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Self-directed bibliotherapy interventions can be effective means of psychological support for individuals with cancer, yet mixed findings as to the efficacy of these interventions indicate the need for further research. We investigated the experience of individuals with cancer after using a new self-help book, based on Acceptance and Commitment Therapy (ACT). Ten participants with cancer (nine females and one male, 40–89 years old) were given access to a bibliotherapy self-help ACT-based book and participated in post-intervention semi-structured interviews. Five themes were generated from reflexive thematic analysis: (1) The value of bibliotherapy (2) Timing is important (3) Resonating with cancer experiences (4) Tools of the book (5) ACT in action. The book was found to be acceptable (self-directed, accessible, understandable content, good responsiveness to exercises) and feasible (easy to use, ACT-consistent). Although not explicitly evaluated, participants' reports indicated defusion, present moment awareness, and consideration of values, as the ACT processes that contributed to adjustment, via helping them to regain control over their lives and become more present within the moment. Findings also indicate that the intervention may be best accessed following completion of initial medical treatment. [ABSTRACT FROM AUTHOR]

Post stroke anxiety is associated with reduced quality of life, worse rehabilitation outcomes and poor social functioning in stroke survivors. Despite its clinical relevance, there are a lack of screening tools to identify post-stroke anxiety. The Hospital Anxiety and Depression Scale (HADS-A) and Geriatric Anxiety Inventory (GAI) are the only self-report screening test for anxiety validated in stroke patients. However, both of these measures have limitations associated with their clinical utility, length of time to administer and cost to purchase. This study aimed to assess the classiciation accuracy of a freely available and shorter alternative, the Generalized Anxiety Disorder 2-item (GAD-2) for use in the acute stroke setting. This study used retrospective analysis of a sequential sample in a clinical database of mood and cognitive scores. Patients' scores on the GAD-2 and HADS-A were compared. The GAD-2 demonstrated strong convergent validity with the HADS-A and good specificity and sensitivity for clinical anxiety. In conclusion, the GAD-2 may be a useful screening assessment of post-stroke anxiety in the acute setting; however, it should be used with due consideration of the methodological limitations of this study. [ABSTRACT FROM AUTHOR]

Background: Psychological distress is common after stroke, and affects recovery. However, there are few evidence-based psychological treatments. This study evaluates a bibliotherapy-based approach to its amelioration. Aims: To investigate a stroke-specific self-management book, based on acceptance and commitment therapy (ACT), as a therapist-supported intervention for psychological distress after stroke. Method: The design was a single case, randomised non-concurrent multiple-baseline design (MBD). Sixteen stroke survivors, eight males and eight females (mean age 60.6 years), participated in an MBD with three phases: A (randomised-duration baseline); B (intervention); and follow-up (at 3 weeks). During the baseline, participants received therapist contact only. In the bibliotherapy intervention, participants received bi-weekly therapist support. The primary measures of psychological distress (General Health Questionaire-12; GHQ-12) and quality of life (Satisfaction with Life Scale; SWLS) were completed weekly. Secondary measures of mood, wellbeing and illness impact were completed pre- and post-intervention. Results: Omnibus whole-group TAU-U analysis was statistically significant for each primary measure with a moderate effect size on both (0.6 and 0.3 for GHQ-12 and SWLS, respectively). Individual TAU-U analyses demonstrated that the majority of individuals exhibited positive change. All the secondary measures showed significant pre–post improvements. Eighty-one per cent of participants reported the book was helpful and 81% also found the ACT-based sections helpful. Relative risk calculations showed finding the book helpful was associated with improvement in GHQ-12 and SWLS scores. Conclusions: ACT-based bibliotherapy, with therapist support, is a promising intervention for psychological difficulties after stroke. [ABSTRACT FROM AUTHOR]

The well‐being of the psychological workforce is an area of concern. However, it has been sparsely studied in a holistic manner encompassing workplace well‐being as well as burnout. This study reports a survey of 1,678 psychological practitioners accessed through professional networks. The short Warwick Edinburgh Mental Well‐being Scale (SWEMWBS) and the Psychological Practitioner Workplace Well‐being Measure (PPWWM) were administered with a demographic questionnaire. The mean for the SWEMWBS was below that of a national population survey. The intercorrelation of these tests was.61. Subgroup analyses showed significant differences: assistant psychologists, counsellors and psychological well‐being practitioners demonstrated better than average workplace well‐being. But for general well‐being (SWEMWBS), trainee clinical psychologists and assistant psychologists showed lower than average well‐being, whereas psychological well‐being practitioners were higher than average. Other factors associated with well‐being were contract type—both measures (higher workplace well‐being in those with temporary contracts and the self‐employed); employment sector—for PPWWM only (private organisation/independent workers and third sector/charitable organisation workers scored above the PPWWM mean); ethnicity—for both measures (Asian groups except Chinese had higher well‐being than average for the PPWWM and SWEMWBS) and disability was strongly associated with lower well‐being on both measures. Harassment, feeling depressed or a failure and wanting to leave the National Health Service (NHS) were associated with lower well‐being. Greater age, pay and years of service were negatively correlated with well‐being. A five‐factor structure was obtained with this sample. The results confirmed psychological practitioners as an at‐risk group and identified a number of factors associated with workplace well‐being. [ABSTRACT FROM AUTHOR]

Copious research on the utility of Acceptance and Commitment Therapy (ACT) in long-term conditions has demonstrated promising results. However, little research has been conducted on ACT within stroke, particularly studies that are qualitative in nature. The aim of this paper was to gain insight into stroke survivors' experiences of ACT and to explore what processes help facilitate adjustment in living with residual disability. Interviews with thirteen stroke survivors following their attendance at a stroke-adapted ACT group were analysed using a grounded theory approach. Stroke survivors varied in age, severity of stroke, limitations and duration since stroke. Interviews revealed a main difficulty of "accepting a changed reality" following stroke. Survivors' narratives regarding their experiences of ACT revealed insight into which processes helped facilitate movement towards accepting symptoms and a changed reality and into helpful and less helpful aspects of the intervention. Stroke survivors find ACT helpful in adjusting to stroke limitations. ACT appears to have potential as a psychological intervention for stroke survivors experiencing psychological distress. Amendments to the format of the intervention to enhance the impact of ACT impact are identified. [ABSTRACT FROM AUTHOR]

The well‐being of psychological practitioners is a key factor in the effective delivery of psychological therapies and the effectiveness of mental health services. Despite this, there are no measures of well‐being for this professional group. The 26‐item psychological practitioner workplace well‐being measure (PPWWM) measures psychological well‐being for psychological practitioners and was informed by a qualitative study. Items were generated and then verified by groups of practitioners using sorting tasks. The items reflect a broad range of issues relevant to the workplace well‐being of psychological practitioners. The PPWWM was validated with a sample of 400 psychological practitioners recruited through professional networks. Internal consistency (α =.92) and test–retest reliability (r =.94) were high. Construct validity was indicated by positive correlations with the Health and Safety Executive Management Standards Indicator Tool and Satisfaction with Life Scale and negative correlation with the General Health Questionnaire. Exploratory factor analysis produced six factors, explaining 61.2% of the variance: professional and organizational; support and flexibility; professional role; physical environment; clinical supervision; and external personal. PPWWM scores were not significantly associated with a range of demographic variables (gender, health/disability, profession, and type of organization), but it did correlate significantly and negatively with age. The PPWWM has potential application as a brief measure, suitable for large‐scale surveys that specifically measures workplace well‐being in psychological practitioners. Future research could include cross validation with new samples and validation with subgroups of psychological practitioners. [ABSTRACT FROM AUTHOR]

Objectives: To examine change in identity after stroke and to elucidate its relationship with mood and quality of life. To test Higgins' theory of the impact of identity (self-discrepancy) on anxiety and depression. To examine the role of self-esteem in mediating the relationship between identity and outcomes.Method: Sixty-five community-living first-time stroke survivors, mean age 61.58 and time since stroke 5.60 years, were recruited from stroke charities. A cross-sectional study used the Head Injury Semantic Differential Scale, the Hospital Anxiety and Depression Scale, the Rosenberg Self-Esteem Scale, the Stroke-Specific Quality of Life Questionnaire (adapted) and the Barthel Index.Results: Identity was rated more negatively after stroke than before (t(64) = 6.46, p < .00). Greater discrepancy in identity was associated with anxiety (r = .38, p < .00), depression (r = .59, p < .00), self-esteem (r = -.48, p < .00) and quality of life (r = -.54, p < .00). Overall positivity of identity after stroke predicted outcomes even better than discrepancy. The association between discrepancy and mood and quality of life was mediated by self-esteem (β = .30, p < .01; β = -.24, p < .01, respectively). Specific types of discrepancy defined by Higgins did not show differential relationships with anxiety and depression as predicted.Conclusions: Identity changes after stroke and identity and self-esteem are associated with important outcomes for stroke survivors. [ABSTRACT FROM AUTHOR]

Objectives: To date, the efficacy of acceptance and commitment therapy (ACT) for stroke survivors has not been established. The aim of this study was to evaluate the efficacy of group‐based ACT for stroke survivors in comparison with treatment as usual (TAU) controls. Methods: Fifty‐three participants were randomly assigned either to group‐based ACT (ACTivate Your Life after Stroke) or to a TAU control group (60% male; mean age: 63 years). The ACT intervention consisted of four weekly 2‐hr didactic group sessions. Therapeutic effects were measured by examining changes in depression (primary outcome), anxiety, hope, health‐related quality of life, self‐rated health status, and mental well‐being. Measures were completed at pre‐treatment, post‐treatment, and 2‐month follow‐up. A mixed‐design repeated‐measures multivariate ANOVA was conducted to analyse the findings. Results: Analysis based on intention to treat found that compared to participants in the TAU control, group‐based ACT significantly reduced depression and increased self‐rated health status and hopefulness in stroke survivors, with medium effect sizes. Significantly more participants reached clinically significant change of depression in the ACT intervention in comparison with the control group. Conclusions: The results correspond with previous studies of group‐based ACT with other long‐term conditions. The findings from this current study suggest group‐based ACT may have promising utility and could offer a suitable low‐intensity psychological intervention for stroke survivors. However, further large‐scale research is required. Practitioner points: Acceptance and commitment therapy (ACT), delivered didactically to groups of stroke survivors, proved feasible and acceptable.ACT had benefits, relative to treatment as usual, for depression, health status, and hope.Several secondary outcome variables did not show dependable benefit for ACT: anxiety; health‐related quality of life; and mental well‐being.Results should be treated as preliminary as the sample size was small, blinding was not possible, concomitant treatments were not monitored, and there was no attention control condition.Despite these limitations, group‐based ACT merits further study as a potentially effective intervention. [ABSTRACT FROM AUTHOR]

Background: Few mental health screening tools are validated for prisoners. Existing tools do not guide referral between primary and secondary care pathways.Aims: This study aimed to assess performance of the CORE-10 in screening any current mental health problem and current severe mental illness (SMI) in prisoners.Method: CORE-10 ratings were compared with mini international neuropsychiatric interview (MINI) version 6.0 ratings and current practice outcomes for 150 male prisoners. Receiver operating curve (ROC) analyses were used to estimate the likelihood with which CORE-10 ratings matched MINI ratings, yielding "area under the curve" statistics.Results: ROC analyses suggested a strong relationship between CORE-10 screen scores and the more detailed assessment both in identifying any problem (AUC 0.85) and severe mental illness (AUC 0.76). Sensitivity was 0.88 and 0.83, and specificity was 0.64 and 0.61, respectively. Retest reliability was moderate (ICC = 0.83). The CORE-10 identified many cases of "any problem" and of severe illness also identified by the MINI who had not been referred to clinical services in routine practice.Conclusions: This study provides evidence for the potential of the CORE-10 for improving appropriate referrals for prisoners to mental health services. [ABSTRACT FROM AUTHOR]

Purpose: The development of post-traumatic growth was studied longitudinally within 14 months poststroke. The predictions of two models of post-traumatic growth were examined. Method: Forty-three stroke survivors were investigated at two time points (i.e., time 1 and time 2), six months apart. Each completed the Post-traumatic Growth Inventory, Rumination Scale, Impact of Events Scale, Multidimensional Scale of Social Support, the Barthel Index and the COPE scale. Results: Post-traumatic growth was evident four to five months after stroke, increasing significantly over the next six months at which point levels resembled those reported in cross-sectional stroke studies. Active and denial coping and rumination at time 1 were positively associated, and age was negatively associated, with post-traumatic growth at time 2, but acceptance coping was not associated. Neither active coping nor rumination mediated the effect of social support on post-traumatic growth as predicted. As predicted, rumination mediated the relationship between post-traumatic stress and post-traumatic growth. Exploratory stepwise regression demonstrated rumination and active coping at time 1 accounted for 45% of variance in post-traumatic growth at time 2. Conclusions: Post-traumatic growth can develop soon after stroke. Deliberate rumination is a key factor in post-traumatic growth. Both active coping and denial coping were associated with post-traumatic growth demonstrating the psychological complexity of poststroke adjustment. Implications for rehabilitation: Therapists can expect stroke survivors to show post-traumatic growth in the first months after stroke. Therapists should look to promote post-traumatic growth and positive adjustment through working with survivors to increase active coping (attempts to deal effectively with the impact of stroke) and rumination (cognitive processing of the impact of the stroke). Since denial coping was also associated with posttraumatic growth, stroke survivors who maintain overly optimistic views about the severity and impact of their stroke are likely to benefit from therapists continually facilitating capacity for growth and well-being. [ABSTRACT FROM AUTHOR]

Purpose: To elucidate how community stroke staff in a major third sector organisation experienced their role and understood and responded to clients’ psychological needs.Method: In stage 1, three focus groups of 28 staff in total were recorded, transcribed and analysed using inductive thematic analysis. Themes were authenticated by new staff groups. In stage 2, these themes informed the construction of a questionnaire delivered through the organisation’s intranet by “Survey Monkey”.Results: Five themes emerged from the focus groups: background and context; perceptions of clients’ psychological issues; approaches to meeting psychological needs; the experience of working with psychological needs and sources of support; aspirations for future development. Four themes were used in constructing the questionnaire. Responses from 144 staff with diverse qualifications and experience were received; over half encountered 16 (of 35) psychological issues at least once per week. Stroke survivors’ needs predominated over carers’ needs. Skills used to address psychological problems were identified, also training and support needs and future aspirations. Support needs included information, training and access to specialist consultants.Conclusions: Psychological issues were central in the work of third sector community stroke staff; psychological skills were routinely used. Attention to means of supporting and developing these skills is required.Implications for RehabilitationService leaders and commissioners should be aware that third sector community stroke staff frequently deal with a diverse range of psychological issues and perceive psychological care as central.Service leaders should consider providing training in assessment and management of mood and cognition, risk assessment and management and basic counselling.Staff should be provided with access to specialist consultation and better information about psychological aspects of referrals.There is uncertainty about key methods for supporting the delivery of psychological care (supervision, mentoring and peer support) which requires consideration. [ABSTRACT FROM PUBLISHER]