Intervention Helps Family Caregivers of People With Dementia Attain Own Therapy Goals.

INTRODUCTION: Caregiver intervention studies typically assess whether participants attain general goals (eg, improved mental/physical health) but not their own individual goals. We used goal attainment scaling to evaluate whether participants of a telephone intervention based on cognitive behavioral therapy (CBT) attained their personal goals. We also evaluated treatment compliance and implementation. METHODS: A sample of 139 family caregivers of people with dementia received 12 telephone sessions over 6 months. Participants personal goals were specified during the first and second sessions. Participants and therapists assessed goal attainment at the end of the intervention. RESULTS: Nearly all participants reported meaningful improvements with regard to their personal goals. Specifically, 20.9% exceeded, 56.4% completely attained, and 21.8% partially attained at least one of their personal goals. There was high agreement between self- and therapist ratings. Treatment compliance and implementation were highly satisfactory. CONCLUSIONS: The CBT telephone intervention successfully helped participants attain their personal goals.

The Tele.TAnDem intervention: study protocol for a psychotherapeutic intervention for family caregivers of people with dementia.

BACKGROUND: Family caregivers are confronted with high demands creating a need for professional support and at the same time hindering its utilization. Telephone support allows easier access than face-to-face support because there is no need to leave the person with dementia alone or find an alternative carer. It is also independent of transport possibilities or mobility. The objectives are to evaluate whether telephone-based cognitive-behavioral therapy, which is implemented in established care provision structures, improves outcomes compared to usual care and whether it is as effective as face-to-face cognitive-behavioral therapy. METHODS/DESIGN: If participants live in the area of one of the study centers (Jena, Berlin, Munich) and indicate that attendance of a face-to-face therapy is possible, they will be assigned to the face-to-face group. The other participants will be randomized to receive either telephone-based cognitive-behavioral therapy or usual care. Data will be collected at baseline, post-intervention, and at a 6-month follow-up. The primary outcomes will be depressiveness, burden of care, health complaints, and problem-solving ability. The secondary outcomes will be anxiety, quality of life, violence in caregiving, utilization of professional assistance, and cost effectiveness. DISCUSSION: This paper describes the evaluation design of our telephone-based cognitive-behavioral therapy in a randomized controlled trial. If this intervention proves to be an effective tool to improve outcomes, it will be made accessible to the public and the use of this support service will be recommended. TRIAL REGISTRATION: German Clinical Trials Register DRKS00006355.

Facial Feedback in Implicit Sequence Learning

There is continuous debate how closely or loosely emotion is linked to behavior and especially to facial expressions. In strong versions of the so-called facial feedback hypothesis, it is assumed that facial activity can intensify, modulate and initiate emotions. The hypothesis has been largely investigated with various emotions, however, surprise was tested only in a few studies. Additionally, it has been discussed frequently how obtrusively manipulations of facial feedback as well as the dependent measures are. Thus, in the present experiment we analyzed whether unobtrusive facial feedback of surprise versus no-surprise can modulate reactions following deviations in an implicit sequence learning task. Participants had to quickly and accurately press keys which corresponded to one of four letters appearing at the screen. After several blocks in which a standard sequence (consisting of a predefined order of 12 letters) was repeated, standard sequences and deviation sequences (i.e. one element differed from the standard sequence) were intermixed. The results confirmed our hypothesis: Participants of the surprise face condition showed longer reaction times to deviation sequences than to standard sequences. In contrast, participants of the no-surprise face condition did not show this difference in reaction times. Results were discussed with respect to implicit learning as well as to theories on emotion and facial feedback taking the special status of surprise into account (AU)

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