Outcomes from a pilot online Acceptance and Commitment Therapy program for dementia family caregivers

Abstract

Objectives

Psychosocial and cognitive-behavioral dementia caregiver interventions are effective, yet accessing counselor/therapist-led programs can be costly and difficult. Face-to-face therapist-led Acceptance and Commitment Therapy (ACT) is highly effective in dementia caregivers, as established by two different randomized control trials. The current study evaluates a pilot ACT for Caregivers program, which is a community-based, self-guided, online adaptation of ACT.

Method

Participants (N = 51; M_age=66.0 S. D =11.7, 80% women) completed 10 self-guided sessions teaching ACT, along with accessing an online dementia education library.

Results

Repeated measures ANOVA from pre-, posttest, and 4-week follow-up demonstrated decreased depressive symptoms, burden, and stress reactions to behavioral symptoms, and increased positive aspects of caregiving and quality of life. ACT-specific measures improved, with decreases in cognitive fusion and psychological inflexibility (AAQ-II), and improvements in living according to personal values (Valuing_Progress increased; Valuing_Obstruction decreased). All outcomes were statistically significant (at p < .01) and sustained over 4-week follow-up. Although this was a non-clinical sample, the program demonstrated clinical significance, as average depressive symptoms were at the clinical cutoff at baseline, but one standard deviation below clinical cut-off at post-test and 4-week followup. Use of education materials was low (29% of participants used these, albeit rating them helpful), suggesting that ACT likely contributed more to overall improvements.

Conclusion

The online ACT for Caregivers pilot program offers an empirically supported translation of traditional ACT, improving accessibility, and affordability for family dementia caregivers.

Keywords:

• Alzheimer’s disease
• web-based intervention
• mindfulness
• quality of life
• depressive symptoms

Acknowledgements

We thank USU Extension faculty that helped test the program, especially Marilyn Albertson for her recruitment efforts, and to Hannah Cragun, Jennifer Krafft, Becka Schultz, and Dr. Alex Schiwal for assisting in preparing the intervention content, recruiting participants, and preparing datasets.

Disclosure statement

The authors have no conflicts to report.

Additional information

Funding

This project was funded by a pilot grant from Utah State University Extension (grant number A38706).