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This research project aimed at obtaining an in-depth analysis of the experiences of self-identified co-dependents, who chose twelve-steps groups as a way for dealing with difficulties identified as co-dependency. Interpretative phenomenological analysis (IPA) was used as the methodology for the research. Eight participants volunteered from local support groups for co-dependency in the UK. Data were collected through 3 in-depth interviews with each participant over a period of 3–6 months. A visual method was used to gain a more in-depth phenomenological perspective. It included photographs, drawings and images chosen by the participants to describe their experiences. The analysis revealed 2 contradicting and complementary themes: (1) representations of the twelve-step group as a helpful tool and (2) representations of the twelve-step group as no longer meaningful. It demonstrated that the participants found their groups useful as an initial pathway for recovery; however, it did not feature as a central aspect in their recovery, as different levels of engagement were described. The results of this study provide a base for developing a more empathic and contextualised understanding of the experience of individuals who attend twelve-step groups for co-dependency, which in turn will enable health professionals to offer support which is relevant to these individuals’ experiences.Co-dependency is a contested psychological concept associated with addictive behaviours. It is a multifactorial problem characterised by a constellation of factors identified as differentiation of self, self-sacrifice, external locus of control, interpersonal conflict and control and emotional constraint (Lampis et al. 2017; Dear and Roberts 2005). Evidence suggests that these factors are typically found in the lives of adults who grew up in dysfunctional families, for example where substance abuse prevailed (Abadi, Maarefvand, Aghaei et al. 2017; Bortolon et al. 2017; Sarkar et al. 2015; Marks et al. 2012).A systematic review of literature in co-dependency offered a summary of various treatment perspectives based on individual and group therapy modalities (Ahmad-Abadi, Vand and Aghaee 2015). The twelve-step group appears to be the preferred pathway for helping individuals who identify with this problem (Askian et al. 2016, 2018; Sohrabnejad et al. 2018; Abadi et al. 2015).However, our review of literature in co-dependency demonstrated that to this date, to our knowledge, the voices and experiences of individuals who attend twelve-step groups have not been included in the discussion, therefore indicating the need for an in-depth analysis of the perspectives of self-identified co-dependents, who chose the twelve-step group as a way for dealing with difficulties identified as co-dependency. Their experiences of the twelve-step recovery groups will illuminate professionals who work in this field, suggesting ways to support people who consider themselves to be co-dependents and who chose the twelve-step group pathway for recovery.

Introduction: People often experience distress following stroke due to fundamental challenges to their identity. Objectives: To evaluate (1) the acceptability of ‘HeART of Stroke’ (HoS), a community-based arts and health group intervention, to increase psychological well-being; and (2) the feasibility of a definitive randomised controlled trial (RCT). Design: Two-centre, 24-month, parallel-arm RCT with qualitative and economic components. Randomisation was stratified by centre and stroke severity. Participant blinding was not possible. Outcome assessment blinding was attempted. Setting: Community. Participants: Community-dwelling adults ≤2 years poststroke recruited via hospital clinical teams/databases or community stroke/rehabilitation teams. Interventions: Artist-facilitated arts and health group intervention (HoS) (ten 2-hour sessions over 14 weeks) plus usual care (UC) versus UC. Outcomes: The outcomes were self-reported measures of well-being, mood, capability, health-related quality of life, self-esteem and self-concept (baseline and 5 months postrandomisation). Key feasibility parameters were gathered, data collection methods were piloted, and participant interviews (n=24) explored the acceptability of the intervention and study processes. Results: Despite a low recruitment rate (14%; 95% CI 11% to 18%), 88% of the recruitment target was met, with 29 participants randomised to HoS and 27 to UC (57% male; mean (SD) age=70 (12.1) years; time since stroke=9 (6.1) months). Follow-up data were available for 47 of 56 (84%; 95% CI 72% to 91%). Completion rates for a study-specific resource use questionnaire were 79% and 68% (National Health Service and societal perspectives). Five people declined HoS postrandomisation; of the remaining 24 who attended, 83% attended ≥6 sessions. Preliminary effect sizes for candidate primary outcomes were in the direction of benefit for the HoS arm. Participants found study processes acceptable. The intervention cost an estimated £456 per person and was well-received (no intervention-related serious adverse events were reported). Conclusions: Findings from this first community-based study of an arts and health intervention for people poststroke suggest a definitive RCT is feasible. Recruitment methods will be revised. Trial registration number: ISRCTN99728983.