Feasibility and acceptability of an acceptance and commitment therapy intervention for caregivers of adults with Alzheimer’s disease and related dementias

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dc.contributor.authorFowler, Nicole R.
dc.contributor.authorJudge, Katherine S.
dc.contributor.authorLucas, Kaitlyn
dc.contributor.authorGowan, Tayler
dc.contributor.authorStutz, Patrick
dc.contributor.authorShan, Mu
dc.contributor.authorWilhelm, Laura
dc.contributor.authorParry, Tommy
dc.contributor.authorJohns, Shelley A.
dc.contributor.departmentMedicine, School of Medicineen_US
dc.date.accessioned2022-05-18T14:20:35Z
dc.date.available2022-05-18T14:20:35Z
dc.date.issued2021-02-16
dc.description.abstractBackground: Caregivers of patients with Alzheimer's disease or a related dementia (ADRD) report high levels of distress, including symptoms of anxiety and depression, caregiving burden, and existential suffering; however, those with support and healthy coping strategies have less stress and burden. Acceptance and Commitment Therapy (ACT) aims to foster greater acceptance of internal events while promoting actions aligned with personal values to increase psychological flexibility in the face of challenges. The objective of this single-arm pilot, Telephone Acceptance and Commitment Therapy Intervention for Caregivers (TACTICs), was to evaluate the feasibility, acceptability, and preliminary effects of an ACT intervention on ADRD caregiver anxiety, depressive symptoms, burden, caregiver suffering, and psychological flexibility. Methods: ADRD caregivers ≥21 years of age with a Generalized Anxiety Disorder Scale (GAD-7) score ≥ 10 indicative of moderate or higher symptoms of anxiety were enrolled (N = 15). Participants received a telephone-based ACT intervention delivered by a non-licensed, bachelor's-prepared trained interventionist over 6 weekly 1-h sessions that included engaging experiential exercises and metaphors designed to increase psychological flexibility. The following outcome measures were administered at baseline (T1), immediately post-intervention (T2), 3 months post-intervention (T3), and 6 months post-intervention (T4): anxiety symptoms (GAD-7; primary outcome); secondary outcomes of depressive symptoms (Patient Health Questionnaire-9), burden (Zarit Burden Interview), suffering (The Experience of Suffering measure), psychological flexibility/experiential avoidance (Acceptance and Action Questionnaire-II), and coping skills (Brief COPE). Results: All 15 participants completed the study and 93.3% rated their overall satisfaction with their TACTICs experience as "completely satisfied." At T2, caregivers showed large reduction in anxiety symptoms (SRM 1.42, 95% CI [0.87, 1.97], p < 0.001) that were maintained at T3 and T4. At T4, psychological suffering (SRM 0.99, 95% CI [0.41, 1.56], p = 0.0027) and caregiver burden (SRM 0.79, 95% CI [0.21, 1.37], p = 0.0113) also decreased. Conclusions: Despite a small sample size, the 6-session manualized TACTICs program was effective in reducing anxiety, suggesting that non-clinically trained staff may be able to provide an effective therapeutic intervention by phone to maximize intervention scalability and reach.en_US
dc.eprint.versionFinal published versionen_US
dc.identifier.citationFowler NR, Judge KS, Lucas K, et al. Feasibility and acceptability of an acceptance and commitment therapy intervention for caregivers of adults with Alzheimer's disease and related dementias. BMC Geriatr. 2021;21(1):127. Published 2021 Feb 16. doi:10.1186/s12877-021-02078-0en_US
dc.identifier.urihttps://hdl.handle.net/1805/29050
dc.language.isoen_USen_US
dc.publisherBMCen_US
dc.relation.isversionof10.1186/s12877-021-02078-0en_US
dc.relation.journalBMC Geriatricsen_US
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.sourcePMCen_US
dc.subjectAlzheimer’s diseaseen_US
dc.subjectAnxietyen_US
dc.subjectDementiaen_US
dc.subjectCaregiveren_US
dc.subjectAcceptance and commitment therapyen_US
dc.titleFeasibility and acceptability of an acceptance and commitment therapy intervention for caregivers of adults with Alzheimer’s disease and related dementiasen_US
dc.typeArticleen_US
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