Does problem-solving training for family caregivers benefit their care recipients with severe disabilities? A latent growth model of the Project CLUES randomized clinical trial.

Abstract

Objective To examine whether an individualized problem-solving intervention provided to family caregivers of persons with severe disabilities provides benefits to both caregivers and their care recipients. Design Family caregivers were randomly assigned to an education-only control group or a problem-solving training (PST) intervention group. Participants received monthly contacts for 1 year. Participants Family caregivers (129 women, 18 men) and their care recipients (81 women, 66 men) consented to participate. Main Outcome Measures Caregivers completed the Social Problem-Solving Inventory–Revised, the Center for Epidemiological Studies-Depression scale, the Satisfaction with Life scale, and a measure of health complaints at baseline and in 3 additional assessments throughout the year. Care recipient depression was assessed with a short form of the Hamilton Depression Scale. Results Latent growth modeling was used to analyze data from the dyads. Caregivers who received PST reported a significant decrease in depression over time, and they also displayed gains in constructive problem-solving abilities and decreases in dysfunctional problem-solving abilities. Care recipients displayed significant decreases in depression over time, and these decreases were significantly associated with decreases in caregiver depression in response to training. Conclusions PST significantly improved the problem-solving skills of community-residing caregivers and also lessened their depressive symptoms. Care recipients in the PST group also had reductions in depression over time, and it appears that decreases in caregiver depression may account for this effect.

Treating Persons With Traumatic Brain Injury

“…Protocol components include training, practice, and rehearsal of situational analysis; generation of multiple options; emotional control; decision-making strategies; and evaluation of outcomes [24,41,42]. Many clinicians have successfully employed group therapy models during implementation [24,41,42]. Caregiver training in problem solving, which can be implemented in person or online, has also shown promise for improving caregiver confidence and competence and for reducing caregiver anxiety [24,32].…”

“…Many clinicians have successfully employed group therapy models during implementation [24,41,42]. Caregiver training in problem solving, which can be implemented in person or online, has also shown promise for improving caregiver confidence and competence and for reducing caregiver anxiety [24,32].…”

“…Several methods, some provided in a standardized manualized format, have been shown to improve problem solving [24,41,42]. Protocol components include training, practice, and rehearsal of situational analysis; generation of multiple options; emotional control; decision-making strategies; and evaluation of outcomes [24,41,42].…”

“…Protocol components include training, practice, and rehearsal of situational analysis; generation of multiple options; emotional control; decision-making strategies; and evaluation of outcomes [24,41,42]. Many clinicians have successfully employed group therapy models during implementation [24,41,42].…”

“…In a general sense, the literature tells us that early and comprehensive inpatient rehabilitation improves both function at discharge from acute care and subsequent community integration [23]. We know that caregiver support and skills training of caregivers have a direct and positive effect on the person with TBI [24]. The literature also shows that injury-related information, work or other productive activity, and a social network result in the best perceived quality of life after TBI [2].…”