Recovering Together: Clinician Guide

Having an acute neurological illness (ANI; e.g., stroke, brain injury) is often traumatic for patients and the family or friends who support them (e.g., caregivers). The sudden onset of symptoms, admission to an intensive care unit, and prognostic uncertainty contribute to emotional distress symptoms (depression, anxiety, posttraumatic stress) in both patients and their informal caregivers. This early distress is interdependent between patients and caregivers, and, if untreated can become chronic and interfere with patient's recovery and caregivers' quality of life. Addressing early emotional distress with both the patient and caregiver (e.g., together called a dyad) accounts for this interdependency and can be an effective and efficient modality to prevent chronic emotional distress in both. Recovering Together (RT) is a 6-session, modular dyadic resiliency intervention that aims to prevent chronic emotional distress following an ANI. This intervention integrates evidence-based approaches including mindfulness, cognitive behavioral therapy, and dialectical behavior therapy and repackages them in ways that decrease cognitive load and increase accessibility in the context of an ANI. It teaches mindfulness skills (e.g., deep breathing, present moment awareness), coping skills (e.g., dialectics, meaning-making, adaptive thinking), and interpersonal skills (e.g., communication, coping with role changes). RT can be delivered within a hospital as well as over live video. This clinician guide provides session-by-session instructions, scripts, in-session activities, and home practice assignments, which can be used in conjunction with the accompanying patient and caregiver workbook. Corresponding materials available online provide additional opportunity for practice.