Videoconferencing Acceptance & Commitment Therapy for Family Caregivers of Persons Living With Dementia: A Pilot Randomized Controlled Trial

Family caregivers of persons living with dementia (PLWD) report psychological distress, decreased participation in meaningful activities, and needs for coping with their emotions and balancing care demands with other important aspects of life (Tatangelo et al., 2018). However, studies have focused mainly on care-related needs (Kishita et al., 2018). Acceptance and commitment therapy (ACT) is an empirically supported approach that can promote mental health and participation in meaningful activities through acceptance and mindfulness processes and behavior change processes for valued living (Hayes et al., 2012). This pilot study tested feasibility and acceptability of procedures in a randomized controlled trial (RCT), in which distressed family caregivers of PLWD were randomly assigned to an eight-week videoconferencing ACT group or to a control group provided with psychoeducation materials. We also tested preliminary effects of ACT on mental health outcomes compared to the control group. The eligibility criteria included at least mild symptoms of psychological distress (Depression, Anxiety and Stress Scale-21). Data was collected at pretest, posttest, and 1-month follow-up using questionnaires and analyzed using statistical tests, including descriptive statistics, Shapiro–Wilk test, and Mann–Whitney U test. This was the first RCT that investigated ACT for these caregivers in the USA and videoconferencing ACT in the world. 43 caregivers completed screening over the seven-month period. Of 25 eligible caregivers, 19 participated in the study. All participants in the ACT group completed all sessions, and only one participant in the control group dropped from the study. Compared to the control group, the ACT group showed a signfiicant reduction in grief, with small to medium effects in grief, anxiety, psychological quality of life, and engagement in meaningful activities. These promising findings warrant a full-scale RCT with adequate power for efficacy testing.

References

Hayes, S. C., Pistorello, J., & Levin, M. E. (2012). Acceptance and commitment therapy as a unified model of behavior change. The Counseling Psychologist, 40(7), 976–1002. https://doi.org/10.1177/0011000012460836

Kishita, N., Hammond, L., Dietrich, C. M., & Mioshi, E. (2018). Which interventions work for dementia family carers?: An updated systematic review of randomized controlled trials of carer interventions. International Psychogeriatrics, 30(11), 1679–1696. https://doi.org/10.1017/s1041610218000947

Tatangelo, G., McCabe, M., Macleod, A., & You, E. (2018). ’I just don’t focus on my needs.’ The unmet health needs of partner and offspring caregivers of people with dementia: A qualitative study. International Journal of Nursing Studies, 77, 8–14. https://doi.org/10.1016/j.ijnurstu.2017.09.011