Psychological Interventions for Carers of People with Dementia: A Systematic Review of Quantitative and Qualitative Evidence
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Abstract Rationale: Carers of people with dementia experience significant levels of stress in their everyday role. The National Dementia Strategy in England identifies the key role that carers play in supporting people with dementia living at home, often to the detriment of their social, emotional and physical health. Aims: To add to the substantive knowledge‐base by combining search criteria used by Pinquart and Sörensen (2006) and Gallagher‐Thompson and Coon (2007) to update the literature on psychological interventions for carers of people with dementia published between 2005 and 2011. Method: Following the study inclusion criteria, comprehensive searches were conducted using the electronic databases Medline, PsycINFO, ERIC, and PubMed. Twenty studies were identified, graded and synthesised into the reported systematic review with both quantitative and qualitative studies included to maximise practice application. Results: Consistent with previous findings, three categories of psychological intervention were identified: (i) psychoeducational‐skill building (n=8); (ii) psychotherapy‐counselling (n=1); (iii) multicomponent (n=6). Our review also identified a fourth intervention category, (iv) technology‐based (n=5). The majority of studies in the updated review examine the constructs of depression, burden, social support and well‐being. The development of focused interventions for carers, whether individually tailored interventions or group interventions around a common issue, was significant for developing practice. Future studies across all categories should continue to embed supervision arrangements within their psychological intervention protocols.
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Well-designed and clearly structured interventions improved the psychological health of caregivers including depression, quality of life, attitudes towards caregiving, and anxiety.
“Well-designed and clearly structured interventions improved the psychological health of caregivers including depression, quality of life, attitudes towards caregiving, and anxiety [17].”
From Mindfulness-Based Intervention for Caregivers of Frail Older Chinese Adults: A Study Protocol (2022) · cites this paper as [17]
The psychoeducational–skill building studies section (page unavailable) reports effects on depression, quality of life, attitudes towards caregiving, and anxiety. But the Discussion (page unavailable) says some significant findings reflected stable well-being in intervention groups while controls declined, rather than improvement in the intervention groups. The review also describes study quality as mixed, so it does not establish that the interventions were uniformly well-designed. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIndividual 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 [7]
The Discussion reports that psychoeducational and skills-building interventions can affect depression, emotional well-being, and quality of life; it also reports improved well-being in multicomponent studies involving individual and family therapy. The review does not report that these interventions delay institutionalization of the person with dementia, so that part of the claim is unsupported. (LLM, conf=0.86)
Experimental — accuracy not yet measuredMost previous traditional interventions on family caregivers' psychological, physical and social wellbeing have addressed caregivers of care recipients with dementia.
“Most of the previous traditional interventions on family caregivers’ psychological, physical and social wellbeing have addressed the caregivers of care recipients with dementia [7].”
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 [7]
The Discussion describes psychological interventions for carers of people with dementia and says most studies examined depression, burden, social support and well-being. But the review is limited to dementia caregiving; it does not establish that most caregiver interventions overall addressed dementia, or that those interventions addressed physical well-being. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPrevious 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 Elvish et al. , 2013
The Discussion (page not provided) says psychoeducational skill-building interventions can affect carers’ emotional well-being, and Implications for practice says interventions based on cognitive-behavioural models can produce meaningful change. But the review describes the evidence for psychotherapy/counselling as relatively poor and identifies multicomponent and technology-based interventions—not the two approaches named in the claim—as the most effective. It therefore does not support the claimed advantage over other approaches. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe main limitation of Elvish et al. (2013) was large heterogeneity in the study designs and in the categories of interventions used.
“The main limitation of this review (Elvish et al. , 2013) was not only a large heterogeneity in the study designs, but also the categories of interventions used.”
From Which interventions work for dementia family carers?: an updated systematic review of randomized controlled trials of carer interventions. (2018) · cites this paper as Elvish et al. , 2013
The 'Updating the two reviews' section reports both quantitative and qualitative studies, and the Discussion refers to four intervention categories and difficulty separating the impact of delivery methods. These passages support variation among the studies and interventions, but the paper does not identify heterogeneity in study designs and intervention categories as the review's main limitation. Page numbers were unavailable in our copy. (LLM, conf=0.78)
Experimental — accuracy not yet measured
The largest effect sizes were found for CBT based psychotherapeutic interventions.
“Third, the largest effect sizes were found for CBT based psychotherapeutic interventions, supporting previous findings (Elvish et al. , 2013; 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 Elvish et al., 2013
The Implications for practice section says cognitive-behavioural interventions can produce meaningful change. It does not say they had the largest effect sizes; instead, it identifies multicomponent and technology-based interventions as the most effective. The Discussion also notes that some studies could be strengthened by reporting effect sizes. (LLM, conf=0.85)
Experimental — accuracy not yet measuredElvish 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 Elvish et al. , 2013
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- Authors
- Elvish, R., Lever, S.-J., Johnstone, J., Cawley, R., & Keady, J.
- Affiliations
- University of Manchester (GB)
- Corresponding author
- Elvish, Ruth
- Venue
- Counselling and Psychotherapy Research
- Publisher
- Wiley
- Published
- 2013-06
- Volume
- 13
- Issue
- 2
- Pages
- 106-125
- ISSN
- 1473-3145 (ISSN-L)
- 1746-1405
- OpenAlex
- W2061290159
- Cited by
- 123
- References
- 33
- Citations by year
- 2026: 1 · 2025: 10 · 2024: 4 · 2023: 6 · 2022: 7 · 2021: 10 · 2020: 17 · 2019: 12 · 2018: 16 · 2017: 10 · 2016: 18 · 2015: 3 · 2014: 5 · 2013: 4
- FWCI
- 0.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Counselling and Psychotherapy Research (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Funders
- British Association for Counselling and Psychotherapy
- University of Manchester
- 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, psychological intervention, caregiver stress, caregiver burden, social support, well-being, psychoeducation, psychotherapy, multicomponent intervention, technology-based interventions, group intervention, individualised intervention, supervision
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