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Therapists’ perceptions and acceptability of providing internet-delivered guided self-help acceptance and commitment therapy (ACT) for family carers of people with dementia (iACT4CARERS): a qualitative study

Published online by Cambridge University Press:  15 December 2021

Milena Contreras ,
Elien Van Hout ,
Morag Farquhar ,
Rebecca L. Gould ,
Lance M. McCracken ,
Michael Hornberger ,
Erica Richmond  and
Naoko Kishita Open the ORCID record for Naoko Kishita [Opens in a new window]
Milena Contreras
Affiliation:
School of Health Sciences, University of East Anglia, Norwich, UK
Elien Van Hout
Affiliation:
School of Health Sciences, University of East Anglia, Norwich, UK
Morag Farquhar
Affiliation:
School of Health Sciences, University of East Anglia, Norwich, UK
Rebecca L. Gould
Affiliation:
Division of Psychiatry, University College London, London, UK
Lance M. McCracken
Affiliation:
Department of Psychology, Uppsala University, Uppsala, Sweden
Michael Hornberger
Affiliation:
Norwich Medical School, University of East Anglia, Norwich, UK
Erica Richmond
Affiliation:
Older People’s Community Team, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
Naoko Kishita*
Affiliation:
School of Health Sciences, University of East Anglia, Norwich, UK
*
*Corresponding author. Email: [email protected]
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Abstract

This study aimed to explore therapists’ perceptions and acceptability of providing internet-delivered, therapist-guided, self-help acceptance and commitment therapy (ACT) for family carers of people with dementia (iACT4CARERS). To achieve this, a qualitative approach with semi-structured interviews was employed with eight novice therapists recruited from primary and secondary care services taking part in a feasibility study of iACT4CARERS. The interviews were audio-recorded, transcribed, and analysed using thematic analysis. Four over-arching themes were identified: (1) positive attitudes towards the intervention, (2) therapists’ workload, (3) therapists’ confidence to perform their role, and (4) connecting with family carers in a virtual context. Theme 1 included seeing their involvement as an opportunity for personal growth and perceiving benefits to the family carers, which contributed to greater acceptability. Theme 2 reflected that while workload and the user-friendliness of the online platform were highly acceptable among the therapists, there were also time-consuming cases that increased therapists’ burden. Theme 3 revealed that practical resources provided during the training, continued supervision, and opportunities to learn from other therapists, increased therapist confidence and facilitated greater acceptability. Finally, Theme 4 highlighted that improving the connection between therapists and carers was critical in a virtual context and strategies to improve the therapist–carer relationship were recommended. The implementation of iACT4CARERS was largely acceptable for the therapists involved in the trial. Ways to strengthen the therapeutic relationship in the virtual context and practical strategies to deal with common problems may enhance therapist experience and delivery in a full-scale effectiveness trial.

Key learning aims

  1. (1) To understand which factors facilitated therapists’ positive perceptions and acceptability of providing internet-delivered guided self-help ACT (iACT4CARERS).

  2. (2) To understand what challenges acted as barriers to therapists’ positive perceptions and acceptability of providing iACT4CARERS.

  3. (3) To learn what aspects of the training and the intervention can be refined to improve the acceptability to therapists in trials involving internet-delivered guided self-help interventions for family carers.

Keywords

acceptabilityinformal caregiversonline therapypsychological interventionstherapeutic relationshiptherapists
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 14 , 2021 , e38
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

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References

Further reading

Geller, S. (2020). Cultivating online therapeutic presence: strengthening therapeutic relationships in teletherapy sessions. Counselling Psychology Quarterly, 1–17. https://doi.org/10.1080/09515070.2020.1787348 Google Scholar
Thew, G. R. (2020). IAPT and the internet: the current and future role of therapist-guided internet interventions within routine care settings. The Cognitive Behaviour Therapist, 13, e4. https://doi.org/10.1017/S1754470X20000033 CrossRefGoogle ScholarPubMed

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