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Table 1 Content of telephone-delivered cognitive behavioural therapy sessions

From: Study protocol for POSITIF, a randomised multicentre feasibility trial of a brief cognitive-behavioural intervention plus information versus information alone for the treatment of post-stroke fatigue

Session numberTreatment outline
1Engagement and preparation
­ Discuss the patient’s experience of post-stroke fatigue
­ Explain symptoms and potential mechanisms of post-stroke fatigue
­ Emphasise that maintaining factors are potentially reversible
­ Explain how to use a diary to monitor daily activities, rest and sleep
2Balancing daily activities, rest and sleep
­ Review diaries the patient has been keeping to determine current levels of activity, rest and sleep
­ Discuss strategies to improve sleep patterns
­ Set SMART goals to increase daily activities and improve sleep
­ Agree on an initial plan to balance activity levels, rest and sleep
3Increasing daily activities in graded increments
­ Review the patient’s diary and discuss progress with the initial plan
­ Discuss new goals to be achieved in the coming weeks (including decreasing the amount of rest)
­ Agree on a weekly plan to work towards new goals
4Improving emotions and thoughts
­ Discuss the ‘3-area model’ to explain the links between thoughts, emotions and behaviour
­ Discuss the unhelpful thoughts and emotions that might occur in response to fatigue
­ Introduce thought challenging sheets
5Dealing with difficulties in making progress
­ Identify common ‘blocks’ and setbacks in making progress
­ Discuss any problems the patient has experienced and agree with the patient solutions (patient taking active role)
6Preparing for the future
­ Check patient’s understanding of the intervention and discuss their progress
­ Encourage the patient to suggest new future targets and a plan for working towards them
­ Ask patient to fill out treatment evaluation forms
Booster (4 mo after starting intervention)Review of overall progress
­ Evaluate the patient’s progress since session 6
­ Help the patient solve any outstanding problems
­ Review the patient’s understanding of treatment rationale and skills
­ Discuss further targets and plans