HEADS:UP
What is HEADS: UP?
Many stroke survivors experience emotional difficulties and problems with mood. This could include feelings of stress, anxiety and depression after a stroke. Mindfulness has been found to help individuals manage these issues.
HEADS: UP is an innovative nine-week course designed to help individuals affected by stroke to learn mindfulness skills that might help them to cope with emotional difficulties, particularly anxiety and depression. It is based on Mindfulness-Based Stress Reduction therapy.
What was it like taking part in HEADS: UP?
Hear from our HEADS: UP. past participants and how the experience has helped them better manage anxiety and depression.
What is Mindfulness-Based Stress Reduction?
Mindfulness expert Jon Kabat Zinn explains mindfulness as paying attention to the present moment on purpose and without judgement.
Mindfulness-Based Stress Reduction (MBSR) is a self-management course that teaches people mindfulness skills that may help them to cope better with anxiety and depression. Exercises used during the course include meditation, mindful breathing, and mindful movement. With practice, these exercises can help improve your mindfulness skills. Working together with people affected by stroke we developed the HEADS: UP course – a stroke-specific version of MBSR.
HEADS: UP Research
Between 2019-2021 we ran two feasibility research studies. The first tested HEADS: UP delivered in person to a group affected by stroke. This study took place in Glasgow. The second research study tested the HEADS: UP course delivered online to a group of people affected by stroke. These studies let us know what worked and what didn't work about the course and how it was delivered. They also let us know what people thought about the research itself, such as what it was like getting involved in the research and filling out questionnaires.
In 2021 we started a third research study- the HEADS: UP Online Pilot Randomised Controlled Trial. Participants were randomly assigned to one of two groups - the intervention group or the control group. All participants completed a set of questionnaires at four different time points over the course of six months and were invited to take part in focus groups. Participants assigned to the ‘control group’ did the questionnaires and the focus groups. Participants assigned to the 'intervention group' also did the HEADS: UP Online nine-week course. Having two groups like this lets us compare the effects of HEADS: UP against the control group.
The pilot randomised controlled trial has now finished and the results have been published. You can use the link in the Publications and Media section, below, to read the Final Report.
Current Research
Planned research
HEADS: Up App - Dr Ben Parkinson, a mental health nurse and senior lecturer, is planning to develop a HEADS: UP app. The HEADS: UP app will allow people who find it difficult to attend weekly classes to learn mindfulness at a time that best suits them. The app will also help people to continue with their mindfulness practice after they have finished a HEADS: UP course.
If you would like to find out more about this work, you can
Email: Ben.Parkinson@gcu.c.uk
Phone: 0141 331 3114
PhD research
HEADS: UP Aphasia - People with aphasia after stroke may not think that the HEADS: UP Online course is easy to do. Matilde Pieri, a Speech and Language Therapist, has been working with people with aphasia to create an aphasia-friendly version called HEADS: UP Aphasia. Working together with people with aphasia, Matilde has created content for the HEADS: UP Aphasia course as part of her PhD research. Matilde is writing up her research at the moment. Once this has been done, she will be able to develop the full course.
If you would like to find out more about this work, you can
Email: Matilde.Pieri@gcu.ac.uk
Practising Mindfulness after the HEADS: UP Online course has finished - After finishing a HEADS: UP Online course many participants told us that keeping up their mindfulness practice in the long-term was sometimes difficult. Naomi Clark, a psychology graduate and former HEADS: UP research assistant, is studying for a PhD about long-term mindfulness practice. Naomi's research involves working with people affected by stroke to learn more about what makes long-term mindfulness practice difficult and what could help to make it easier. If you would like to find out more about this work, you can
Email: Naomi.Clark@gcu.ac.uk
Phone: 0141 331 3107
Publications and media
- Parkinson, B., Lawrence, M., McElhinney, E., & Booth, J. (2019). Mindfulness for people with long-term conditions and their family caregivers: A systematic review. Complementary therapies in clinical practice, 34, 76-86.
- Lawrence, M., Booth, J., Mercer, S., & Crawford, E. (2013). A systematic review of the benefits of mindfulness-based interventions following transient ischemic attack and stroke. International Journal of Stroke, 8(6), 465-474.
- Lawrence M, Davis B, De Amicis L, Booth J, Dickson S, Dougall N, Grealy M, Jani B, Maxwell M, Parkinson B, Pieri M, Mercer S. The HEADS: UP Development Study: Working with Key Stakeholders to Adapt a Mindfulness-Based Stress Reduction Course for People with Anxiety and Depression after Stroke. Healthcare. 2023; 11(3):355.
- Parkinson, B, Lawrence, M, McElhinney, E & Booth, J 2023, 'Online mindfulness with care partnerships experiencing anxiety and depression symptoms after stroke: mixed methods case study research', Journal of Holistic Nursing, vol. 41, no. 2, pp. 185-199.
- Lawrence M, Davis B, Clark N, et al. In-person and online mixed method non-randomised studies exploring feasibility and acceptability of HEADS: UP, an adapted Mindfulness-Based Stress Reduction programme for stroke survivors experiencing symptoms of anxiety and depression. Pilot and Feasibility Studies 10, 119 (2024).
- Newspaper article from The Herald: Glasgow stroke study uses mindfulness to manage anxiety and depression
- Article from Stroke Rehab Times: HEADS:UP: The mindfulness course for stroke survivors
Abstracts from the European Stroke Journal:
- Assessing the benefit, acceptability and feasibility of a stroke-specific psychological self-management intervention, HEADS: UP
- Hashtag research: utilising social media for recruitment of stroke survivors to the HEADS: UP online randomised controlled trial, a stroke-specific psychological self-management intervention
- HEADS: UP mixed methods development study: working with stakeholders to adapt a mindfulness-based stress reduction course for stroke survivors with mood disorder.
Published abstracts from the 18th UK Stroke Forum Annual Conference 2024
- Abstract booklet: International Journal of Stroke 2024 19:1_suppl, 3-139; doi: 10.1177/17474930241228206
- Davis B, et al. The Heads: Up Online Intervention For Self-Management Of
- Depression And Anxiety Symptoms Post-Stroke: How We Tested Online Recruitment And Delivery In Response To Covid-19. Cognitive, Emotional And Psychological (Completed Study)
- Lawrence, M et al. Helping Ease Anxiety And Depression After Stroke: Results Of The Heads: Up Online Mixed-Methods Pilot RCT
- Pieri et al. Heads: Up Aphasia. Helping Ease Anxiety And Depression Following Stroke Related Aphasia: A Co-Created Aphasia-Friendly Mindfulness-Based Course
Published abstracts from the UK Stroke Forum Annual Conference 2023
- 18th UK Stroke Forum conference, 4 - 6 December 2023, ICC Birmingham, UK. International Journal of Stroke. 2024;19(1_suppl):3-139. doi:10.1177/17474930241228206
- Davis B, et al. The HEADS: UP Online intervention for self-management of depression and anxiety symptoms post-stroke: how we tested online recruitment and delivery in response to covid-19.
- Pieri M, et al. HEADS: UP Aphasia. Helping Ease Anxiety and Depression Following Stroke Related Aphasia: A Co-Created Aphasia-Friendly Mindfulness-Based Course
Published abstracts from the UK Stroke Forum Annual Conference 2022
- Abstract booklet 2022. International Journal of Stroke. 2023;18(1_suppl):3-124. doi:10.1177/17474930221142512
- Davis B, et al. ‘Making a path in the snow’, keeping no-treatment control participants on the research path; lessons learned from the HEADS: UP online pilot randomised trial
- Lawrence M, et al. Determining the feasibility and acceptability of delivering HEADS: UP, a psychoeducational intervention for self-management of depression and anxiety symptoms post-stroke, face-to-face and online
- Davis B, et al. Enhancing accessibility for participants in HEADS: UP Online RCT research: the essential role of a Patient and Public Involvement and Engagement group
- Pieri M, et al. HEADS: UP Aphasia: co-creating a Mindfulness Based Stress Reduction self-management intervention for people with post-stroke aphasia
- Parkinson B, et al. Online mindfulness for anxiety and depression symptoms after stroke: a mixed methods study
- Clark N, et al. Using social media to recruit stroke survivors to the HEADS: UP Online randomised control trial, a stroke-specific psychological self-management intervention: reflections and lessons learned
- Lawrence M, et al. Helping Ease Anxiety and Depression After Stroke: Results of the HEADS: UP Online Mixed-Methods Pilot RCT
Public Talk
Registered protocols
- HEADS: UP Pilot Feasibility Protocol
- Feasibility 2: ClinicalTrials.gov: NCT04567472
- Pilot RCT: ClinicalTrials.gov: NCT04985838
Project team
- Dr Bridget Davis is a Senior Research Fellow and HEADS: UP Project Manager
- Naomi Clark is the HEADS: UP Researcher
- Dr Ben Parkinson
Funders
- Chief Scientists Office: August 2017 – January 2019
- The Stroke Association: June 2019 – October 2022
Project Advisory Group
The Project Advisory Group (PAG) is a group of people who support and advise the HEADS: UP study. There are eight members who are people affected by stroke, family members and health professionals involved in stroke care. They all have an interest in and experience of mindfulness.The PAG meet with members of the HEADS: UP research team every month and are involved in all aspects of the study.
Acknowledgements
We would like to thank all individuals and organisations who have contributed to our project and especially our lay representative.
Taking part in other HEADS: UP research
If you are interested in taking part in any future HEADS: UP research or any of the other related research studies mentioned here, please get in touch! We’d be happy to hear from you.
Email: headsup@gcu.ac.uk
Find out more
