Psychological Management of Stroke

Psychological Management of Stroke presents a review and synthesis of the current theory and data relating to the assessment, treatment, and psychological aspects of stroke.

• Provides comprehensive reviews of evidence based practice relating to stroke
• Written by clinical psychologists working in stroke services
• Covers a broad range of psychological aspects, including fitness to drive, decision making, prevention of stroke, and involvement of carers and families
• Reviews and synthesizes new data across a wide range of areas relevant to stroke and the assessment, treatment, and care of stroke survivors and their families
• Represents a novel approach to the application of psychological theory and principles in the stroke field

About the Authors vii

Foreword by The Stroke Association ix

Preface xi

Acknowledgements xiii

Section 1 Background to Stroke and Stroke Services 1

Chapter 1 Experiences and Effects of Stroke and Its Aftermath 3

Chapter 2 Clinical Stroke Services 28

Chapter 3 Neurological Basis of Stroke and Related Vascular Disorders 60

Section 2 Cognitive Effects of Stroke 85

Chapter 4 Neuropsychological Symptoms of Stroke 87

Chapter 5 Screening for Cognitive Problems after Stroke 109

Chapter 6 Neuropsychological Assessment after Stroke 130

Chapter 7 Communication Problems after Stroke 160

Chapter 8 Driving after Stroke 181

Chapter 9 Decision Making and Mental Capacity 203

Chapter 10 Neuropsychological Aspects of Rehabilitation 232

Chapter 11 Cognitive Rehabilitation 248

Chapter 12 Challenging Behaviour after Stroke 266

Section 3 Emotional Effects of Stroke 281

Chapter 13 Emotional Problems after Stroke 283

Chapter 14 Screening and Evaluation of Emotional Problems After Stroke 299

Chapter 15 Managing Emotional Problems after Stroke 329

Chapter 16 Behavioural and Cognitive-Behavioural Therapy for Depression after Stroke 336

Chapter 17 Stroke and Fear of Falling 349

Chapter 18 Prevention of Psychological Distress after Stroke 362

Chapter 19 Pain and Fatigue 378

Section 4 Social Dimensions of Stroke 391

Chapter 20 Carers of Stroke Survivors 393

Chapter 21 Strokes in Young People: Families and Children, Carers, Employment and Long-Term Survival 425

Chapter 22 Prevention of Stroke 455

Chapter 23 Conclusions and Future Directions 486

Appendix 1 491

References 493

Index 589

“This comprehensive and inspirational book ensures psychological care equals the importance of physical interventions to maximise quality of life poststroke. It is relevant to occupational therapy stroke clinicians, researchers and students, as well as being a valuable asset to multidisciplinary stroke services at all stages of the patient journey.” (British Journal of Occupational Therapy, 1 December 2012)

“Overall I found this a timely text that would be an excellent resource for anyone working in stroke services.” (The Psychologist, 1 January 2013)

“I offer my congratulations to the authors and my thanks on behalf of psychologists, stroke survivors, and their families.” (Psyccritiques, 5 September 2012)

Nadina Lincoln is Professor of Clinical Psychology at the University of Nottingham and Honorary Consultant Clinical Neuropsychologist at Nottingham University Hospitals NHS Trust. She has conducted an extensive programme of research to evaluate clinical stroke services.

Ian Kneebone is a Consultant Clinical Psychologist and a Visiting Reader at the University of Surrey. He has published on screening measures to detect psychological problems after stroke and on psychological interventions to manage them.

Jamie Macniven is a Consultant Clinical Neuropsychologist for Nottingham University Hospitals NHS Trust and Course Director of the MSc programme in clinical neuropsychology at the University of Nottingham.

Reg Morris is Programme Director of the South Wales Doctorate Programme in Clinical Psychology, Honorary Professor at the Cardiff University and Consultant Clinical Psychologist in Wiltshire NHS Trust and has published widely about facets of stroke care.

Psychological Management of Stroke presents a comprehensive review and synthesis of the current data relating to the assessment, treatment, and psychological wellbeing of stroke patients. Information on clinical practice -- and the research evidence to support that practice -- will assist clinical psychologists and other relevant health care professionals through all phases of stroke recovery and care.

Each chapter features a careful synthesis of recent international research about psychological factors relevant to stroke survivors, their families, and the services in which they are cared for and treated. Research results and effective treatment approaches are complemented by the inclusion of several personal case studies that reveal the perspectives of both survivors and their carers. Written by clinical psychologists working in stroke services, Psychological Management of Stroke represents an invaluable resource for anyone involved in the treatment of the psychological aspects of stroke.

This timely book offers a comprehensive, authoritative, evidence-based and practical guide to the psychological management of stroke. Chapters deal thoroughly with topics such as neuropsychological symptoms, screening for cognitive problems and cognitive rehabilitation, managing emotional problems, fear of falling, carers and prevention. The text offers a balance between research finding and reviews of evidence on the one hand and practical clinical suggestions with examples on the other.

I expect that this book will be highly valued by those offering psychological services and support to stroke patients and their families, as well as those providing medical care in acute and rehabilitation settings. I would strongly recommend it.
—Marie Johnston, Emeritus Professor of Health Psychology, University of Aberdeen, Scotland