Article

Emotional difficulties are common after stroke and have an impact on rehabilitation outcome. It is a challenge to manage these problems effectively,
particularly in times of resource stringency. One proposal for how to do this has
arisen out of an approach to general mental health management: a system of
'stepped care'. Such a system directs intervention by considering level of need,
thereby making the most efficient use of available resources.
It is the purpose
of this article to articulate a stepped psychological care approach for emotional
problems after stroke. METHOD: Narrative review and elaboration of the model
proposed by the Department of Health in England for the management of emotional
problems after stroke. RESULTS: A stepped care model for the management of
emotional problems after stroke is presented in detail, including descriptions of
specific interventions and guidance to inform the level of management.
CONCLUSIONS: The stepped psychological care proposal for emotional problems after
stroke requires evaluation but is potentially of use within comparable healthcare
systems. Implications for Rehabilitation Emotional problems are common after
stroke and effect rehabilitation outcomes. A stepped care approach to these
problems offers the ability to cater to all according to need. Greater
specification of the services at each step can be outlined. While recommended,
such an approach requires evaluation to prove its efficacy.

Langue : ANGLAIS