Therapists’ perceptions and acceptability of providing internet-delivered guided self-help acceptance and commitment therapy (ACT) for family carers of people with dementia (iACT4CARERS): a qualitative study
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This study aimed to explore therapists’ perceptions and acceptability of providing internet-delivered, therapist-guided, self-help acceptance and commitment therapy (ACT) for family carers of people with dementia (iACT4CARERS). To achieve this, a qualitative approach with semi-structured interviews was employed with eight novice therapists recruited from primary and secondary care services taking part in a feasibility study of iACT4CARERS. The interviews were audio-recorded, transcribed, and analysed using thematic analysis. Four over-arching themes were identified: (1) positive attitudes towards the intervention, (2) therapists’ workload, (3) therapists’ confidence to perform their role, and (4) connecting with family carers in a virtual context. Theme 1 included seeing their involvement as an opportunity for personal growth and perceiving benefits to the family carers, which contributed to greater acceptability. Theme 2 reflected that while workload and the user-friendliness of the online platform were highly acceptable among the therapists, there were also time-consuming cases that increased therapists’ burden. Theme 3 revealed that practical resources provided during the training, continued supervision, and opportunities to learn from other therapists, increased therapist confidence and facilitated greater acceptability. Finally, Theme 4 highlighted that improving the connection between therapists and carers was critical in a virtual context and strategies to improve the therapist–carer relationship were recommended. The implementation of iACT4CARERS was largely acceptable for the therapists involved in the trial. Ways to strengthen the therapeutic relationship in the virtual context and practical strategies to deal with common problems may enhance therapist experience and delivery in a full-scale effectiveness trial. Key learning aims: (1) To understand which factors facilitated therapists’ positive perceptions and acceptability of providing internet-delivered guided self-help ACT (iACT4CARERS). (2) To understand what challenges acted as barriers to therapists’ positive perceptions and acceptability of providing iACT4CARERS. (3) To learn what aspects of the training and the intervention can be refined to improve the acceptability to therapists in trials involving internet-delivered guided self-help interventions for family carers.
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Pre-defined criteria for progression from the feasibility study to a full-scale RCT were successfully met.
“Based on the current evidence, we conducted feasibility and acceptability studies of internet-delivered self-help ACT for family carers of people with dementia (iACT4CARERS) [13 -15] in which pre-defined criteria for progression from the feasibility study to a full-scale RCT were successfully met.”
From The clinical and cost effectiveness of internet-delivered self-help Acceptance and Commitment Therapy for family carers of people with dementia (iACT4CARERS): Study protocol for a randomised controlled trial with ethnically diverse family carers (2024) · cites this paper as [15]
The Introduction says the iACT4CARERS findings supported feasibility, including recruitment and treatment completion, and could inform a full-scale effectiveness trial. It does not state that pre-defined progression criteria were met; the Participants section directs readers to a separate paper for the quantitative feasibility findings. Page numbers are unavailable in our copy. (LLM, conf=0.78)
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“iACT4CARERS consists of the online programme, iACT4CARERS, which has been tested in the previous feasibility and acceptability studies [13 – 15], and two one-to-one sessions via telephone or video call with the therapist, each lasting 30 min.”
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- Authors
- Contreras, M., Van Hout, E., Farquhar, M., Gould, R. L., McCracken, L. M., Hornberger, M., Richmond, E., & Kishita, N.
- Affiliations
- University of East Anglia (GB)
- University College London (GB)
- Uppsala University (SE)
- Norfolk and Suffolk NHS Foundation Trust (GB)
- Corresponding author
- Kishita, Naoko
- ORCID
- Venue
- The Cognitive Behaviour Therapist
- Publisher
- Cambridge University Press (CUP)
- Published
- 2021
- Volume
- 14
- ISSN
- 1754-470X (ISSN-L)
- OpenAlex
- W3208977880
- Cited by
- 9
- References
- 44
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 2
- FWCI
- 1.12
- Type
- journal article
- Language
- en
- Open access
- green
- ueaeprints.uea.ac.uk
- Locations
- The Cognitive Behaviour Therapist (publishedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (PB-PG-0418-20001)
- Department of Health and Social Care
- Research for Patient Benefit Programme
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- acceptance and commitment therapy, online therapy, guided self-help, family caregivers, dementia, therapist perspectives, acceptability, therapist workload, therapist confidence, virtual connections, therapist training and supervision
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