Gallagher-Thompson Dolores, Coon David W
Older Adult and Family Center, Stanford University School of Medicine, CA 94025, USA.
Psychol Aging. 2007 Mar;22(1):37-51. doi: 10.1037/0882-7974.22.1.37.
This review identifies evidence-based psychological treatments (EBTs) for reducing distress, and improving well-being, of family members caring for an older relative with significant cognitive and/or physical impairment. Three categories of psychologically derived treatments met EBT criteria: psychoeducational programs (N = 14 studies), psychotherapy (N = 3 studies), and multicomponent interventions (N = 2 studies). Specifically, support within the psychoeducational category was found for skill-training programs focused on behavior management, depression management, and anger management and for the progressively lowered threshold model. Within the psychotherapy category, cognitive-behavioral therapy enjoys strong empirical support. Within the multicomponent category, programs using a combination of at least 2 distinct theoretical approaches (e.g., individual counseling and support group attendance) were also found to be effective. Suggestions for future research include the development of more well-integrated multicomponent approaches, greater inclusion of ethnically diverse family caregivers in research protocols, and greater incorporation of new technologies for treatment delivery.
本综述确定了基于证据的心理治疗方法(EBTs),用于减轻照顾患有严重认知和/或身体损伤的老年亲属的家庭成员的痛苦,并改善其幸福感。三类心理衍生治疗方法符合EBT标准:心理教育项目(N = 14项研究)、心理治疗(N = 3项研究)和多成分干预(N = 2项研究)。具体而言,在心理教育类别中,针对专注于行为管理、抑郁管理和愤怒管理的技能培训项目以及逐步降低阈值模型找到了支持证据。在心理治疗类别中,认知行为疗法获得了强有力的实证支持。在多成分类别中,使用至少两种不同理论方法组合(例如个体咨询和参加支持小组)的项目也被发现是有效的。对未来研究的建议包括开发更完善整合的多成分方法、在研究方案中更多纳入不同种族的家庭照顾者,以及更多采用新技术进行治疗。