Cognitive reframing for carers of people with dementia

Abstract

Background The balance of evidence about whether psychosocial interventions for caregivers of people with dementia could reduce carers' psychological morbidity and delay their relatives' institutionalisation is now widely regarded as moderately positive (Brodaty 2003; Spijker 2008). Multi-component, tailor-made psychosocial interventions are considered to be particularly promising (Brodaty 2003; Spijker 2008). These interventions involve multiple mechanisms of action. In this review we focused solely on the effectiveness of one element within psychosocial interventions, cognitive reframing. Cognitive reframing is a component of cognitive behavioral therapy (CBT). In dementia care, cognitive reframing interventions focus on family carers' maladaptive, self-defeating or distressing cognitions about their relatives' behaviors and about their own performance in the caring role. Objectives The objective of this review was to evaluate the effectiveness of cognitive reframing interventions for family carers of people with dementia on their psychological morbidity and stress. Search strategy The trials were identified by searching (5 April 2009) the Cochrane Dementia and Cognitive Improvement Group Specialized Register, which contains records from major healthcare databases: The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and LILACS, ongoing trial databases and grey literature sources. For more detailed information on what the Group's specialized register contains and to view the search strategies see the Cochrane Dementia and Cognitive Improvement Group methods used in reviews. The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS and a number of trial registers and grey literature sources were also searched separately on 5 April 2009. Selection criteria Randomised controlled trials of cognitive reframing interventions for family carers of people with dementia. Data collection and analysis Three assessors (MVD, ID, JmC) independently judged whether the intervention being studied was documented in a trial; two assessors assessed trial quality.

Process evaluation of a multicomponent dyadic intervention study with exercise and support for people with dementia and their family caregivers

“…Because the evaluation of the pilot study showed that a proper execution of the intervention took more than 1 hour, we decided to concentrate on physical exercise, education and pleasant activities training and to drop the time-consuming ABC training. This choice was further motivated by the fact that cognitive reframing (based on the ABC theory) has already been shown to be effective [21], whereas the effectiveness of physical exercise and pleasant activities training for people with dementia and their caregivers in the community is less well studied. In addition, we used elements of a Dutch exercise program for people with dementia and their caregivers designed by Dutch physiotherapists [22].…”

Effectiveness of Supporting Informal Caregivers of People with Dementia: A Systematic Review of Randomized and Non-Randomized Controlled Trials

“…Most research in the past decade has shown that informal caregivers have more health problems, visit healthcare professionals more frequently, suffer from isolation, and have an increased risk of depression, distress, and other illness [1,2,6,[11][12][13][14][15]. Because caregiver burden can reduce quality of caregiving and increases the likelihood of care-recipient placement into institutional care, there is also a substantial risk for the care-recipient [6,16,17].…”

Raising the standard of applied dementia care research: addressing the implementation error

“…Psychosocial intervention research has emerged as today's forerunner, given its aim to improve daily practice among professionals who provide support to people and families living with dementia. Psychosocial interventions in dementia involve interactions between people to improve psychological and social functioning (Moniz-Cook, Vernooij-Dassen, Woods, & Orrell, 2011;Rabins et al, 2007), such as cognitive stimulation therapy (Woods, Aguirre, Spector, & Orrell, 2012), occupational therapy (Graff et al, 2006) and support programmes for family carers (Vernooij-Dassen, Draskovic, McCleery, & Downs, 2011). This paper outlines the rationale for a paradigm shift in the design and methodology for evaluation of complex interventions in applied dementia care research.…”