A framework to support cognitive behavior therapy for emotional disorder after stroke

Emotional disorders are common after stroke, but lacking is a complete framework to inform their treatment with cognitive behavioral therapy (CBT). This paper describes such a framework. It considers modification of CBT in light of cognitive and communication disability, and the involvement of carers in treatment, and presents brief case studies to illustrate the different elements of the framework. The development of a modified CBT should form the foundation for randomized controlled trials (RCT) to support treatment in this population. Service delivery issues include pathways to treatment, therapist confidence, and the overall positioning of CBT within stroke care.