The effectiveness of problem solving therapy for stroke patients: study protocol for a pragmatic randomized controlled trial

If you were smart you would realize that the whole problem here is that survivors have a small chance of full recovery  using current methods. Making them feel better about the lack of recovery is not useful. Go back and start figuring out how to reduce disability in the first place by maybe using one of these 177 hyperacute therapies.

This is just another version of getting better at breaking bad news.
 http://7thspace.com/headlines/440170/the_effectiveness_of_problem_solving_therapy_for_stroke_patients_study_protocol_for_a_pragmatic_randomized_controlled_trial.html
Coping style is one of the determinants of health-related quality of life after stroke. Stroke patients make less use of active problem-oriented coping styles than other brain damaged patients.

Coping styles can be influenced by means of intervention. The primary aim of this study is to investigate if Problem Solving Therapy is an effective group intervention for improving coping style and health-related quality of life in stroke patients.

The secondary aim is to determine the effect of Problem Solving Therapy on depression, social participation, health care consumption, and to determine the cost-effectiveness of the intervention.

Methods: We strive to include 200 stroke patients in the outpatient phase of rehabilitation treatment, using a multicenter pragmatic randomized controlled trial with one year follow-up. Patients in the intervention group will receive Problem Solving Therapy in addition to the standard rehabilitation program.

The intervention will be provided in an open group design, with a continuous flow of patients. Primary outcome measures are coping style and health-related quality of life.

Secondary outcome measures are depression, social participation, health care consumption, and the cost-effectiveness of the intervention.DiscussionWe designed our study as close to the implementation in practice as possible, using a pragmatic randomized trial and open group design, to represent a realistic estimate of the effectiveness of the intervention. If effective, Problem Solving Therapy is an inexpensive, deliverable and sustainable group intervention for stroke rehabilitation programs.Trial registration: Nederlands Trial Register, NTR2509