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Cited by 281Dementia and Cognitive Impairment ResearchNursing care and researchFamily Caregiving in Mental Illness

Psychological Interventions for Dementia Caregivers: What We Have Achieved, What We Have Learned

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Cheng, Sheung-Tak, Au, Alma, Losada, Andrés, Thompson, Larry W., Gallagher-Thompson, Dolores·2019·Current Psychiatry Reports
DOI 10.1007/s11920-019-1045-9PMC PMC6554248
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Abstract

With the rising dementia population, more and more programs have been developed to help caregivers deal with the care-recipient as well as their own frustrations. Many interventions aim to enhance caregiver's ability to manage behavior problems and other deteriorations in functioning, with less direct emphasis placed on caring for the caregivers. We argue that techniques based on psychotherapy are strategically important in assistance provided to caregivers because of their utility for promoting emotional health. This article provides a focused review of such methods used in evidence-based intervention programs, along with the mechanisms of change associated with these methods. While cognitive-behavioral therapy (CBT) has a strong evidence base, there is also a growing trend to package CBT techniques into various psychoeducational programs. These programs, which we call psychoeducation with psychotherapeutic programs, have been consistently found to be effective in reducing caregiver distress and are suited for delivery in group format, even by paraprofessionals, to lower the cost of intervention. A recent trend is the effective use of technological aids (e.g., the internet) to deliver CBT and psychoeducation, reaching more caregivers. As for therapeutic mechanisms, the use of coping skills, reduced dysfunctional thoughts, and increased self-efficacy in controlling upsetting thoughts has received support in studies. We conclude that psychotherapeutic techniques are increasingly being used effectively and efficiently to assist caregivers, aided by successful adaptation for educational or technologically advanced means of delivery. More research on therapeutic mechanisms is needed to understand how the techniques work and how they can be further refined.

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  • CBT is less effective for ADRD caregiver anxiety or suffering.

    “CBT is less effective at addressing ADRD caregiver anxiety or suffering (Cheng et al., 2019; Cooper, Balamurali, Selwood, et al., 2007; Gitlin et al., 2015; Olazarán & et al., 2010; Walter & Pinquart, 2020).”

    From Feasibility and acceptability of a telephone-based ACT intervention for caregivers (TACTICs) of adults with Alzheimer's disease and related dementias (ADRD): a randomized pilot during the COVID-19 pandemic. (2025) · cites this paper as Cheng et al., 2019

    In “Counseling and Psychotherapy” (page unavailable), the review reports that CBT and ACT were equally effective in significantly reducing caregiver anxiety. The same section reports improvements in caregiver distress and burden with group CBT and concludes that CBT has a strong evidence base. It does not characterize CBT as less effective for these outcomes. (LLM, conf=0.86)

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  • A recent review of mainstream psychoeducation for caregivers reported that self-efficacy predicted positive outcomes.

    “A recent review of mainstream psychoeducation for caregivers reported that self-efficacy predicted positive outcomes [44]”

    From Mindfulness-Based Intervention for Caregivers of Frail Older Chinese Adults: A Study Protocol (2022) · cites this paper as [44]

    The Psychological Models of Caregiver Stress section (page unavailable) says self-efficacy in controlling upsetting thoughts is an important predictor of caregiver outcomes. The Therapeutic Mechanisms section (page unavailable) reports that increases in this specific form of self-efficacy partially mediated outcomes in two benefit-finding intervention trials. The review does not establish the broader claim that self-efficacy predicts positive outcomes for mainstream psychoeducation generally. (LLM, conf=0.84)

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Authors
Cheng, S.-T., Au, A., Losada, A., Thompson, L. W., & Gallagher-Thompson, D.
Affiliations
  • University of East Anglia (GB)
  • Hong Kong Polytechnic University (HK)
  • Stanford Medicine (US)
Corresponding author
Cheng, Sheung-Tak
ORCID
Venue
Current Psychiatry Reports
Publisher
Springer Science and Business Media LLC
Published
2019-06-06
Volume
21
Issue
7
Pages
59-59
ISSN
  • 1523-3812 (ISSN-L)
  • 1535-1645
DOI
10.1007/s11920-019-1045-9
PMC
PMC6554248
OpenAlex
W2948632526
Cited by
281
References
102
Citations by year
2026: 27 · 2025: 43 · 2024: 52 · 2023: 34 · 2022: 48 · 2021: 56 · 2020: 16 · 2019: 4
FWCI
5.21
Type
journal article
Language
en
Open access
Licence
Locations
  • Current Psychiatry Reports (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UEA Digital Repository (University of East Anglia) (acceptedVersion)
  • PolyU Institutional Research Archive (Hong Kong Polytechnic University) (submittedVersion, cc-by)
Funders
University of East Anglia
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
  • Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
Keywords
dementia caregivers, caregiver distress, psychotherapy, cognitive behavioral therapy, psychoeducation, group intervention, online intervention, mechanisms of change, coping strategies, self-efficacy, dysfunctional thoughts, behavioral symptoms of dementia
MeSH terms
Adaptation, Psychological, Dementia, Depression, Humans, Learning, Stress, Psychological, Cognitive Behavioral Therapy, Caregivers, Self Efficacy

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