"A Better Way of Just Being Free": Exploring How Stroke Survivors With Aphasia Experienced an Intervention Combining...

Depression, anxiety, and social isolation are prevalent among stroke survivors with aphasia (SSwA). However, evidence-based mental health interventions for SSwA are limited. The Acceptance and Commitment Therapy (ACT) for Aphasia Phase I clinical trial (NCT04984239) sought to bridge this gap by adapting and piloting an intervention combining ACT with communication strategy training to improve mental health and functional communication in SSwA. Here, we present the qualitative findings of this study to characterize experiential outcomes and inform intervention refinement.

Following a content analysis approach, we examined the posttreatment interviews of participants who received a refined version of the intervention (n = 14). Interviews were coded via an iterative consensus process. The final codebook included 190 unique codes and three main categories: (a) Positive Intervention Experiences, (b) Intervention Critiques, (c) Mechanisms of Change.

Participants reported satisfaction with the intervention, positive changes in mood and behavior, and increased acceptance of their aphasia. Findings supported the utility of all core intervention components and highlighted the importance of mindfulness practice, forming a therapeutic alliance, and supporting patient autonomy. Findings were consistent with hypothesized mechanisms of change regarding psychological flexibility and treatment generalization.

This study provides qualitative support for further evaluation of ACT for Aphasia and contributes to an emerging evidence base for adapted psychological interventions developed specifically for SSwA.

https://doi.org/10.23641/asha.32316024.