Wilkinson, Emily;
(2024)
Does an enhanced delivery of metaphors and experiential exercises from Acceptance and Commitment Therapy improve experience amongst people living with dementia?
Doctoral thesis (D.Clin.Psy), UCL (University College London).
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Abstract
Purpose: Research suggests that people with dementia and mild cognitive impairment demonstrate high prevalence rates of psychological distress and poor quality of life. The aim of this research was to provide a systematic scoping review of the literature investigating psychological benefits of third wave CBT therapies for people with dementia and mild cognitive impairment. Several aims were used to guide the review, which focussed on participant characteristics, intervention type, research design, research quality, outcome measures, preliminary effectiveness, and intervention adaptations of quantitative data. Methods: The databases PsycINFO, PubMed, Embase, CINAHL, and Web of Science were searched online, and all research designs involving quantitative data were eligible for inclusion. Results were narratively synthesised. Results: Participants were predominantly UK-based white men and women with a diagnosis of mild dementia or mild cognitive impairment living in the community. The most researched third wave therapies were mindfulness-based interventions. Although seven of the studies were controlled trials (six randomised), these were predominantly feasibility studies and therefore underpowered to detect effectiveness. Outcomes measures primarily included psychological distress, quality of life, and process measures, with limited outcomes assessing psychological wellbeing (n=1). Preliminary effectiveness outcomes demonstrated mixed findings, but showing signals of effectiveness across interventions. All studies included general adaptations, and all detailed intervention specific adaptations except ACT. Conclusions: Future research would benefit from inclusion of a more diverse sample in terms of ethnicity and severity of dementia, using adequately powered randomised control trials to investigate mindfulness-based interventions, and further feasibility studies for other third wave interventions. Research may benefit from prioritising wellbeing measures alongside quality of life and process measures given that the symptom reduction is often not the primary aim of third wave interventions. Such measures would benefit from being validated across people living with dementia.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | D.Clin.Psy |
| Title: | Does an enhanced delivery of metaphors and experiential exercises from Acceptance and Commitment Therapy improve experience amongst people living with dementia? |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2024. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10197888 |
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