Department of Human Development and Family Studies, Utah State University, Logan, UT, USA.
Department of Human Development and Family Science, Auburn University, Auburn, AL, USA.
Aging Ment Health. 2022 Aug;26(8):1620-1629. doi: 10.1080/13607863.2021.1942432. Epub 2021 Jul 7.
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.
Participants ( = 51; =66.0 S. D =11.7, 80% women) completed 10 self-guided sessions teaching ACT, along with accessing an online dementia education library.
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 increased; Valuing decreased). All outcomes were statistically significant (at < .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.
The online ACT for Caregivers pilot program offers an empirically supported translation of traditional ACT, improving accessibility, and affordability for family dementia caregivers.
心理社会和认知行为痴呆症照顾者干预措施是有效的，但获得顾问/治疗师主导的计划可能成本高昂且困难。面对面治疗师主导的接受与承诺疗法（ACT）在痴呆症照顾者中非常有效，这已被两项不同的随机对照试验所证实。目前的研究评估了一种基于社区的、自我指导的、在线适应的 ACT 作为照顾者的试验性方案。
参与者（n=51；年龄=66.0 岁，标准差=11.7，80%为女性）完成了 10 次自我指导的 ACT 课程，同时还可以访问在线痴呆症教育图书馆。
从预测试、后测试和 4 周随访的重复测量方差分析表明，抑郁症状、负担和对行为症状的应激反应减少，积极照顾和生活质量增加。ACT 特定的测量指标有所改善，认知融合和心理灵活性（AAQ-II）降低，根据个人价值观生活（重视增加；重视减少）改善。所有结果均具有统计学意义（p<.01），并在 4 周随访中持续存在。尽管这是一个非临床样本，但该方案显示出临床意义，因为平均抑郁症状在基线时处于临床截止值，但在后测试和 4 周随访时下降到临床截止值的一个标准差以下。教育材料的使用率较低（29%的参与者使用了这些材料，尽管他们认为这些材料很有帮助），这表明 ACT 可能对整体改善贡献更大。
在线 ACT 作为照顾者的试验方案提供了对传统 ACT 的一种经验支持的转化，为家庭痴呆症照顾者提高了可及性和可负担性。
