Effects of Acceptance and Commitment Therapy (ACT) group intervention for the treatment of anxiety in family carers of people with dementia: an exploratory randomised controlled trial

Abstract

Background: The prevalence of anxiety symptoms is estimated to be equal to or higher than the prevalence of depressive symptoms in family carers of people with dementia. However, anxiety is currently somehow neglected in the carer literature. Previous studies demonstrated that Acceptance and Commitment Therapy (ACT) is effective for treating anxiety symptoms in family carers of people with dementia, but these studies were mainly conducted in developed countries. The current study explored the effectiveness of an ACT group intervention on the anxiety symptoms in Brazilian family carers of people with dementia. Method: A single‐centre, unblinded, double‐arm exploratory randomised trial was conducted. Fifty‐seven family carers of people with dementia presenting with mild to severe anxiety symptoms were randomised to the intervention group (n = 29) or waiting list group (n = 28). The intervention group received eight weekly sessions of Group ACT, delivered through videoconference. Participants completed the measure of anxiety and depressive symptoms, caregiver burden, psychological flexibility and quality of life at Week 0, Week 9 and Week 20. Multiple linear regression analyses were performed to evaluate whether there was a significant difference in scores between the intervention and control groups, at week 9 and week 20, while controlling for the baseline scores using both intention‐to‐treat and completers data analyses. Result: Participants were mostly women, from low‐ to middle‐income socioeconomic levels, with a mean age of 52 years and median education of 15 years. Participants in the intervention group had lower scores of anxiety and depression symptoms compared to participants in the control condition at weeks 9 and 20 in both the intention‐to‐treat and completer analyses. Only participants who attended six or more sessions (i.e. completer sample) demonstrated reduced caregiver burden at both follow‐up points. The completer sample also showed improvement in quality of life at week 9. The results did not show any effect of the intervention on psychological flexibility. Conclusion: This study provides evidence supporting the use of group ACT, delivered through videoconference, with family carers of people with dementia to help them cope better with anxiety and depressive symptoms.