title: Cognitive-behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for dementia family caregivers with significant depressive symptoms: Results of a randomized clinical trial.
abstract: OBJECTIVE
  The differential efficacy of acceptance and commitment therapy (ACT) and cognitive-behavioral therapy (CBT) for dementia family caregivers' is analyzed through a randomized controlled trial.
  
  
  METHODS
  Participants were 135 caregivers with high depressive symptomatology who were randomly allocated to the intervention conditions or a control group (CG). Pre-, postintervention, and follow-up measurements assessed depressive symptomatology, anxiety, leisure, dysfunctional thoughts, and experiential avoidance.
  
  
  RESULTS
  Depression: Significant effects of interventions compared with CG were found for CBT (p < .001, d = 0.98, number needed to treat [NNT] = 3.61) and ACT (p < .001, d = 1.17, NNT = 3.53) at postintervention, but were maintained only at follow-up for CBT (p = .02, d = 0.74, NNT = 9.71). Clinically significant change was observed in 26.7% participants in CBT, 24.2% in ACT, and 0% in CG. At follow-up, 10.53% in CBT and 4% in ACT were recovered (0% CG). Anxiety: At postintervention, ACT participants showed lower anxiety than CBT participants (p < .05, d = 0.50) and CG participants (p < .01, d = 0.79, NNT = 3.86), with no effects at follow-up. At postintervention, 23.33% in CBT, 36.36% in ACT, and 6.45% in CG showed clinically significant change. At follow-up, 26.32% in CBT, 36% in ACT, and 13.64% in CG were recovered. Significant changes at postintervention were found in leisure and dysfunctional thoughts in both ACT and CBT, with changes in experiential avoidance only for ACT.
  
  
  CONCLUSIONS
  Similar results were obtained for ACT and CBT. ACT seems to be a viable and effective treatment for dementia caregivers.
authors.affiliation: Psychology Department, Universidad Rey Juan Carlos.
authors.forename: Andrés
authors.initials: A
authors.lastname: Losada
authors.affiliation: Department of Biological and Clinical Psychology, Universidad Autónoma de Madrid.
authors.forename: María
authors.initials: M
authors.lastname: Márquez-González
authors.affiliation: Psychology Department, Universidad Rey Juan Carlos.
authors.forename: Rosa
authors.initials: R
authors.lastname: Romero-Moreno
authors.affiliation: Department of Psychiatry, University of California, San Diego.
authors.forename: Brent T
authors.initials: BT
authors.lastname: Mausbach
authors.affiliation: Department of Psychology, Universidad CEU San Pablo.
authors.forename: Javier
authors.initials: J
authors.lastname: López
authors.affiliation: Psychology Department, Universidad Rey Juan Carlos.
authors.forename: Virginia
authors.initials: V
authors.lastname: Fernández-Fernández
authors.affiliation: Psychology Department, Universidad Rey Juan Carlos.
authors.forename: Celia
authors.initials: C
authors.lastname: Nogales-González
mesh_terms: D064869:Acceptance and Commitment Therapy; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000628:therapy; D017028:Caregivers / Q000523:psychology*; D015928:Cognitive Behavioral Therapy; D003704:Dementia / Q000451:nursing*; D003863:Depression / Q000209:etiology / Q000628:therapy*; D003865:Major Depressive Disorder / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome