SOlution Focused brief therapy In post-stroke Aphasia (SOFIA) feasibliity trial
Published on (GMT) by Sarah Northcott
Background and aims Around a quarter of people post stroke will experience aphasia, a language disability which can affect speaking, understanding, reading and writing. People with aphasia are at risk of becoming depressed and isolated. There is limited evidence for effective interventions to enhance psychological well-being for this client group. A potential intervention is Solution Focused Brief Therapy (SFBT), which supports a person to build meaningful, achievable change through focusing on a person’s skills and resources. The aims of the SOlution Focused brief therapy In post-stroke Aphasia (SOFIA) trial are to explore the acceptability of SFBT to people with aphasia, including severe aphasia, and to assess the feasibility of conducting a future definitive trial investigating clinical and cost effectiveness. Methods The SOFIA Trial is a single-blind, randomised, wait-list controlled feasibility trial with nested qualitative research and pilot economic evaluation comparing SFBT plus usual care to usual care alone. The study will recruit 32 participants with aphasia who are at least six months post stroke. All participants will be assessed on psychosocial outcome measures at baseline, then at three months and six months post randomisation by assessors blinded to treatment allocation. Participants will be randomly assigned to intervention group (start intervention immediately post randomisation) or wait-list group (start intervention six months post randomisation). Wait-list group will additionally be assessed nine months post randomisation. The intervention is up to six SFBT sessions delivered over three months by Speech and Language Therapists, who will receive specialist training and support. All participants and therapists will take part in in-depth interviews exploring their experiences of the study at six months post randomisation; the wait-list group will additionally be invited to take part in interviews at nine months post randomisation. The pilot economic evaluation will use the EQ-5D-5L measure and the Client Service Receipt Inventory adapted so as to be more accessible to people with aphasia. People with aphasia have been involved in designing and monitoring the trial through the SOFIA Aphasia Advisory Group. Discussion Given the high levels of distress and isolation in this client group, and the current poor evidence base, there is a need to investigate effective interventions. SFBT is potentially a practical relatively brief approach deliverable by Speech and Language Therapists. Exploring how to adapt SFBT for people with aphasia, including severe aphasia, may provide a valuable tool with which to address their psychosocial needs.
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