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Social Problem-Solving Telephone Partnerships Skill Training

Purpose

Learning to walk
Derived from the COPE model for use with family caregivers of recent stroke survivors. Developed to ease the transition from the rehabilitation hospital to the home and community


Strategy

Initial Face-to-Face Session to Establish Partnership Prior to Discharge from Facility

  1. Describe the purpose of the partnership to assist the caregiver in handling problems likely to be encountered upon returning home
  2. Cover COPE problem-solving sequence and delineate problem-solving steps.
  3. Stress developing preventive plans or when problems are beginning rather than during a crisis.
  4. Emphasize the healthcare provider and family caregiver partnership. The healthcare provider’s role is to support and assist the caregiver to learn how to solve the problems at home
  5. Review common caregiving problems and informational materials about stroke and caregiving
  6. Assist caregivers to practice applying problem-solving skills to the problem of safety.
  7. Assist caregivers to practice applying problem-solving skills to another problem they identify based on their unique caregiving issues.
  8. Remind caregiver of sequence for future telephone contacts

Subsequent SPTP skill training

Problem orientation:

1. Explore feelings about caregiver role and responsibilities.
2. Emphasize optimistic attitude and view caregiving as a set of challenges.
3. Encourage involvement of survivor in planning strategies to solve caregiving problems.


Identify and define problem:

4. Identify most frequent and/or most stressful caregiving problem, including personal problems such as fatigue, and feelings of isolation, that have been experienced since last contact.
5. Discuss feelings about the problem, factors that make the situation a problem, and relevant, objective facts about the problem


Decide what needs to be accomplished and list possible solutions:

6. Develop realistic goals and brainstorm possible solutions to the problem.
7. Examine alternatives based on cost/benefit analysis.


Choose and test the best solution or solutions:

8. Select and identify planned activities to achieve goals.
9. Encourage implementation of a number of solutions simultaneously, if necessary.


Evaluate outcomes of problem-solving:

10. Evaluate the consequences or effectiveness of the solutions. Assist in planning to implement new strategies if the ones they tried failed to provide the desired results.
11. Emphasize that lack of success is a stimulus for more planning rather than as sign of failure.
12. Confirm and congratulate the caregiver for the appropriateness of actions in solving caregiving problems.

Target Population

Family caregivers of persons with recent strokes.

Research Outcomes

Evidence from an initial randomized clinical trial found the SPTP provided in telephone sessions was associated with significant decreases in caregiver depression over the first two months in the transition from the hospital to home. Caregivers who received SPTP also reported a significantly greater sense of preparation as a caregiver, and reported greater satisfaction with services received than caregivers assigned to two different control groups.

Outcomes Research References

Grant, J.S., Elliott, T., Weaver, M., Bartolucci, A., & Giger, J. (2002). A telephone intervention with family caregivers of stroke survivors after hospital discharge. Stroke, 33, 2060–2065.

Clinical Approach References

Grant, J.S., Elliott, T., Giger, J., & Bartolucci, A. (2001). Social problem-solving telephone partnerships with family caregivers of persons with stroke. International Journal of Rehabilitation Research, 24(3), 181–189.