Ecosystem focused therapy in poststroke depression: a preliminary study

ALEXOPOULOS George S., et al
Journal article citation:
International Journal of Geriatric Psychiatry, 27(10), October 2012, pp.1053-1060.

Poststroke depression (PSD) occurs in the context of abrupt, often catastrophic disability. It finds the patient and their family unprepared and can have a devastating effect. The authors developed the Ecosystem Focused Therapy (EFT), a systematic intervention that targets the ensuing “psychosocial storm”. It consists of five integrated components: action orientated perspectives on recovery; enhanced treatment adherence; problem solving structures; reengineered family goals; and it coordinates care. This paper reports a preliminary study of the efficacy of EFT in reducing depression and disability in 24 patients with PSD. Patients were randomly assigned to receive weekly sessions of EFT or Education on Stroke and Depression alongside their treatment for 12 weeks. The mean ages of the groups were 72.3 years and 69.4 years respectively. The results suggest that EFT may be more efficacious than Education on Stroke and Depression in reducing depressive symptoms and signs, in leading to a higher remission rate, and in ameliorating disability in PSD. Reduction of disability in the early part of the trial mediated later improvement in depressive symptomatology. The authors suggest that beyond its potential direct benefits in PSD, EFT may also provide an appropriate context for efficient and timely administration of pharmacotherapy and of physical, speech, and occupational therapy in order to maximise their efficacy.

Subject terms:
older people, psychotherapy, stroke, depression, health education;
Content type:
United States
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