Date of Award


Document Type

Scholarly Project

Degree Name

Master of Occupational Therapy (MOT)


Occupational Therapy

First Advisor

Jan Stube


Cognitive Therapy -- methods; Occupational Therapy -- methods; Stroke -- rehabilitation


Strokes are a leading cause of disability in the United States, with approximately 7 million adults currently living with a stroke. The incidence rate of strokes is expected to significantly increase by 2030, which demonstrates a need for this population to receive quality care (Billinger et al., 2014). There is extensive research on how occupational therapists provide skilled interventions for the physical and cognitive deficits of a stroke; however, a gap in the literature exists regarding treatment of the psychosocial impairments an individual may experience post-stroke. Specifically, there is limited research on how to treat post-stroke depression (PSD) and post-stroke anxiety (PSA), which are two prevalent psychosocial impairments resulting from a stroke, that lead to an interruption in occupational performance. Cognitive-behavioral therapy (CBT) is a common frame of reference implemented in mental health practice; the authors investigated how CBT techniques could be implemented into post-stroke therapy to target PSD and PSA, thereby leading to increased occupational performance.

The authors completed an extensive literature review before creating the product; this included the overall need for addressing PSA and PSD in typical post-stroke rehabilitation, and evidence supporting the use of CBT with this population. The literature review was completed using reliable databases and journals that generated articles relevant to the proposed topic and profession. Upon completion of the literature review, the authors created the guide following the occupational therapy process addressed within the Occupational Therapy Practice Framework: Domain and Process (2014). The most evidence-based strategies and interventions were included within the guide.

Additionally, the product was based on the Model of Human Occupation (MOHO), and contains five sections. Part 1 is an overview of the psychosocial limitations that may present after a stroke, and how CBT can be incorporated into occupational therapy interventions as an adjunctive method to enhance the therapy process and outcomes. Part II provides occupational therapists with assessments that are appropriate to use with individuals post-stroke. Part III is an overview of occupational therapy intervention planning strategies to facilitate collaboration between the client and therapist. Part IV is the actual guide, and contains several CBT strategies, handouts, and worksheets that can assist the occupational therapist in providing the client with helpful tools to learn more about and overcome the psychosocial impairments they are experiencing. This guide is not intended to replace existing methods of occupational therapy intervention, but rather to serve as a supplement for providing a more comprehensive approach to post-stroke rehabilitation. Part V is a summary of the materials presented in the guide, as well as explaining the need for continuing research. The overall purpose of this guide was to facilitate occupational performance and functioning among this post-stroke population by occupational therapists using CBT strategies as a means for treating post-stroke depression (PSD) and post-stroke anxiety (PSA).