Compassion-Focused Therapy for an Older Adult with Motor Functional Neurological Disorder: A Case Study.

OBJECTIVES: Motor functional neurological disorder (mFND) is a condition where individuals may experience difficulties such as tremors, gait impairments, and paralysis which are not explained by identified structural damage to the brain. Studies on chronic conditions have suggested that psychological interventions such as compassion-focused therapy (CFT) may be effective in improving well-being in people with mFND. However, no evidence is currently available on psychotherapy for older people with mFND. METHODS: A 12-session CFT intervention was delivered to an 81-year-old British male with mFND. Standardized measures were administered at baseline and post-intervention. RESULTS: At post-intervention, a 30% decrease in perceived psychological impact of mFND was found, along with clinically significant changes in anxiety and depression. Good levels of feasibility and acceptability were also observed. CONCLUSIONS: To our knowledge, this is the first evidence of the feasibility, acceptability, and potential effectiveness of CFT for psychological difficulties linked with mFND, as well as the first evidence for any psychotherapy with an older adult with mFND. CLINICAL IMPLICATIONS: CFT shows the potential to be effective, feasible, and acceptable for treating difficulties linked with mFND in older people. However, further high-quality investigations based on experimental designs are needed to build on the present preliminary findings.

Compassion focused therapy for people with dementia: A feasibility study.

OBJECTIVES: There is a lack of evidence-based psychological therapies for dementia and psychological distress. The study aimed to develop a compassion focused therapy intervention for people with dementia with depression and/or anxiety, and to assess its feasibility, acceptability, and utility. METHODS: A mixed methods multiple case series (n = 7) was used to assess the intervention's feasibility and changes in self-compassion, mood, anxiety, and quality of life. Outcome measures were administered at pre-intervention, midpoint, and post-intervention. Data were analysed using reliable change and clinically significant change. Thematic analysis on post-therapy interviews and session rating forms was used to assess acceptability and perceived change from the intervention. RESULTS: Over the course of the intervention, improvements in mood, anxiety, and self-compassion were seen, and three of six participants moved out of the clinical depression range. Six participants were able to engage in soothing rhythm breathing, and five in discussion of self-criticism and developing self-compassion. Several participants and their carers described increased self-compassion in response to cognitive decline. CONCLUSIONS: Compassion focused therapy can be adapted to be delivered to people with dementia and low mood, anxiety, or other distress. The intervention may improve self-compassion, mood, and anxiety. A larger pilot trial with a comparator group and follow-up is needed to evaluate the intervention's effectiveness for people with dementia.

The Evaluation of a Compassion-Focused Therapy Group for Couples Experiencing a Dementia Diagnosis.

OBJECTIVES: This study evaluated the effectiveness of a Compassion-Focused Therapy (CFT) group on reducing anxiety, depression, and respiratory rate (RR) in people with dementia (PwD) and their spouses, and improving quality of life (QoL) of PwD. METHOD: Sixty-four participants completed six weekly CFT sessions. Baseline and post-intervention assessments were analyzed using t-tests and Reliability Change Index. RESULTS: Mean baseline and post-assessment anxiety and depression scores fell in the 'normal range'; although a significant reduction in depression with moderate effect was observed for PwD. Fifty-seven percent of PwD with borderline to abnormal baseline scores showed clinically significant improvement in anxiety and depression. For spouses, 80% showed clinically significant improvement in depression and 50% in anxiety. RR reduced for PwD and spouses with large and medium effects respectively. QoL of PwD improved with a large effect. CONCLUSIONS: CFT appears effective in improving QoL and depression in PwD and reducing RR in PwD and spouses. CFT reduces anxiety and depression in most PwD and spouses with borderline to abnormal symptoms. CLINICAL IMPLICATIONS: This study indicates benefits of a group-CFT intervention delivered to people with a range of dementia diagnosis and their spouses. The service should investigate whether individuals in greater distress are not accessing the group and improve engagement.