Generalization of the effects of a cognitive-behavioral intervention for family caregivers of individuals with dementia

A small but growing body of literature indicates that cognitive-behavioral therapy can be effective for reducing depression and frustration in caregivers of persons with dementia. The majority of these studies have failed to examine patient outcomes through means other than caregiver report and have ignored the issue of whether treatment effects generalize to patient-caregiver interactions. The purpose of the current study was to determine if the effects of a cognitive-behavioral intervention generalized to caregiver-patient interactions and to determine if reductions in caregiver displays of negative affect during these interactions were associated with reductions on measures of patient affect and behavior. An experimental design involving random assignment of caregivers to either the CBT intervention or a wait-list control group was utilized. Although no significant differences between groups were observed at post-treatment, this could be due to the small sample size (N = 16) and/or the presence of significant pre-treatment differences between groups on measures of caregiver anger and length of caregiving career. Estimates of the effect size associated with the intervention, however, indicated that the intervention was effective in reducing caregiver self-reported anger and depression. A reduction in behavioral indicators of frustration displayed by caregivers and patients was also observed on some behavioral tasks, suggesting that the effects of the intervention may generalize to caregiver-patient interactions. Results of this study could have implications for addressing larger social issues such as elder abuse. Future research should focus on improving the measurement of caregiver-patient interactions and examining the use of similar interventions for professional caregivers.