evidenced by MiniCog score <4 at screening.
4. Either dyad member reports an intent to harm him/herself or others.
5. Either dyad member has any concurrent conditions that would interfere with participation.