ACT for People With Dementia Experiencing Psychological Distress

University of Nottingham

Status

Completed

Conditions

Acceptance and Commitment Therapy

Dementia

Treatments

Other: Acceptance and Commitment Therapy

Study type

Interventional

Funder types

Other

Identifiers

NCT04630912

20064

Details and patient eligibility

About

Introduction: People with dementia have a high prevalence of psychological distress but are under-served with evidence-based psychological interventions. To promote choice and improve clinical outcomes, there is a necessity to test different psychological intervention options for this population. Purpose: To investigate the effectiveness and acceptability of Acceptance and Commitment Therapy (ACT) for people with dementia, considering carer-supported, remote delivery and necessary therapy adaptations. Methods: A hermeneutic single case efficacy design (HSCED) series was used to analyse therapy process and change for three clients with dementia and psychological distress. Quantitative and qualitative data was collated ('rich case records') and analysed by three independent psychotherapy experts ('judges') who determined the outcome for each client. Results: Over the course of therapy, it was concluded that one client with dementia made positive changes, specifically reliable reductions in psychological distress, which were largely attributable to Acceptance and Commitment Therapy (ACT). Two clients remained unchanged. Discussion/Conclusion: Where change was achieved, the ACT-specific processes of values, committed action and acceptance, in combination with non-specific therapy factors including a strong client-carer relationship, existing client interests and individualised therapy adaptations, were facilitative of change. Hence, ACT may be feasible and effective by helping carers to better meet the needs of their loved ones with dementia. Future research to optimise ACT delivery in this population may be beneficial. Furthermore, the assessment of carer factors (e.g., their psychological flexibility, the client-carer relationship) may strengthen the evidence-base for systemic ACT-use.

Enrollment

6 patients

Sex

All

Ages

65+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Inclusion criteria for people with dementia

Participants were included in the study if they had:

A clinical diagnosis of dementia (any type)
A clinically significant level of psychological distress (a score of ≥8 on the GAD-7 and ≥10 on the PHQ-9).
Ability to give informed consent

Inclusion criteria for caregiver of person with dementia

Participants were included in the study if they:

Cared for someone with a clinical diagnosis of dementia (any type)
Were paid or unpaid and regularly supported them with activities of daily living
Aged 18+ (no maximum age limit)
Able to give informed consent

Exclusion criteria

Exclusion criteria for people with dementia

Participants were excluded if they:

Were already receiving psychotherapy
Had insufficient English or language abilities to engage in therapy
Were unable to consent to and/or engage in therapy

Exclusion criteria for caregiver of person with dementia

Participants were excluded if they:

Had insufficient English or language abilities to support the person with dementia or engage in study/Change Interviews
Were unable to consent to and/or engage in study