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Experimental Evaluation of the Effectiveness of Group Intervention for Dementia Caregivers

The current project was aimed at systematically evaluating the effectiveness of group intervention for caregivers of elderly dementia patients. Two formats were compared, a supportive group and a group with both supportive and stress-management components. A waiting list control group was also used. Also included in the study were several important methodological features, such as random assignment of caregivers to conditions and confidential assessment of outcome measures by research assistants who were blind to whether caregivers were in treatment versus waiting list conditions. A comprehensive series of outcome measures was used which in prior research (Haley et al., in press) has been found to be affected by the stress of caregiving, including depression, life satisfaction, and social activity variables. In addition, effects of the groups were assessed on a number of exploratory variables, such as coping style. Finally, measures of participant satisfaction were included with the groups as a whole and major components of the groups as a way of identifying particular aspects of group participation seen as most helpful by participants. The hypothesis was that participation in the groups would lead to decreased depression, increased life satisfaction, and increased social activity.

 Caregivers’ responses to the participant checklist provided important information about caregivers’ perceptions of the important components of successful group intervention. Supported by these results was the suggestion by Zarit and Zarit (1982) that information, problem-solving, and emotional support are essential components of such intervention. In particular, caregivers valued specific information about community resources and dementia and its effects on the brain and behavior. The importance of emotional support was most apparent in caregivers’ ratings of the importance of identifying with other group members, belonging to a cohesive group, learning from others in the group, and support for increasing attention to their own needs. Assistance with problem-solving appeared to be important to caregivers, as indicated on several items having to do with encouragement to experiment with new approaches, direct advice, and modeling from other group participants. These ratings revealed that caregivers valued a number of outcomes not assessed in this project, including increases in knowledge about dementia and about coping skills which might help them to face the progression of dementia expected. Clinically, many caregivers also seemed more concerned with the goal of improving their effectiveness as caregivers than with decreasing their current levels of distress. Objectively assessing changes in these kinds of long-term outcomes to more fully understand the benefits and limitations of psychosocial intervention will be a major challenge for future clinical research with caregiving families.


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