An online, group Acceptance and Commitment Therapy is acceptable to stroke survivors: a qualitative interview study

Foote, Hannah ORCID: https://orcid.org/0000-0002-1929-4139, Bowen, Audrey ORCID: https://orcid.org/0000-0003-4075-1215, Cotterill, Sarah ORCID: https://orcid.org/0000-0001-5136-390X and Patchwood, Emma ORCID: https://orcid.org/0000-0002-4198-5761 (2025) An online, group Acceptance and Commitment Therapy is acceptable to stroke survivors: a qualitative interview study. Neuropsychological Rehabilitation. pp. 1-19. ISSN 0960-2011

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Abstract

Mental health difficulties are common post-stroke and developing support for psychological adjustment is a research priority. Wellbeing After Stroke (WAterS) is a nine-week, online, group-based Acceptance and Commitment Therapy (ACT)-informed intervention, delivered by trained third-sector practitioners, supervised by a clinical neuropsychologist. This study aimed to explore the acceptability of WAterS from the stroke survivors’ perspective. Semi-structured interviews were conducted with twelve stroke survivors who received WAterS. The interview schedule was informed by theorised components of acceptability, including understanding, burden and perception of effectiveness. The data were analysed inductively and deductively using Template Analysis. Six qualitative themes were generated. Results indicate the intervention was mostly understandable and participants were able to engage with ACT and apply it to life. Online delivery reduced burden in accessing the intervention, and was acceptable when supported by live facilitation and a physical handbook. Group cohesion and understanding was facilitated by practitioners. The social aspect of the group was beneficial. Attending WAterS supported some participants to seek further support; others were left feeling unsupported when the intervention ended. Stroke survivors valued attending an online, group ACT-informed intervention, delivered by practitioners. This is a promising avenue in increasing the reach of interventions to support wellbeing.