Discussion
cognitive behavior, aphasia
RECRUITMENT
This cluster RCT showed no measurable benefit of ASK intervention, for improving mood and QoL outcomes for the person with aphasia and their family member. Both hypotheses were not supported. There was a significant difference between the interventions in favor of the attention control group on the primary outcome measure (SADQ-21,Several biases in the study methodology may have contributed to these results. The Catalogue of Biases by the Centre for Evidence-based Medicine (The cluster RCT design may have limited the effectiveness of the trial, given the complexity of the intervention. Siebenhofer et al.The ASK intervention alone may not have been sufficient to improve mood. ASK aimed for active discussion of psychosocial topics with planned activities between sessions that operationalized well-being strategies, supported by regular follow-up phone calls. Continued investigation of treatment fidelity and the process evaluation will shed light on important questions such as therapists’ experiences of recruitment and delivering the interventions. Future trials might consider approaches such as cognitive behavior therapy (CBT).