Cognitive-behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for dementia family caregivers with significant depressive symptoms: Results of a randomized clinical trial

J Consult Clin Psychol. 2015 Aug;83(4):760-72. doi: 10.1037/ccp0000028. Epub 2015 Jun 15.

Abstract

Objective: The differential efficacy of acceptance and commitment therapy (ACT) and cognitive-behavioral therapy (CBT) for dementia family caregivers' is analyzed through a randomized controlled trial.

Method: Participants were 135 caregivers with high depressive symptomatology who were randomly allocated to the intervention conditions or a control group (CG). Pre-, postintervention, and follow-up measurements assessed depressive symptomatology, anxiety, leisure, dysfunctional thoughts, and experiential avoidance.

Results: Depression: Significant effects of interventions compared with CG were found for CBT (p < .001, d = 0.98, number needed to treat [NNT] = 3.61) and ACT (p < .001, d = 1.17, NNT = 3.53) at postintervention, but were maintained only at follow-up for CBT (p = .02, d = 0.74, NNT = 9.71). Clinically significant change was observed in 26.7% participants in CBT, 24.2% in ACT, and 0% in CG. At follow-up, 10.53% in CBT and 4% in ACT were recovered (0% CG). Anxiety: At postintervention, ACT participants showed lower anxiety than CBT participants (p < .05, d = 0.50) and CG participants (p < .01, d = 0.79, NNT = 3.86), with no effects at follow-up. At postintervention, 23.33% in CBT, 36.36% in ACT, and 6.45% in CG showed clinically significant change. At follow-up, 26.32% in CBT, 36% in ACT, and 13.64% in CG were recovered. Significant changes at postintervention were found in leisure and dysfunctional thoughts in both ACT and CBT, with changes in experiential avoidance only for ACT.

Conclusion: Similar results were obtained for ACT and CBT. ACT seems to be a viable and effective treatment for dementia caregivers.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acceptance and Commitment Therapy*
  • Adult
  • Aged
  • Anxiety / etiology
  • Anxiety / therapy
  • Caregivers / psychology*
  • Cognitive Behavioral Therapy*
  • Dementia / nursing*
  • Depression / etiology
  • Depression / therapy*
  • Depressive Disorder, Major / etiology
  • Depressive Disorder, Major / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Treatment Outcome