What can the SLN do to support Lisa? 

 What can the SLN do to support Lisa?

• Actively listen to Lisa, empathise with the challenges and difficult emotions that she’s facing and validate her experience.  Yes. These are core skills when working with people in psychological distress. 
• Provide information about post-stroke fatigue and emotional adjustment. Yes – this could be helpful, but only after the SLN has actively listened and validated Lisa’s experience, to make sure that the SLN fully understands Lisa’s concerns, and Lisa feels listened to and supported. 

• Provide information written for children about the effects of stroke. Yes – this could be helpful, but only after the SLN has actively listened and validated Lisa’s experience, to make sure that the SLN fully understands Lisa’s concerns, and Lisa feels listened to and supported. 

• Tell Lisa that these feelings are really common after a stroke, and they’ll probably pass in time as she recovers. No – whilst psychological distress is common after a stroke, Lisa is experiencing clinically significant levels of anxiety and depression, and there is no reason to think that it will improve if it is not treated.

• Give Lisa the contact details of her local CAB, who could review her benefit entitlements and any other financial support that she may be entitled to. Yes – this could be helpful, but only after the SLN has actively listened and validated Lisa’s experience, to make sure that the SLN fully understands Lisa’s concerns, and Lisa feels listened to and supported. 

• Give Lisa the contact details of any local support groups or online forums for stroke survivors, particularly younger stroke survivors (e.g. CHSS, Stroke Association, Different Strokes). Yes – this could be helpful, but only after the SLN has actively listened and validated Lisa’s experience, to make sure that the SLN fully understands Lisa’s concerns, and Lisa feels listened to and supported. 

• Discuss referring to her local Stroke Clinical Psychology Service. Yes – in cases of moderate to severe depression/anxiety/psychological distress post-stroke, clinical guidelines state that specialist intervention from Stroke Clinical Psychology / Clinical Neuropsychology should be offered. Not all patients will want to be referred to Stroke Clinical Psychology / Neuropsychology, and the patient’s wishes should be noted and incorporated into the agreed treatment plan. 

• Discuss contacting her GP to trial an antidepressant. Yes – in cases of moderate to severe depression/anxiety/psychological distress post-stroke, clinical guidelines state that antidepressants should be considered, with an appropriate management plan, including a review date. However, not all patients will want to take antidepressant medication, and the patient’s wishes should be noted and incorporated into the agreed treatment plan.