Objectives: Due to psychological and physical strain, family caregivers of patients with Alzheimer’s disease and related dementias are at high risk for depression and stress related disorders. We investigated the feasibility of a mobile application (App) intervention delivering Mentalizing Imagery Therapy (MIT), which incorporates guided imagery and mindfulness, to facilitate self-regulation and increase perspective on the mental life of self and others. Method: A 4-week pilot trial of an MIT App for family caregivers of people with dementia was conducted to assess feasibility of use, mood and depression symptom benefit, and relationship changes. Semi-structured interviews were conducted at the study’s conclusion to characterize participants’ perceived benefits. Results: 80% of 21 consented participants downloaded the App, utilized it at least once, and were further analyzed. Of these participants, average usage of audio recordings was 14 ± 10 (SD) days out of 28 possible, and 29 ± 28 individual sessions. Acute improvement in mood from before to after completion of exercises was uniformly observed (p < .001), and after four weeks there was a significant increase in positive affect and a reduction in negative affect. Participants with severe levels of depression (n=3) at baseline exhibited an improvement in symptoms at 4 weeks averaging 30% (p < .05). Semi-structured interviews revealed an increase in the ability to remain “centered" despite caregiving challenges, take the perspective of the loved one, and positively reframe the caregiver experience.Conclusion: App delivery of MIT is feasible for family dementia caregivers. Results showed moderate to high usage of the app for a majority of the users, and promising improvements in mood and depression. These data provide justification for larger, controlled trials.

BackgroundFamily caregivers of patients with dementia experience high levels of interpersonal stress that often results in elevated anxiety, depression and negative impacts on social networks. Changes in behaviors and the structure of relationships with the care recipient (CR) and others in the social milieu challenge the caregivers’ ability to mentalize, or understand the links between mental states and behaviors. This study investigates the perceived benefits for family dementia caregivers of Mentalizing Imagery Therapy (MIT), which aims to improve balanced mentalizing of both self and others and reduce psychological symptoms. Methods11 family members who identified as the primary caregiver of a relative with dementia underwent a 4-week pilot trial of MIT and completed semi-structured interviews post-intervention to identify subjective benefits, putative psychological mediators and perceived active components. ResultsCaregivers reported improvements in general well-being, mood, anxiety, and sleep, and a majority stated the intervention helped with forming and maintaining healthier relationships. Some participants noted benefits extending to how they reacted to their social environment and perceived themselves more objectively from others’ perspectives. Specific elements of the intervention, including self-compassion, self-care, and the ability to reflect on emotionally arousing challenges, might have mediated these improvements. The combination of instructor, meditations, homework, group sessions, and educational sessions was well received by participants.ConclusionOur results show that family dementia caregivers described perceived salutary benefits of MIT on multiple domains of well-being. The self reports suggest MIT holds promise for reducing non-mentalizing patterns of thought, and facilitating improvements in balanced mentalization within the caregivers’ relationships. These results should be further extended in larger samples.

Dual language learners (DLLs) are sensitive to teachers’ language influence in early childhood classrooms. In this mixed methods study incorporating 53 teachers from 28 preschools in Northern California, we investigated the characteristics of teachers’ language use in preschools teaching Chinese–English and Spanish–English DLLs. We further examined the links of teachers’ language use to the DLLs’ expressive vocabulary in English and their heritage language (HL), controlling for home language exposure and other confounding variables. Finally, we conducted interviews with teachers to understand how they make meaning of their daily language practices. The sample of children consisted of 190 Chinese–English (N = 125) and Spanish–English (N = 65) DLLs (mean age = 48.3 months; 48% females). The teacher survey showed that most teachers spoke two or more languages and used a mix of English and their HL during their interactions with DLLs. The results of random-intercept models showed that teachers’ language use did not uniquely predict children’s vocabulary, controlling for family-level factors. However, the teachers with more years of teaching DLLs oversaw children with a higher HL vocabulary. The interview data revealed that teachers employ several strategies to communicate with DLLs and support HL maintenance. Our study reveals the multilingual backgrounds of preschool teachers and the rich language strategies they implement in multilingual classrooms. Future directions concerning the quality and development of teachers’ language use are discussed.

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