Effectiveness of online cognitive behavioral therapy on family caregivers of people with dementia

Purpose Family caregivers of persons with dementia (PWD) may receive caregiver training because of logistical constraints and privacy concerns. This study evaluated the effectiveness of an online intervention for family caregivers of PWD in improving their self-efficacy in managing behavioral and psychological symptoms of dementia (BPSD), and their emotion well-being. Subjects and methods A total of 36 family caregivers of people with dementia participated in a 9-week online intervention based on the cognitive behavioral therapy model. Outcomes of the intervention were measured by the Chinese version of the Neuropsychiatric Inventory Questionnaire and two domains of the Revised Scale for Caregiving Self-Efficacy. Wilcoxon signed rank tests were used to compare the change in outcome variables. Results The severity of BPSD of PWD and BPSD-related distress in family caregivers showed a statistically significant reduction after the intervention. Subgroup analysis showed self-efficacy in controlling upsetting thoughts significantly improved in caregivers of PWD at moderate to severe stages. Conclusion Online cognitive behavioral therapy for family caregivers reduced BPSD of PWD and the related distress in their caregivers.

[1]  R. Schulz,et al.  Family caregiving of persons with dementia: prevalence, health effects, and support strategies. , 2004, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[2]  R. Hales,et al.  J Neuropsychiatry Clin Neurosci , 1992 .

[3]  Linda O. Nichols,et al.  Dementia Caregivers' Most Pressing Concerns , 2008 .

[4]  D. gallagher-Thompson,et al.  Evidence-based psychological treatments for distress in family caregivers of older adults. , 2007, Psychology and aging.

[5]  Gerald L. Vale,et al.  Basics and Beyond , 2004 .

[6]  J. Cummings,et al.  Validation study of the Chinese version of the neuropsychiatric inventory (CNPI) , 2001, International journal of geriatric psychiatry.

[7]  J. Cummings,et al.  Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. , 2000, The Journal of neuropsychiatry and clinical neurosciences.

[8]  Paul Duberstein,et al.  How effective are interventions with caregivers? An updated meta-analysis. , 2002, The Gerontologist.

[9]  L. Nichols,et al.  Primary care interventions for dementia caregivers: 2-year outcomes from the REACH study. , 2003, The Gerontologist.

[10]  A. Bandura,et al.  The revised scale for caregiving self-efficacy: reliability and validity studies. , 2002, The journals of gerontology. Series B, Psychological sciences and social sciences.

[11]  Elsa Marziali,et al.  Caring for others: Internet video-conferencing group intervention for family caregivers of older adults with neurodegenerative disease. , 2006, The Gerontologist.

[12]  Gerhard Andersson,et al.  Computer‐Aided Psychotherapy for Anxiety Disorders: A Meta‐Analytic Review , 2009, Cognitive behaviour therapy.

[13]  Martin Pinquart,et al.  Helping caregivers of persons with dementia: which interventions work and how large are their effects? , 2006, International Psychogeriatrics.

[14]  S. Czaja,et al.  The Cost‐Effectiveness of a Behavior Intervention with Caregivers of Patients with Alzheimer's Disease , 2008, Journal of the American Geriatrics Society.

[15]  G. Terence Wilson.  Cognitive Behavior Therapy , 1978 .

[16]  Paul Duberstein,et al.  Dementia care: mental health effects, intervention strategies, and clinical implications , 2006, The Lancet Neurology.

[17]  W. Sanderson,et al.  Cognitive behavior therapy. , 1997, American journal of psychotherapy.

[18]  L. Burgio,et al.  Modifying repetitive verbalizations of community-dwelling patients with AD. , 1997, The Gerontologist.

[19]  G. Andersson,et al.  Internet-Based and Other Computerized Psychological Treatments for Adult Depression: A Meta-Analysis , 2009, Cognitive behaviour therapy.

[20]  Patricia Flatley Brennan,et al.  The Buffering Effect of a Computer Support Network on Caregiver Strain , 1998, Journal of aging and health.

[21]  Sölve Elmståhl,et al.  Family caregivers' subjective experiences of satisfaction in dementia care: aspects of burden, subjective health and sense of coherence. , 2005, Scandinavian journal of caring sciences.

[22]  J. Beck.  Cognitive behavior therapy: Basics and beyond, 2nd ed. , 2011 .

[23]  Henry Brodaty,et al.  Meta‐Analysis of Psychosocial Interventions for Caregivers of People with Dementia , 2003, Journal of the American Geriatrics Society.

[24]  B. Mausbach,et al.  Depression and distress predict time to cardiovascular disease in dementia caregivers. , 2007, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[25]  Cathy C. Schubert,et al.  Acute Care Utilization by Dementia Caregivers Within Urban Primary Care Practices , 2008, Journal of General Internal Medicine.

[26]  Heleen Riper,et al.  Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis , 2006, Psychological Medicine.

[27]  Linda Lam,et al.  Social support and well-being in dementia family caregivers: The mediating role of self-efficacy , 2009, Aging & mental health.

[28]  Jeffrey S. Loomis,et al.  Online support and education for dementia caregivers: overview, utilization, and initial program evaluation. , 2004, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[29]  Pim Cuijpers,et al.  Effectiveness and cost-effectiveness of an internet intervention for family caregivers of people with dementia: design of a randomized controlled trial , 2013, BMC Psychiatry.

[30]  E. Hersch,et al.  Management of the behavioral and psychological symptoms of dementia , 2007, Clinical interventions in aging.

[31]  S. Ostwald,et al.  Reducing anxiety in Alzheimer's disease family caregivers: The effectiveness of a nine-week cognitive-behavioral intervention , 2004, American journal of Alzheimer's disease and other dementias.

[32]  R. Schulz,et al.  Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. , 1999, JAMA.

[33]  D. gallagher-Thompson,et al.  The Coping with Caregiving Group Program for Chinese caregivers of patients with Alzheimer's disease in Hong Kong. , 2010, Patient education and counseling.

[34]  A. Beck,et al.  Cognitive behavior therapy : basics and beyond , 2011 .