Acceptance and Commitment Therapy for Family Caregivers of People With Dementia

Study Overview
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Brief Summary
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The pilot project aims to investigate the feasibility and the preliminary efficacy of a guided online acceptance and commitment therapy (ACT) intervention for distressed family caregivers of people with dementia. A one-group pretest-posttest design (n=15) will be used to investigate the potential effects of the 10 weekly online ACT intervention session on caregivers' outcomes at posttest (10 weeks).

Detailed Description
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This project will employ one-group pretest-posttest design to investigate the potential impact of a guided online ACT intervention on improving quality of life and psychological health in distressed family caregivers of people with dementia. After the baseline evaluation, eligible caregivers will receive 10 weekly ACT sessions, individually delivered by a licensed professional counselor online. Each session lasts for one hour. Primary outcome measures will be psychological distress measured by the Depression, Anxiety and Stress Scale (DASS)- 21 and care-related quality of life measured by the Care-related Quality of Life instrument (CarerQol). A one-time interview at the completion of the 10 weekly sessions will be conducted to explore caregivers' experiences in the intervention.

Official Title
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Internet-based Acceptance and Commitment Therapy for Family Caregivers of People With Dementia

Conditions
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Psychological Distress

Intervention / Treatment
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* Behavioral: Acceptance and Commitment Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: community-dwelling adults (age 18 or over) who are currently taking primary responsibility for the care of a relative with dementia living in the community devoting at least 1 hour daily to the care of the relative with dementia having cared for a relative with dementia for at least 3 months suffering at least mild symptoms of psychological distress measured by the DASS-21 (scores ≥ 5 on Depression Subscale of DASS-21, scores ≥ 4 on Anxiety Subscale, or scores ≥ 8 on Stress Subscale) having a computer/smartphone with internet access capable of doing web browsing and video-conferencing being able to provide informed consent by understanding the nature of study participation. Exclusion Criteria: having cognitive, physical, or sensory deficits, or language barriers (non-English communicator) that impede study participation receiving a psychological therapy currently having psychiatric hospitalizations or diagnoses of mental illness in the previous 2 years taking antipsychotic or anticonvulsant medication at the time of recruitment considering or planning to place family members of dementia in a nursing home within 6 months having the possibility of study dropouts due to other medical conditions of family members with dementia (e.g., conditions that may impede study participation due to frequent hospitalization or death).

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Acceptance and Commitment Therapy<br> | Behavioral: Acceptance and Commitment Therapy<br>* Participants will receive 10 weekly individual acceptance and commitment therapy by a trained coach through zoom video-conferencing.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Depression, Anxiety and Stress Scale - 21 | The Depression, Anxiety and Stress Scale (DASS)- 21 is a 21-item self report instrument designed to measure the three related negative emotional states of depression, anxiety and stress. Higher scores represent greater symptomatology. | Change from baseline to 10 weeks | 
| Care-related Quality of Life instrument | Care-related Quality of Life instrument (CarerQol) assesses the impact of providing informal care on caregivers and combines a 7-item subjective burden measure (CarerQol-7D) with well-being (CarerQol-VAS). Higher scores indicate higher levels of quality of life. | Change from baseline to 10 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Zarit Burden Interview | The Zarit Burden Interview (ZBI) is a 12-item self-report questionnaire assessing caregiver. Higher scores indicate higher levels of burden. | Change from baseline to 10 weeks | 
| Brief Coping Orientation to Problems Experienced | Brief COPE (Coping Orientation to Problems Experienced) is a 28-item self-report questionnaire measuring coping strategies in response to stressors. Three composite subscales include problem-focused, emotion-focused, and dysfunctional coping strategies. Higher scores on a subscale indicates more frequent use of the relevant coping strategies. | Change from baseline to 10 weeks | 
| Engagement in Meaningful Activities Survey | The Engagement in Meaningful Activities Survey (EMAS) is a 12-item self-assessment instrument that measures a person's subjective experience of the meaningfulness of everyday activities. Higher scores indicate greater levels of engagement in meaningful activities. | Change from baseline to 10 weeks | 
| Experiential Avoidance in Caregiving Questionnaire | The Experiential Avoidance in Caregiving Questionnaire (EACQ) is a 15-item self-report questionnaire measuring experiential avoidance in caregivers. Higher scores indicate greater levels of experiential avoidance. | Change from baseline to 10 weeks | 
| Acceptance and Action Questionnaire-II | The Action and Acceptance Questionnaire (AAQ)-II is a 7-item self-report questionnaire measuring psychological flexibility. Higher scores indicate poor psychological flexibility. | Change from baseline to 10 weeks | 
| Cognitive Fusion Questionnaire | The Cognitive Fusion Questionnaire (CFQ)-7 is a 7-item self-report questionnaire measuring cognitive fusion. Higher scores indicate greater levels of cognitive fusion. | Change from baseline to 10 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Burden, Caregivers, Dementia, Alzheimer's Disease, Quality of life, Acceptance and Commitment Therapy, Mindfulness, Psychological health