TY - JOUR
T1 - The use of Acceptance and Commitment Therapy (ACT) in informal caregivers of people with dementia and other long-term or chronic conditions
T2 - A systematic review and conceptual integration
AU - Atefi, Golnaz L.
AU - de Vugt, Marjolein E.
AU - van Knippenberg, Rosalia J.M.
AU - Levin, Michael E.
AU - Verhey, Frans R.J.
AU - Bartels, Sara Laureen
N1 - Funding Information:
This article presented a review of ACT interventions for informal caregivers of adults with chronic or long-term conditions. Broad inclusion criteria were applied to maximize the breadth of findings and reduce potential publication bias. While the literature was limited by methodological inadequacies and an overall low number of studies, the current findings provide preliminary support for ACT in increasing psychological flexibility, functioning, and symptom reduction in informal caregivers.
Publisher Copyright:
© 2023 The Authors
PY - 2023/11/1
Y1 - 2023/11/1
N2 - Informal caregivers are the primary source of support for adults with chronic conditions and disabilities. Empirical research highlights chronic stress and other risks of adverse outcomes of caregiving. Acceptance and Commitment Therapy (ACT) is an emerging evidenced-based practice that shows promise in improving an array of outcomes, theoretically by increasing psychological flexibility as the primary process of change. Research has begun to evaluate ACT among informal caregivers of adult populations, and a systematic review is now needed to summarise this evidence base. Electronic searches from five databases, including PubMed, PsycInfo, Embase, CINAHL, and Cochrane Library, yielded an initial 7896 hits, which after screening for inclusion criteria, resulted in 21 clinical trials. Studies were coded to synthesise the feasibility, effectiveness, and quality of evidence. Findings show that ACT was reported to be largely feasible and acceptable. However, the efficacy of ACT was mixed, with a more consistent pattern for informal caregivers of people with dementia. Several methodological quality issues limited the findings. However, theoretical synthesis and preliminary evidence support the promising effect of ACT in subgroups of informal caregivers. Research on the process of change, as well as larger-scale, methodologically rigorous trials, are needed to consolidate these findings.
AB - Informal caregivers are the primary source of support for adults with chronic conditions and disabilities. Empirical research highlights chronic stress and other risks of adverse outcomes of caregiving. Acceptance and Commitment Therapy (ACT) is an emerging evidenced-based practice that shows promise in improving an array of outcomes, theoretically by increasing psychological flexibility as the primary process of change. Research has begun to evaluate ACT among informal caregivers of adult populations, and a systematic review is now needed to summarise this evidence base. Electronic searches from five databases, including PubMed, PsycInfo, Embase, CINAHL, and Cochrane Library, yielded an initial 7896 hits, which after screening for inclusion criteria, resulted in 21 clinical trials. Studies were coded to synthesise the feasibility, effectiveness, and quality of evidence. Findings show that ACT was reported to be largely feasible and acceptable. However, the efficacy of ACT was mixed, with a more consistent pattern for informal caregivers of people with dementia. Several methodological quality issues limited the findings. However, theoretical synthesis and preliminary evidence support the promising effect of ACT in subgroups of informal caregivers. Research on the process of change, as well as larger-scale, methodologically rigorous trials, are needed to consolidate these findings.
KW - Acceptance and commitment therapy
KW - Caregiver stress
KW - Dementia
KW - Informal caregivers
KW - Long-term condition
KW - Systematic review
U2 - 10.1016/j.cpr.2023.102341
DO - 10.1016/j.cpr.2023.102341
M3 - (Systematic) Review article
SN - 0272-7358
VL - 105
JO - Clinical Psychology Review
JF - Clinical Psychology Review
IS - 1
M1 - 102341
ER -