Technology-based cognitive behavioural therapy (CBT) is likely just as effective at reducing depression among dementia caregivers as traditional care

Scott JL, Dawkins S, Quinn MG, et al.  Caring for the carer: A systematic review of pure technology-based cognitive behavioral therapy (TB-CBT) interventions for dementia carers  Aging & Mental Health. 2015 May

Review question

Is technology-based cognitive behavioural therapy effective in reducing psychological distress in dementia caregivers?

Background

When providing care to people with dementia, caregivers often face stress, depression and financial burden. This can reduce the quality of care provided and increases the likelihood that people with dementia will be institutionalized, which can increase the burden on health systems. 

CBT for caregivers has been shown to reduce the stressors associated with caregiving, and is most effective when tailored to specific caregiver needs. However, there are high costs associated with tailored CBT.

Technology-based CBT is cost-effective, offers the same content as traditional, tailored CBT, and is supported by the literature as an effective, practical intervention for reducing psychological distress. However, no systematic reviews have focused on the potential of using this approach for dementia caregivers.

How the review was done

A detailed search of a number of electronic databases for studies published from 1995 to 2014 was conducted. Studies that focused on CBT delivered to informal dementia caregivers using technology in any format (internet, DVD, video) while reporting outcomes related to psychological functioning were included in the review.

A total of 442 studies were identified in searches and four were included in the review after assessment for eligibility.

This review was funded by a grant from the Tasmanian (Australia) Home and Community Care Program.

What the researchers found

Technology-based CBT therapy was just as effective as traditional, face-to-face CBT in reducing caregiver depression in the short term.

When a strong relationship between the caregiver and care receiver exists, it may reduce the likelihood of the caregiver experiencing psychological distress and voluntarily seeking CBT.

Younger participants were more likely to withdraw from technology-based CBT than older participants, who required a greater length of time to learn and benefit from CBT techniques.

Conclusion

While there is a lack of trials assessing technology-based CBT in the context of dementia, this review found that technology-based CBT was comparable to traditional CBT in treating caregiver distress. Caregivers may have difficulty accessing traditional CBT services, giving technology-based options advantages over other techniques due to their feasibility, cost-effectiveness and proven efficacy. Strong conclusions cannot be drawn from this review due to the low quality of studies included.