Videoconference-Delivered Acceptance and Commitment Therapy for Family Caregivers of People With Dementia: Pilot Randomized Controlled Trial
BackgroundFamily caregivers of individuals with dementia face significant mental health challenges. Acceptance and commitment therapy (ACT) has emerged as a promising intervention for improving these caregivers’ mental health. While various delivery modes of ACT have been exp...
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JMIR Publications
2025-03-01
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| Series: | JMIR Formative Research |
| Online Access: | https://formative.jmir.org/2025/1/e67545 |
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| author | Areum Han Robert Oster Hon Yuen Jeremy Jenkins Jessica Hawkins Lauren Edwards |
| author_facet | Areum Han Robert Oster Hon Yuen Jeremy Jenkins Jessica Hawkins Lauren Edwards |
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BackgroundFamily caregivers of individuals with dementia face significant mental health challenges. Acceptance and commitment therapy (ACT) has emerged as a promising intervention for improving these caregivers’ mental health. While various delivery modes of ACT have been explored, there is a need for evidence on the efficacy of videoconference-delivered ACT programs for this population.
ObjectiveThis pilot randomized controlled trial, conducted in the United States, aims to assess the effects of a videoconference-delivered, therapist-guided ACT program on reducing depressive symptoms and improving other mental health outcomes among family caregivers with depression who give care to individuals with dementia, compared to a control group that received psychoeducation materials only.
MethodsThis 2-arm, parallel-group pilot randomized controlled trial randomly assigned 33 family caregivers to either a 10-week videoconference-delivered ACT program (n=16, 48%) or a control group that received psychoeducation materials alone (n=17, 52%). Depressive symptoms (primary outcome) were measured using the Patient Health Questionnaire-9. Secondary outcomes included anxiety, stress, psychological quality of life (QoL), caregiver burden, predeath grief, guilt, and ACT process measures. Outcomes were assessed in the pretest, posttest (10-12 weeks after pretest), and a 3-month follow-up (3 months after posttest, approximately 5-6 months after pretest). An intent-to-treat approach was used for all outcome analyses. Linear mixed-effects models for repeated measures were used to analyze outcomes.
ResultsThe ACT group reported significantly greater improvements in stress (P=.043) and psychological QoL (P=.014) in the posttest compared to the control group. Within the ACT group, participants experienced a significant decrease in depressive symptoms, with a mean (SE) change of –6.09 (1.16) points (95% CI –8.42 to –3.76; P<.001) in the posttest and –6.71 (1.45) points (95% CI –9.63 to –3.81; P<.001) in the 3-month follow-up. These changes exceed the estimated minimal clinically important difference on the Patient Health Questionnaire-9. In addition, the ACT group reported significant improvements in anxiety, stress, psychological QoL, caregiver burden, predeath grief, guilt, values-driven action, and experiential avoidance at both posttest and 3-month follow-up. A sensitivity analysis, excluding 1 participant with near-outlier data, revealed statistically significant between-group differences in depressive symptoms at posttest (P=.037); stress at posttest (P<.001) and in 3-month follow-up (P=.001); psychological QoL at posttest (P<.001); caregiver burden at posttest (P=.003) and in 3-month follow-up (P=.003); predeath grief in 3-month follow-up (P=.031); and values-driven action at posttest (P=.032).
ConclusionsThe videoconference-delivered ACT program showed promise in improving mental health outcomes and ACT processes among family caregivers with depression who give care to individuals with dementia. Future studies should aim to replicate these findings with larger, more diverse caregiver populations and explore the long-term efficacy of videoconference-delivered ACT programs.
Trial RegistrationClinicalTrials.gov NCT05043441; https://clinicaltrials.gov/study/NCT05043441 |
| format | Article |
| id | doaj-art-d3f5b1f3ab434931aa197227cf9d6413 |
| institution | OA Journals |
| issn | 2561-326X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | JMIR Publications |
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| series | JMIR Formative Research |
| spelling | doaj-art-d3f5b1f3ab434931aa197227cf9d64132025-08-20T01:50:49ZengJMIR PublicationsJMIR Formative Research2561-326X2025-03-019e6754510.2196/67545Videoconference-Delivered Acceptance and Commitment Therapy for Family Caregivers of People With Dementia: Pilot Randomized Controlled TrialAreum Hanhttps://orcid.org/0000-0003-1369-9052Robert Osterhttps://orcid.org/0000-0002-2247-8596Hon Yuenhttps://orcid.org/0000-0001-5696-1845Jeremy Jenkinshttps://orcid.org/0000-0003-0740-3999Jessica Hawkinshttps://orcid.org/0009-0002-3285-082XLauren Edwardshttps://orcid.org/0000-0002-8620-0972 BackgroundFamily caregivers of individuals with dementia face significant mental health challenges. Acceptance and commitment therapy (ACT) has emerged as a promising intervention for improving these caregivers’ mental health. While various delivery modes of ACT have been explored, there is a need for evidence on the efficacy of videoconference-delivered ACT programs for this population. ObjectiveThis pilot randomized controlled trial, conducted in the United States, aims to assess the effects of a videoconference-delivered, therapist-guided ACT program on reducing depressive symptoms and improving other mental health outcomes among family caregivers with depression who give care to individuals with dementia, compared to a control group that received psychoeducation materials only. MethodsThis 2-arm, parallel-group pilot randomized controlled trial randomly assigned 33 family caregivers to either a 10-week videoconference-delivered ACT program (n=16, 48%) or a control group that received psychoeducation materials alone (n=17, 52%). Depressive symptoms (primary outcome) were measured using the Patient Health Questionnaire-9. Secondary outcomes included anxiety, stress, psychological quality of life (QoL), caregiver burden, predeath grief, guilt, and ACT process measures. Outcomes were assessed in the pretest, posttest (10-12 weeks after pretest), and a 3-month follow-up (3 months after posttest, approximately 5-6 months after pretest). An intent-to-treat approach was used for all outcome analyses. Linear mixed-effects models for repeated measures were used to analyze outcomes. ResultsThe ACT group reported significantly greater improvements in stress (P=.043) and psychological QoL (P=.014) in the posttest compared to the control group. Within the ACT group, participants experienced a significant decrease in depressive symptoms, with a mean (SE) change of –6.09 (1.16) points (95% CI –8.42 to –3.76; P<.001) in the posttest and –6.71 (1.45) points (95% CI –9.63 to –3.81; P<.001) in the 3-month follow-up. These changes exceed the estimated minimal clinically important difference on the Patient Health Questionnaire-9. In addition, the ACT group reported significant improvements in anxiety, stress, psychological QoL, caregiver burden, predeath grief, guilt, values-driven action, and experiential avoidance at both posttest and 3-month follow-up. A sensitivity analysis, excluding 1 participant with near-outlier data, revealed statistically significant between-group differences in depressive symptoms at posttest (P=.037); stress at posttest (P<.001) and in 3-month follow-up (P=.001); psychological QoL at posttest (P<.001); caregiver burden at posttest (P=.003) and in 3-month follow-up (P=.003); predeath grief in 3-month follow-up (P=.031); and values-driven action at posttest (P=.032). ConclusionsThe videoconference-delivered ACT program showed promise in improving mental health outcomes and ACT processes among family caregivers with depression who give care to individuals with dementia. Future studies should aim to replicate these findings with larger, more diverse caregiver populations and explore the long-term efficacy of videoconference-delivered ACT programs. Trial RegistrationClinicalTrials.gov NCT05043441; https://clinicaltrials.gov/study/NCT05043441https://formative.jmir.org/2025/1/e67545 |
| spellingShingle | Areum Han Robert Oster Hon Yuen Jeremy Jenkins Jessica Hawkins Lauren Edwards Videoconference-Delivered Acceptance and Commitment Therapy for Family Caregivers of People With Dementia: Pilot Randomized Controlled Trial JMIR Formative Research |
| title | Videoconference-Delivered Acceptance and Commitment Therapy for Family Caregivers of People With Dementia: Pilot Randomized Controlled Trial |
| title_full | Videoconference-Delivered Acceptance and Commitment Therapy for Family Caregivers of People With Dementia: Pilot Randomized Controlled Trial |
| title_fullStr | Videoconference-Delivered Acceptance and Commitment Therapy for Family Caregivers of People With Dementia: Pilot Randomized Controlled Trial |
| title_full_unstemmed | Videoconference-Delivered Acceptance and Commitment Therapy for Family Caregivers of People With Dementia: Pilot Randomized Controlled Trial |
| title_short | Videoconference-Delivered Acceptance and Commitment Therapy for Family Caregivers of People With Dementia: Pilot Randomized Controlled Trial |
| title_sort | videoconference delivered acceptance and commitment therapy for family caregivers of people with dementia pilot randomized controlled trial |
| url | https://formative.jmir.org/2025/1/e67545 |
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