Table 1 An overview of the group-based ACT program for older stroke survivors

Confronting the Agenda

Start with an “Ice-breaking tour” (5–10 min)

Patient self-introduction (10–15 min)

Introduction of ACT team members and content (5 min)

Mindfulness exercises (10–15 min)

Home task (5 min)

Accepting everything (Acceptance)

Begin with a mindfulness exercise and homework review (5–10 min);

Watch a video of sinking into a swamp (10-15 min);

Play the game “Chinese Finger Glove” (10–15 min);

Share and summarize (10–15 min);

Home task (5 min).

Observing cognition objectively

(Cognitive Defusion)

Homework review (5–10 min);

Play the video “Passengers on the Bus” (5–10 min);

Play the game “Folder push” (10 to 15 min);

Share and summarize (10–15 min);

Home task (5 min).

The Hours (Being Present)

Begin with a review of last week’s homework (5-10 min);

Mindful eating (10 min);

Mindful breathing exercise (10-15 min);

Share and summarize this activity (5–10 min);

Home task (5 min).

Feeling yourself (Self as Context)

Begin with a mindfulness exercise and homework review (5-10 min);

Play the video “Sky and Weather” (5 min);

Share and summarize (15-20 min);

Share poems, stories or elements of Chinese culture with the patients (5–10 min);

Home task (5 min).

Identifying your value (Values)

Start with a few people sharing thoughts on last week’s homework (5–10 min);

Play the game “Life Button” (15-20 min);

Share and summarize (5-10 min);

Home task (5 min).

Looking forward (Committed Action)

Start with a few people sharing thoughts on last week’s homework(10-15 min);

Set goals (20–25 min);

Share and summarize (5–10 min);

Home task (5 min).

Review

Start with homework review (5 min);

Play photos and videos (5–10 min);

Share feelings (15-20 min);

Give blessings, encouragement, and gifts (10–15 min).