Psychoeducation

According to Pinquart and Sørensen (2006), the results from numerous intervention studies show that psychoeducational interventions are significantly effective at decreasing caregiver burden, depression and negative care recipient symptoms. The effects are modestly positive for enhancing subjective well being (SWB) and there are no significant effects on delaying the time to institutionalization of a care recipient.  Parker et al (2008) found that psychoeducational interventions modestly decreased depression and burden and enhanced SWB whilst having no significant effect on self-rated health, self-efficacy or time to institutionalization.  Gallagher-Thompson and Coon (2007) found that psychoeducational interventions (such as behaviour management skills training, depression management, progressively lowered stress threshold (PLST), and anger management skill training) as a category of interventions showed a notable effect size (0.81). While the reporting of results was not as detailed as Pinquart and Sørensen (2006), the reported benefits of this intervention category include the reduction of caregiver distress (e.g., depressive symptoms, anxiety, and/or feelings of anger and frustration) and improvement of caregiver coping skills and self-efficacy.

In the context of ‘home care’, Schoenmakers et al (2010) looked at psychosocial interventions and their impact on depression and burden. Although they pooled psychoeducational interventions, CBT and general support in their analyses, they found a slight decreasing effect on burden and depression, which may point to the possible effect of the home setting for delivering interventions to the populations studied versus a clinical/remote site. Lastly, Eagar et al (2007) report their review of psychoeducational interventions as positive for caregivers.

Data from several different reviews and meta-analyses show that there is encouraging evidence in support of psychoeducational interventions for caregivers. There are, however, also conflicting results of the specific outcomes that psychoeducational interventions may have an impact on.  The lack of consistent categories of interventions makes the comparability between reviews limited and there is also uncertainty as to the size of the treatment effect. Nonetheless, a modest to significant effect of this type of intervention has been observed in multiple studies and across many sites and a range of caregivers.  For these reasons psychoeducational interventions ought to be considered relatively “effective” types of interventions to make available. 

While there are a large variety of psychoeducational interventions, there is evidence to suggest that certain features of these interventions and/or how they are delivered may influence their effectiveness.  Specifically, it has been shown that providing educational materials alone to caregivers does increase awareness of caregiving related issues but it has no impact on burden, SWB, depression, CR symptoms or time to institutionalization ( see Table 5 & Eagar et al., 2007). Rather, active interventions that provide an opportunity for caregivers to practice and role-play appear to be more effective at reducing burden, depression and CR symptoms while enhancing SWB and knowledge of caregiving related issues. (Pinquart & Sørensen, 2006; Parker, Mills, & Abbey, 2008).

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