iCare Stress Management e-Training for Dementia Family Caregivers

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DESCRIPTION (provided by applicant): The consequences of Alzheimer's Disease (AD) and related dementia are devastating not only for dementia patients, but also for family caregivers (estimated at 8.9 million), who are considered the hidden patients, and are at high risk for depressive symptoms and syndromes related to the stress and difficulties of dementia caregiving. Efficient, low-cost and accessible interventions are needed to cope with dementia caregiving, particularly stress management. The goals of our Fast Track Phase I/Phase II project are: (1) to enhance the quality of life and reduce the caregiving stress of dementia family caregivers with a new psychotherapy intervention (iCare eTraining); and (2) to develop the iCare stress management eTraining in low-cost and accessible methods (DVD and Internet) for deployment to millions of families who need it. The novel iCare incorporates: (a) integration of content from our caregiving studies with different ethnic groups; (b) adaptation of our psychotherapy curriculum, based on Cognitive Behavioral Therapy (CBT), for video and Internet modalities; and (c) creative use of DVD, online video, and web technology. The result is an innovative psychotherapy intervention to treat dementia caregiver stress with more effective and powerful features: engaging methods (DVD and online video); tools to encourage supportive interactions with professionals and other caregivers; enhanced communication; methods to gather and distribute collective knowledge on coping with caregiving; and other supportive tools. Related clinical advantages are: encourage training participation, enable user interaction, and promote better assimilation of concepts; which should enhance caregivers' skills to deal with demanding tasks of caregiving (ultimately leading to alleviate stress and improve quality of life). The basis for the iCare curriculum was developed in many evidence-based procedures by Dr. Gallagher-Thompson, Dr. Thompson, and associates, resulting in a successful "Coping with Caregiving " class series (CWC), evaluated in several randomized clinical trials, e.g. a component of NIH-funded multi-site national research project "Resources for Enhancing Alzheimer's Caregiver Health" (REACH; Belle et al., 2006; Schulz et al., 2003), which demonstrated that CWC trainings reduced stress for caregivers from diverse communities. The psychotherapy aspect of iCare refers to "psychological techniques designed to encourage insight into problems for personal growth and behavior modification" (oriented by eTraining), rather than treatment by therapist (not feasible for broad deployment due to costs). The pedagogical format of iCare is a combination of DVD/online video training and use of supplemental materials that build skills and stimulate practice. In collaboration with the Alzheimer's Association, Family Caregiver Alliance, and other organizations, we will develop and evaluate iCare (targeting general caregiver population), with an expert Advisory Board (for scientific review) and family caregivers (for consumer input). We will assess the iCare effectiveness in improving the well-being and decreasing the stress of caregivers with a randomized clinical trial (Phase II).