Mechanisms of sustained mindfulness practice in stroke survivors: A critical realist secondary analysis of the HEADS: UP intervention.
Complementary therapies in clinical practice December 23, 2025 Naomi E Clark, Ben Parkinson, Xu Wang et al.
Anxiety and depression are common after stroke and often persist without adequate long-term support. Mindfulness-based interventions can help stroke survivors self-manage these symptoms, but little is known about what keeps survivors practicing after an intervention ends. This secondary analysis of follow-up interviews with 12 stroke survivors who completed the HEADS: UP mindfulness program identified seven mechanisms that supported continued practice: believing practice brings benefits, personal preferences and accessibility, continued learning, attitudes of others and society, togetherness and connection, structuring and scaffolding practice, and competing priorities. The findings suggest that post-intervention support may help sustain mindfulness practice and could inform future intervention design and clinical guidance.