title: Behavioral activation for dementia caregivers: scheduling pleasant events and enhancing communications.
abstract: BACKGROUND
  Dementia caregiving is often associated with increase in depressive symptoms and strained relationships. This study tested whether telephone-delivered psychoeducation combined with an enhanced behavioral activation (BA) module had a better effect on the well-being of Alzheimer's caregivers than psychoeducation alone. The focus is on enhancing the competent use of coping skills via BA. The program is delivered by telephone to increase accessibility and sustainability for caregivers. Senior citizens are trained as paraprofessionals to deliver the BA module to increase the potential for sustainability of the program.
  
  
  METHODS
  The study compared two telephone interventions using a 4-month longitudinal randomized controlled trial. For the first 4 weeks, all participants received the same psychoeducation program via telephone. Then for the following 4 months, eight biweekly telephone follow-up calls were carried out. For these eight follow-up calls, participants were randomized into either one of the two following groups with different conditions. For the psychoeducation with BA (PsyED-BA) group, participants received eight biweekly sessions of BA practice focused on pleasant event scheduling and improving communications. For the psychoeducation only (PsyED only) group, participants received eight biweekly sessions of general discussion of psychoeducation and related information. A total of 62 family caregivers of persons living with dementia were recruited and 59 (29 in the PsyED-BA group and 30 in the PsyED only group) completed the whole study.
  
  
  RESULTS
  As compared to the group with psychoeducation and discussion, the group with enhanced BA had decreased levels of depressive symptoms. The study had a low attrition rate.
  
  
  CONCLUSIONS
  Results suggested that competence-based training could be effectively administered through the telephone with the help of senior citizens trained and engaged as paraprofessionals. Results contribute to the present literature by offering some framework for developing effective, accessible, sustainable, and less costly interventions.
authors.affiliation: Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China ; Institute of Active Aging, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China.
authors.forename: Alma
authors.initials: A
authors.lastname: Au
authors.affiliation: Department of Psychiatry and Behavioral Sciences and Geriatric Education Centre, School of Medicine, Stanford University, Stanford, CA, USA.
authors.forename: Dolores
authors.initials: D
authors.lastname: Gallagher-Thompson
authors.affiliation: Department of Psychiatry, United Christian Hospital, Hong Kong, People's Republic of China.
authors.forename: Meng-Kong
authors.initials: MK
authors.lastname: Wong
authors.affiliation: Department of Psychiatry, United Christian Hospital, Hong Kong, People's Republic of China.
authors.forename: Jess
authors.initials: J
authors.lastname: Leung
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong, People's Republic of China.
authors.forename: Wai-Chi
authors.initials: WC
authors.lastname: Chan
authors.affiliation: Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong, People's Republic of China.
authors.forename: Chun Chung
authors.initials: CC
authors.lastname: Chan
authors.affiliation: Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China.
authors.forename: Hui-Jing
authors.initials: HJ
authors.lastname: Lu
authors.affiliation: Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China.
authors.forename: Man Kin
authors.initials: MK
authors.lastname: Lai
authors.affiliation: Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China.
authors.forename: Kevin
authors.initials: K
authors.lastname: Chan
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000193:education* / Q000523:psychology; D003704:Dementia / Q000523:psychology / Q000628:therapy*; D003863:Depression / Q000517:prevention & control; D005260:Female; D006801:Humans; D006849:Hydrocephalus; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D013689:Telephone
keywords: accessibility; paraprofessional; sustainability; telephone-assisted
references.citation: Gerontol Geriatr Educ. 2004;25(1):73-88
references.pmid: 15364661
references.citation: Aging Ment Health. 2015 Jan;19(1):55-62
references.pmid: 24866207
references.citation: J Gerontol A Biol Sci Med Sci. 2009 Aug;64(8):873-9
references.pmid: 19351695
references.citation: Hong Kong Med J. 2014 Jun;20(3 Suppl 3):30-3
references.pmid: 25001033
references.citation: Fam Community Health. 2009 Jan-Mar;32(1 Suppl):S83-92
references.pmid: 19065098
references.citation: Br J Psychiatry. 2012 May;200(5):361-3
references.pmid: 22550329
references.citation: J Clin Nurs. 2009 Feb;18(4):502-11
references.pmid: 19191999
references.citation: Int Psychogeriatr. 2012 Feb;24(2):212-22
references.pmid: 21995966
references.citation: Patient Educ Couns. 2010 Feb;78(2):256-60
references.pmid: 19619974
references.citation: Am J Alzheimers Dis Other Demen. 2006 Dec-2007 Jan;21(6):391-7
references.pmid: 17267370
references.citation: J Am Geriatr Soc. 2010 Jan;58(1):30-7
references.pmid: 20122038
references.citation: J Gerontol B Psychol Sci Soc Sci. 2003 Mar;58(2):P112-28
references.pmid: 12646594
references.citation: Gerontologist. 2009 Feb;49(1):91-102
references.pmid: 19363007
references.citation: Aging Ment Health. 2009 Sep;13(5):761-8
references.pmid: 19882415
references.citation: Am J Geriatr Psychiatry. 2008 Mar;16(3):229-39
references.pmid: 18310553
references.citation: Am J Geriatr Psychiatry. 2007 May;15(5):425-34
references.pmid: 17463192
references.citation: J Affect Disord. 2013 Mar 5;145(3):292-9
references.pmid: 22884236
references.citation: Aging Ment Health. 2004 Sep;8(5):438-49
references.pmid: 15511742
references.citation: Int J Geriatr Psychiatry. 2011 Nov;26(11):1119-27
references.pmid: 21061414
references.citation: Gerontologist. 2003 Aug;43(4):514-20
references.pmid: 12937330
references.citation: Aging Ment Health. 2010 Apr;14(3):263-73
references.pmid: 20425645
references.citation: Dementia (London). 2008;7(4):503-520
references.pmid: 20228893
references.citation: Behav Res Ther. 2013 Oct;51(10):623-32
references.pmid: 23916631
references.citation: Alzheimer Dis Assoc Disord. 2008 Apr-Jun;22(2):131-6
references.pmid: 18525284
references.citation: Am J Alzheimers Dis Other Demen. 2010 Aug;25(5):446-54
references.pmid: 20484748
references.citation: Psychol Aging. 2003 Sep;18(3):361-74
references.pmid: 14518800
references.citation: Br J Psychiatry. 2011 Jan;198(1):66-72
references.pmid: 21200079