title: Caring for the carer: a systematic review of pure technology-based cognitive behavioral therapy (TB-CBT) interventions for dementia carers.
abstract: Face-to-face delivery of CBT is not always optimal or practical for informal dementia carers (DCs). Technology-based formats of CBT delivery (TB-CBT) have been developed with the aim to improve client engagement and accessibility, and lower delivery costs, and offers potential benefits for DCs. However, research of TB-CBT for DCs has maintained heavy reliance on therapist involvement. The efficacy of pure TB-CBT interventions for DCs is not currently established Methods: A systematic review of trials of pure TB-CBT intervention for DCs from 1995 was conducted. PsycINFO, Cochrane Reviews, Scopus and MedLine databases were searched using key terms related to CBT, carers and dementia. Four hundred and forty two articles were identified, and inclusion/exclusion criteria were applied; studies were only retained if quantitative data was available, and there was no active therapist contact. Four articles were retained; two randomized and two waitlist control trials. Methodological and reporting quality was assessed. Meta-analyses were conducted for the outcome measures of caregiver depression.
  
  
  
  Meta-analysis revealed small significant post-intervention effects of pure TB-CBT interventions for depression; equivalent to face-to-face interventions. However, there is no evidence regarding long-term efficacy of pure TB-CBT for DCs. The systematic review further identified critical methodological and reporting shortcomings pertaining to these trials Conclusions: Pure TB-CBT interventions may offer a convenient, economical method for delivering psychological interventions to DCs. Future research needs to investigate their long-term efficacy, and consider potential moderating and mediating factors underpinning the mechanisms of effect of these programs. This will help to provide more targeted interventions to this underserviced population.
authors.affiliation: a School of Medicine (Psychology) , University of Tasmania , Hobart , Australia.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Scott
authors.affiliation: a School of Medicine (Psychology) , University of Tasmania , Hobart , Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Dawkins
authors.affiliation: a School of Medicine (Psychology) , University of Tasmania , Hobart , Australia.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Quinn
authors.affiliation: b Menzies Institute for Medical Research, Tasmania , University of Tasmania , Hobart , Australia.
authors.forename: Kristy
authors.initials: K
authors.lastname: Sanderson
authors.affiliation: c School of Medicine and Wicking Dementia Research and Education Centre , University of Tasmania , Hobart , Australia.
authors.forename: Kate-Ellen J
authors.initials: KE
authors.lastname: Elliott
authors.affiliation: d School of Health Science , University of Tasmania , Hobart , Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Stirling
authors.affiliation: a School of Medicine (Psychology) , University of Tasmania , Hobart , Australia.
authors.forename: Ben
authors.initials: B
authors.lastname: Schüz
authors.affiliation: e School of Health Sciences and Wicking Dementia Research and Education Centre , University of Tasmania , Hobart , Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Robinson
mesh_terms: D017028:Caregivers / Q000523:psychology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003704:Dementia; D003863:Depression; D005260:Female; D006801:Humans; D008297:Male; D013672:Technology
keywords: carers; cognitive behavioral therapy; dementia; depression; systematic review; technology