Project Title:

Online Acceptance and Commitment Therapy (ACT) for family carers of people
with dementia

Type of Research:

Primary research

Background & Scientific Rationale:

The problem: Recent systematic reviews led by the lead researcher (1,2) demonstrated that the pooled prevalence of depression and anxiety in family carers of
people with dementia are 31.2% and 32.1% respectively. Mental health disorders among family carers are considered to be one of the strongest predictors of  institutionalisation of people with dementia3. This means if carers are distressed not only is their health at risk, but the quality of their care is also likely to be impacted.
The current evidence base: Another recent systematic review led by the lead researcher (4) evaluated the efficacy of different interventions for family carers of people with dementia. Psychological interventions underpinned by cognitive and behavioural models including both conventional Cognitive Behaviour Therapy (CBT) and Acceptance and Commitment Therapy (ACT) demonstrated strong empirical support for treating anxiety and depression in family carers. The results of an additional analysis showed that the study that used ACT had a large impact on the overall effect size for anxiety, suggesting that ACT may be particularly beneficial for carers experiencing anxiety among other CBT approaches.
Why ACT is being proposed: ACT is an acceptance-based form of CBT with a strong
evidence base for improving outcomes such as mood and quality of life in various
populations5. ACT does not aim to change thoughts and feelings but rather to reduce
avoidance and enhance goal-directed behaviour. This strategic focus is highly practical because it is easier to change what we do, and how we do it, than to stop or change what we think or feel. In a phrase when suffering is inevitable, it is better to embrace it and focus on what can do, than to fight it.

Research aims:

The primary aims are to:

  1. investigate the acceptability of revised face-to-face ACT (Phase 1)
  2. evaluate the feasibility and acceptability of online ACT in family carers of people with dementia (Phase 2).


Phase 1 uses a small open-label, single-arm trial. Fifteen eligible participants will be asked to complete standardised questionnaires at baseline, postintervention, and 6-month follow-up. The acceptability of the treatment will be examined using responses to open-ended questions, which will be conducted at 6-month follow-up.

Expected Output of Research / Impact and added value:

(1) scientific research publication on Phase 1 acceptability study; and (2) successful funding application to peruse
Phase 2 study. Completion of Phase 2 online ACT study will lead to further research outputs.


For further information on this project, please contact Naoko Kishita

1. Collins R, Kishita N. Prevalence of depression and burden among informal caregivers of people with dementia: a meta-analysis.
Submitted for publication 2018.
2. Kaddour L, Kishita N. Anxiety in informal dementia caregivers: a meta-analysis of prevalence. Submitted for publication 2018.
3. Spijker A, Vernooij-Dassen M, Vasse E, et al. Effectiveness of nonpharmacological interventions in delaying the institutionalization
of patients with dementia: A meta-analysis. Journal of the American Geriatrics Society 2008; 56(6): 1116-28.
4. Kishita N, Hammond L, Dietrich C, Mioshi E. Which intervention work for dementia family carers?: An updated systematic review
of randomised controlled trials of carer interventions. International Psychogeriatrics 2018: Advance online publication.
5. A-Tjak JGL, Davis ML, Morina N, Powers MB, Smits JAJ, Emmelkamp PMG. A meta-analysis of the efficacy of acceptance and
commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics 2015; 84(1):
Share this article
Tweet about this on Twitter