Long-Term Outcomes of the Benefit-Finding Group Intervention for Alzheimer Family Caregivers: A Cluster-Randomized Double-Blind Controlled Trial

Objectives
To examine the effects of the group benefit-finding intervention (BFT) for Alzheimer family caregivers up to 10-month follow-up.
Design
Cluster-randomized double-blind controlled trial.
Setting
Social centers and clinics.
Participants
129 caregivers. Inclusion criteria were (a) primary caregiver aged 18+ and without cognitive impairment, (b) providing ≥14 care hours per week to a relative with mild-to-moderate Alzheimer's disease, and (c) scoring ≥3 on the Hamilton Depression Rating Scale. Exclusion criterion was care-recipient having parkinsonism or other forms of dementia.
Interventions
BFT (using cognitive reappraisal to find positive meanings) was evaluated against two forms of psychoeducation as controls—standard (STD-PE) and simplified (lectures only; SIM-PE) psychoeducation. All interventions had eight weekly sessions of 2 hours each.
Measurements
Primary outcome was depressive symptom, whereas secondary outcomes were global burden, role overload, and psychological well-being. Measures were collected at baseline, post-intervention, and 4- and 10-month follow-up.
Results
Mixed-effects regression showed that BFT's effect on depressive symptoms conformed to a curvilinear pattern, in which the strong initial effect leveled out after post-intervention and was maintained up to 10-month follow-up; this was true when compared against either control group. The effect on global burden was less impressive but moderate effect sizes were found at the two follow-ups. For psychological well-being, there was an increase in the BFT group at 4-month follow-up and a return to baseline afterwards. No effect on role overload was found.
Conclusions
Benefit-finding reduces depressive symptoms as well as global burden in the long-term, and increases psychological well-being in the medium-term.