Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-26T15:26:47.896Z Has data issue: false hasContentIssue false
  • English
  • Français

Review of family therapy and dementia: twenty-five years on

Published online by Cambridge University Press:  15 July 2014

Susan Mary Benbow  and
Victoria Sharman
Susan Mary Benbow*
Affiliation:
Centre for Ageing Studies, University of Chester, Chester, UK
Victoria Sharman
Affiliation:
V2Recovery Ltd, Harrow, Middlesex, UK
*
Correspondence should be addressed to: Dr Susan Mary Benbow, Centre for Ageing Studies, Faculty of Health and Social Care, University of Chester, Room CRV305/6, Riverside Campus, Chester CH1 1SL, UK. Phone: +44-1244-512249; Mobile: +44-7789-485435. Email: drsmbenbow@gmail.com.
Get access

Abstract

Background:

We reviewed the literature on family therapy and dementia to investigate the following: what is known about the use of family therapy in the context of living with dementia; what are the challenges of working in this context; and what guidelines/models are available to guide family therapists working with families living with dementia.

Methods:

We searched English language literature from 1992 onwards, classified the resulting papers into broad categories of theoretical, expository, or research (descriptive, quantitative, or qualitative), and conducted a narrative review to draw learning points from the identified papers.

Results:

In total 31 papers were identified: five theoretical, 11 expository; and 15 research papers. Several papers described methodologies; psychotherapeutic interventions applied to family members; or complex intervention packages in which the role of family therapy could not be separately identified, rather than family therapy. A range of outcomes were investigated, often involving the caregiver. Several authors suggest areas in dementia care where family therapy is likely to be beneficial.

Conclusions:

Although the literature on family therapy and dementia has grown over the past 25 years and suggests potentially useful roles for therapy, a number of challenges exist in terms of context, family, and therapy itself. There is a need for further research, particularly into the following fields: How to evaluate the success of therapy; how to ensure treatment integrity; how to make techniques from family therapy available more widely; and how to train the health and social care workforce in working with families.

Keywords

dementiafamiliesfamily caregiversfamily therapypeople with dementiasystemic therapy
Type
Review Article
Information
International Psychogeriatrics , Volume 26 , Special Issue 12: young onset dementia , December 2014 , pp. 2037 - 2050
Copyright
Copyright © International Psychogeriatric Association 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alzheimer's Disease International. (2010). The Global Economic Impact of Dementia. World Alzheimer Report 2010. London: Alzheimer's Disease International.Google Scholar
Anderson, H. and Goolishian, H. (1996). Problem determined systems: towards transformation in family therapy. Journal of Strategic and Systemic Therapies, 5, 1–13.Google Scholar
Association for Family Therapy & Systemic Practice (n/d). Information for Commissioners. Available at: http://www.aft.org.uk/SpringboardWebApp/userfiles/aft/file/Employers%20and%20Commissioners/AFT%20Information%20for%20Commissioners%20V2.pdf; last accessed on 30 June 2014.Google Scholar
Auclair, U., Epstein, C. and Mittelman, M. (2009). Couples counseling in Alzheimer's disease: additional clinical findings from a novel intervention study. Clinical Gerontologist, 32, 130–146.CrossRefGoogle ScholarPubMed
Barber, C. E. and Lyness, K. P. (2001). Ethical issues in family care of older persons with dementia: implications for family therapists. Home Health Care Services Quarterly, 20, 1–26.Google Scholar
Benbow, S. M. (2012). Patient and carer participation in old age psychiatry in England. Part I: a systemic perspective of the historical and policy context. International Psychogeriatrics, 24, 175–184.Google Scholar
Benbow, S. M. and Goodwillie, G. (2010). Think family: systemic therapy in later life. In N. A. Pachana, Laidlaw, K. and Knight, B. G. (eds.) Casebook of Clinical Geropsychology (pp. 91–106). Oxford, UK: Oxford University Press.Google Scholar
Benbow, S. M. et al. (1990). Using the family life cycle with later life families. Journal of Family Therapy, 12, 321–340.CrossRefGoogle Scholar
Benbow, S. M., Marriott, A., Morley, M. and Walsh, S. (1993). Family therapy and dementia: review and clinical experience. International Journal of Geriatric Psychiatry, 8, 717–725.Google Scholar
Bhattacharyya, S. and Benbow, S. M. (2013). Mental health services for black and minority ethnic elders in the United Kingdom: a systematic review of innovative practice with service provision and policy implications. International Psychogeriatrics, 25, 359–373.Google Scholar
Burnham, J. C. (1992). Approach, method and technique: making distinctions and creating connections. Human Systems, 3, 3–36.Google Scholar
Child, N. (2012). Systemic means much more: in the community and for other professions. Context, 125, 26–31.Google Scholar
Child, N. (2013). On, in and out the box: big ideas for Britain. Context, 128, 26.Google Scholar
Czaja, S. J., Schulz, R., Lee, C. C. and Belle, S. H. (2003). A methodology for describing and decomposing complex psychosocial and behavioral interventions. Psychology and Aging, 18, 385–395.Google Scholar
Dallos, R. and Draper, R. (2010). An Introduction to Family Therapy. Systemic Theory and Practice. Maidenhead, UK: Open University Press.Google Scholar
Dementia Plus. (2001). Twice a Child. Project report on Dementia Care for African-Caribbean and Asian Older People in Wolverhampton. Lancashire, UK: Caring Hands Group.Google Scholar
Department of Health. (2011). Talking Therapies: A Four-Year Plan of Action. Report on No Health Without Mental Health: A Cross-Government Mental Health Outcomes Strategy for People of All Ages. London: Department of Health, UK.Google Scholar
Dilworth-Anderson, P. and Gibson, B. E. (2002). The cultural influence of values, norms, meanings, and perceptions in understanding dementia in ethnic minorities. Alzheimer Disease & Associated Disorders, 16, S56–S63.Google Scholar
Divac, A. and Heaphy, G. (2005). Space for GRRAACCES: 1 training for cultural competence in supervision. Journal of Family Therapy, 27, 280–284.Google Scholar
Eisdorfer, C. et al. (2003). The effect of a family therapy and technology-based intervention on caregiver depression. The Gerontologist, 43, 521–531.Google Scholar
Evans, S. (2004). Sex and death: the ramifications of illness and aging in older couple relationships. Sexual and Relationship Therapy, 19, 319–335.CrossRefGoogle Scholar
Fisher, L. and Lieberman, M. A. (1994). Alzheimer's disease: the impact of the family on spouses, offspring, and inlaws. Family Process, 33, 305–325.Google Scholar
Fowers, B. J. and Olson, D. H. (1993). ENRICH Marital Satisfaction Scale: a brief research and clinical tool. Journal of Family Psychology, 7, 176–185.CrossRefGoogle Scholar
Fung, W.-Y. and Chien, W.-T. (2002). The effectiveness of a mutual support group for family caregivers of a relative with dementia. Archives of Psychiatric Nursing, 16, 134–144.CrossRefGoogle ScholarPubMed
Gallagher-Thompson, D. and DeVries, H. M. (1994). Coping with frustration classes: development and preliminary outcomes with women who care for relatives with dementia. The Gerontologist, 34, 548–552.CrossRefGoogle ScholarPubMed
Garner, J. (1997). Dementia: an intimate death. British Journal of Medical Psychology, 70, 177–184.Google Scholar
Garner, J. (2003). Psychotherapies and older adults. Australian & New Zealand Journal of Psychiatry, 37, 537–548.CrossRefGoogle ScholarPubMed
Garwick, A. W., Detzner, D. and Boss, P. (1994). Family perceptions of living with Alzheimer's disease. Family Process, 33, 327–340.Google Scholar
Ginther, S. D., Webber, P., Fox, P. J. and Miller, L. (1993). Professional allocations of counseling service to persons with Alzheimer's disease: an exploration. Social Work In Health Care, 19, 99–114.CrossRefGoogle ScholarPubMed
Joling, K. J. et al. (2008). (Cost)-effectiveness of family meetings on indicated prevention of anxiety and depressive symptoms and disorders of primary family caregivers of patients with dementia: design of a randomized controlled trial. BMC Geriatrics, 8. doi:10.1186/1471-2318-8-2.Google Scholar
Joling, K., van Marwijk, H., Smit, F., van der Horst, H. and Scheltens, P. (2012). Does a family meetings intervention prevent depression and anxiety in family caregivers of dementia patients? A randomized trial. PLoS ONE, 7, e30936.Google Scholar
Kissane, D. W. and Bloch, S. (1994). Family grief. British Journal of Psychiatry, 164, 728–740.Google Scholar
Kmet, L. M., Lee, R. C. and Cook, L. S. (2004). Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields. Draft paper of Alberta Heritage Foundation for Medical Research. Edmonton, Canada.Google Scholar
Koder, D.-A. (1998). Treatment of Anxiety in the Cognitively Impaired Elderly: Can Cognitive-Behavior Therapy Help? International Psychogeriatrics, 10, 173–182.Google Scholar
Kruglov, L. S. (2003). The early stage of vascular dementia: significance of a complete therapeutic program. International Journal of Geriatric Psychiatry, 18, 402–406.Google Scholar
Lampley-Dallas, V. T. (2002). Research issues for minority dementia patients and their caregivers: what are the gaps in our knowledge base? Alzheimer's Disease & Associated Disorders, 16, S46–S49.CrossRefGoogle ScholarPubMed
Lévesque, L. et al. (2002). The process of a group intervention for caregivers of demented persons living at home: conceptual framework, components, and characteristics. Aging & Mental Health, 6, 239–247.CrossRefGoogle ScholarPubMed
Marriott, A., Donaldson, C., Tarrier, N. and Burns, A. (2000). Effectiveness of cognitive – behavioural family intervention in reducing the burden of care in carers of patients with Alzheimer's disease. British Journal of Psychiatry, 176, 557–562.CrossRefGoogle ScholarPubMed
Martire, L. M., Lustig, A. P., Schulz, R., Miller, G. E. and Helgeson, V. S. (2004). Is it beneficial to involve a family member? A meta-analysis of psychosocial interventions for chronic illness. Health Psychology, 23, 599–611.CrossRefGoogle ScholarPubMed
McDaniel, S. H. (2005). The psychotherapy of genetics. Family Process, 44, 25–44.Google Scholar
Milne, A. and Chryssanthopoulou, C. (2005). Dementia care-giving in black and Asian populations: reviewing and refining the research agenda. Journal of Community & Applied Social Psychology, 15, 319–337.Google Scholar
Mitrani, V. B. and Czaja, S. J. (2000). Family-based therapy for dementia caregivers: clinical observations. Aging & Mental Health, 4, 200–209.Google Scholar
Mittelman, M. S., Brodaty, H., Wallen, A. S. and Burns, A. (2008). A three-country randomized controlled trial of a psychosocial intervention for caregivers combined with pharmacological treatment for patients with Alzheimer's disease: effects on caregiver depression. American Journal of Geriatric Psychiatry, 16, 893–904. 810.1097/JGP.1090b1013e3181898095.Google Scholar
Mittelman, M., Epstein, C. and Pierzchala, A. (2002). Counseling the Alzheimer's Care Giver: A Resource for Health Care Professionals. Chicago, IL: American Medical Association.Google Scholar
Mittelman, M., Ferris, S. H., Shulman, E., Steinberg, G. and Levin, B. (1996). A family intervention to delay nursing home placement of patients with Alzheimer's disease: a randomized controlled trial. JAMA, 276, 1725–1731.Google Scholar
Mittelman, M., Haley, W., Clay, O. and Roth, D. (2006). Improving care-giver well-being delays nursing home placement of patients with Alzheimer's disease. Neurology, 67, 1592–1599.CrossRefGoogle Scholar
Mittelman, M. S., Roth, D. L., Clay, O. J. and Haley, W. E. (2007). Preserving health of Alzheimer's caregivers: impact of a spouse caregiver intervention. American Journal of Geriatric Psychiatry, 15, 780–789. 710.1097/JGP.1090b1013e31805d31858a.Google Scholar
NICE/SCIE (2007). Dementia. A NICE–SCIE Guideline on Supporting People with Dementia and Their Carers in Health and Social Care. Leicester, UK: British Psychological Society.Google Scholar
Peisah, C. (2006a). Practical application of family and systems theory in old age psychiatry: three case reports. International Psychogeriatrics, 18, 345–353.CrossRefGoogle ScholarPubMed
Peisah, C. (2006b). Practical application of family and systems theory in old age psychiatry: Three case reports. International Psychogeriatrics, 18, 345–353.Google Scholar
Peisah, C., Brodaty, H. and Quadrio, C. (2006). Family conflict in dementia: prodigal sons and black sheep. International Journal of Geriatric Psychiatry, 21, 485–492.Google Scholar
Pote, H., Stratton, P., Cottrell, D., Boston, P., Shapiro, D. and Hanks, H. (n/d). Systemic Family Therapy Manual. Leeds, UK: Leeds Family Therapy & Research Centre.Google Scholar
Pote, H., Stratton, P., Cottrell, D., Shapiro, D. and Boston, P. (2003). Systemic family therapy can be manualized: research process and findings. Journal of Family Therapy, 25, 236–262.Google Scholar
Qualls, S. H. (2000). Therapy with aging families: rationale, opportunities and challenges. Aging & Mental Health, 4, 191–199.Google Scholar
Qualls, S. H. and Anderson, L. N. (2009). Family therapy in late life. Psychiatric Annals, 39, 844–850.Google Scholar
Rolland, J. S. and Williams, J. K. (2005). Toward a biopsychosocial model for 21st-century genetics. Family Process, 44, 3–24.CrossRefGoogle Scholar
Sobel, S. and Cowan, C. B. (2003). Ambiguous loss and disenfranchised grief: the impact of DNA predictive testing on the family as a system. Family Process, 42, 47–57.Google Scholar
Stratton, P. (2014). SCORE. SCORE-15 Index of Family Functioning and Change. Cheshire, UK: Association for Family Therapy and Systemic Practice.Google Scholar
Tremont, G., Jennifer Duncan, D. and Bishop, D. S. (2006). Unique contribution of family functioning in caregivers of patients with mild to moderate dementia. Dementia and Geriatric Cognitive Disorders, 21, 170–174.CrossRefGoogle ScholarPubMed
Ugarriza, D. N. and Gray, T. (1993). Alzheimer's disease: nursing interventions for clients and caretakers. Journal of Psychosocial Nursing & Mental Health Services, 31, 7–10.Google Scholar
Vernooij-Dassen, M., Joling, K., van Hout, H. and Mittelman, M. S. (2010). The process of family-centered counseling for caregivers of persons with dementia: barriers, facilitators and benefits. International Psychogeriatrics, 22, 769–777.Google Scholar
World Health Organization. (2012). Dementia: A Public Health Priority. Geneva, Switzerland: World Health Organization.Google Scholar
Wykle, M. L. (1996). Interventions for family management of patients with Alzheimer's disease. International Psychogeriatrics, 8, 109–111.CrossRefGoogle ScholarPubMed