Experts know that family caregivers of people with dementia experience more burden and are at greater risk of developing depression than caregivers of people with a chronic illness.
The evidence-based practice review documented that a psychotherapy technique called cognitive reframing can help reduce caregivers’ stress when they are caring for loved ones with dementia.
Cognitive reframing focuses on thinking differently by “reframing” negative or untrue assumptions and thoughts into ones that promote adaptive behavior and lessen anxiety and depression, say the professionals.
Cognitive reframing is typically delivered in context of cognitive behavioral therapy (CBT) by a trained mental health care professional, such as a psychologist.
While studies have focused on psychosocial intervention in dementia care, the new review is the first to focus on the specific effects of cognitive reframing.
The review appears in the latest issue of The Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research.
Researchers looked at whether caregivers benefited from various interventions to provide education about dementia and whether their beliefs about caregiving responsibilities and their own needs could be changed.
“We found that changing their thinking and understanding helps a lot to allow more positive feelings to emerge and to reduce distress,” said Myrra Vernooij-Dassen, Ph.D., of the Radboud University Nijmegen Medical Centre in the Netherlands.
Investigators discovered that caregivers who received a cognitive reframing intervention had fewer symptoms of anxiety and depression and felt less stress or distress related to their caregiving.
However, although reframing helped caregivers manage their stress, the practice did not change the burden of being a dementia caregiver or their coping skills.
Nevertheless, reframing may lead to a more positive relationship with the person who has dementia.
“When a caregiver is able to reframe self-defeating cognitions into more constructive reasoning, it is a major change,” said Vernooij-Dassen.
The evidence-based review comprised eleven randomized controlled trials involving family caregivers of people with dementia. None of the trials focused solely on cognitive reframing, but they all used cognitive reframing as the main component in their intervention.
“Alzheimer’s is a chronic, progressive, fatal disease and caregiving at home for someone with the disease is fraught with many challenges but also rewards,” said, Beth Kallmyer, M.S.W., senior director of constituent services for the Alzheimer’s Association, a non-profit advocacy organization.
As people continue to live longer, tools to decrease stress for family dementia caregivers will be even more important in years to come.
Kallmyer said cognitive reframing is one among many appropriate interventions as part of a package of individual support for caregivers. “More research is needed overall for improving our knowledge of how to best support and educate caregivers.”
Vernooij-Dassen emphasized dementia caregivers don’t need to go it alone. “When they need support, reframing their thinking and understanding about dementia can yield positive results.”
Source: Health Behavior News