Evidence-based psychological treatments for distress in family caregivers of older adults.
Abstract
This review identifies evidence-based psychological treatments (EBTs) for reducing distress, and improving well-being, of family members caring for an older relative with significant cognitive and/or physical impairment. Three categories of psychologically derived treatments met EBT criteria: psychoeducational programs (N = 14 studies), psychotherapy (N = 3 studies), and multicomponent interventions (N = 2 studies). Specifically, support within the psychoeducational category was found for skill-training programs focused on behavior management, depression management, and anger management and for the progressively lowered threshold model. Within the psychotherapy category, cognitive-behavioral therapy enjoys strong empirical support. Within the multicomponent category, programs using a combination of at least 2 distinct theoretical approaches (e.g., individual counseling and support group attendance) were also found to be effective. Suggestions for future research include the development of more well-integrated multicomponent approaches, greater inclusion of ethnically diverse family caregivers in research protocols, and greater incorporation of new technologies for treatment delivery.
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Individual and family counseling, psychoeducational programs, skills training programs and multi-component intervention programs have shown potential in improving caregiver mood, quality of life and delaying institutionalization of the care recipient.
“Individual and family counseling, psychoeducational programs, skills training programs and multi-component intervention programs have shown potential in improving caregiver mood, quality of life and delaying institutionalization of the care recipient [7–9].”
From CareACT - internet-based intervention for enhancing the psychological well-being of elderly caregivers - a study protocol of a controlled trial (2019) · cites this paper as [8]
Gallagher-Thompson and Coon (2007) identified three categories of psychologically derived interventions: psychoeducational programmes (N = 14 studies), psychotherapy (CBT) (N = 3), and multicomponent interventions (family counselling with support group) (N = 2).
“They identified three categories of psychologically derived interventions: psychoeducational programmes ( N = 14 studies), psychotherapy (CBT) ( N = 3), and multicomponent interventions (family counselling with support group) ( N = 2).”
From Which interventions work for dementia family carers?: an updated systematic review of randomized controlled trials of carer interventions. (2018) · cites this paper as Gallagher-Thompson and Coon, 2007
Previous comprehensive reviews (Elvish et al., 2013; Gallagher-Thompson and Coon, 2007) suggested that psychoeducational programmes and CBT based psychotherapeutic interventions can better impact on emotional wellbeing of dementia carers among other approaches.
“The current review particularly focuses on psychoeducational programmes and CBT based psychotherapeutic interventions as previous comprehensive reviews (Elvish et al. , 2013; Gallagher-Thompson and Coon, 2007) suggested that these approaches can better impact on emotional wellbeing of dementia carers among other approaches.”
From Which interventions work for dementia family carers?: an updated systematic review of randomized controlled trials of carer interventions. (2018) · cites this paper as Gallagher-Thompson and Coon, 2007
In Gallagher-Thompson and Coon (2007), the largest effect size was found in the psychotherapy category (CBT), with an overall effect size of CBT for psychological distress of 1.20.
“The largest effect size was found in the psychotherapy category (CBT). An overall effect size of CBT for psychological distress was 1.20.”
From Which interventions work for dementia family carers?: an updated systematic review of randomized controlled trials of carer interventions. (2018) · cites this paper as Gallagher-Thompson and Coon, 2007
Existing research on dementia carers is still largely focused on treating depression and burden, and this trend has not changed substantially since earlier systematic reviews.
“First, the existing research on dementia carers is still largely focused on treating depression and burden and this trend has not changed substantially since earlier systematic reviews (Gallagher-Thompson and Coon, 2007; Pinquart and Sörensen, 2006).”
From Which interventions work for dementia family carers?: an updated systematic review of randomized controlled trials of carer interventions. (2018) · cites this paper as Gallagher-Thompson and Coon, 2007
The main limitation of Gallagher-Thompson and Coon (2007) was the relatively small number of studies identified, partly because studies were included only if they showed beneficial treatment effects in target problems.
“The main limitation of this study was the relatively small number of studies identified, partly due to studies only being included if they showed beneficial treatment effects in target problems, a criterion proposed by Yon and Scogin (2007).”
From Which interventions work for dementia family carers?: an updated systematic review of randomized controlled trials of carer interventions. (2018) · cites this paper as Gallagher-Thompson and Coon, 2007
Gallagher-Thompson and Coon (2007) highlighted the importance of distinguishing studies grounded in CBT theories from psychoeducational programmes because the former place emphasis on the development of therapeutic relationship as part of the treatment process.
“Gallagher-Thompson and Coon (2007) particularly highlighted the importance of distinguishing studies grounded in CBT theories from psychoeducational programmes in that the former place emphasis on the development of therapeutic relationship as part of the treatment process.”
From Which interventions work for dementia family carers?: an updated systematic review of randomized controlled trials of carer interventions. (2018) · cites this paper as Gallagher-Thompson and Coon, 2007
The categorisation of interventions needs to be theory-driven rather than driven by the mode of delivery.
“The categorisation of interventions needs to be theory-driven rather than driven by the mode of delivery.”
From Which interventions work for dementia family carers?: an updated systematic review of randomized controlled trials of carer interventions. (2018) · cites this paper as Gallagher-Thompson and Coon, 2007
Elvish et al. (2013) identified four categories of psychologically derived interventions: psychoeducational programmes, psychotherapy (no quantitative study identified), multicomponent interventions, and technology-based interventions.
“Similar to the previous review (Gallagher-Thompson and Coon, 2007), this study identified four categories of psychologically derived interventions: psychoeducational programmes, psychotherapy (no quantitative study was identified for this category), multicomponent interventions, and technology-based interventions.”
From Which interventions work for dementia family carers?: an updated systematic review of randomized controlled trials of carer interventions. (2018) · cites this paper as Gallagher-Thompson and Coon, 2007
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“The current review particularly focuses on psychoeducational programs and CBTbased psychotherapeutic interventions as previous comprehensive reviews (Gallagher-Thompson and Coon, 2007; Elvish et al., 2013) suggested that these approaches can better impact on emotional well-being of dementia carers among other approach…”
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- Authors
- Gallagher-Thompson, D., & Coon, D. W.
- Affiliations
- Stanford Medicine (US)
- Arizona State University (US)
- Venue
- Psychology and Aging
- Published
- 2007-03
- Volume
- 22
- Issue
- 1
- Pages
- 37-51
- ISSN
- 0882-7974 (ISSN-L)
- 1939-1498
- OpenAlex
- W2094437177
- Cited by
- 358
- References
- 89
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 9 · 2023: 8 · 2022: 4 · 2021: 14 · 2020: 18 · 2019: 14 · 2018: 22 · 2017: 25 · 2016: 20 · 2015: 28 · 2014: 33 · 2013: 24 · 2012: 19
- FWCI
- 70.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychology and Aging (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (AG 18784; AG 13289)
- Topics
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Sociology and Political Science › Intergenerational Family Dynamics and Caregiving
- Keywords
- family caregivers, older adults, caregiver distress, psychological intervention, psychoeducational intervention, psychotherapy, multicomponent intervention, cognitive behavioral therapy, anger management, depression treatment, behavior management, support groups, well-being
- MeSH terms
- Aged, Alzheimer Disease, Counseling, Major Depressive Disorder, Humans, Stress, Psychological, Cognitive Behavioral Therapy, Caregivers
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