Psychotherapeutic Support for Family Caregivers of People With Dementia

Book Title: Psychotherapeutic Support for Family Caregivers of People With Dementia

Author: Gabriele Wilz

Publication Details: Hogrefe, 2024, 202 pp., $49.99 paperback

Psychotherapeutic support is commonly perceived to be the service needed both for those struggling with mental illness and for family members caring for them. Dementia poses similar challenges because of feelings of lack of control leading to caregiver burnout.

Although an estimated prevalence of depression and anxiety has been reported in the caregiver population, no clear estimate of prevalence of stress in caregivers for people with dementia is available. Strong associations between caregiver stress, anxiety, and dementia severity have been demonstrated in studies. ¹ Currently, 69% of patients with dementia are cared for at home, and two-thirds of these by immediate family members. Estimating the demand of 57.4 million dementia patients to be tripled by 2050, this book responds to the gap in psychotherapeutic support for the family caregivers who will be serving the increasing number of people with dementia. ², ³

With an academic and clinical background in clinical psychology, Gabriele Wilz has created an evidence-based resource that integrates scenarios from different clinical settings. The book walks through varied challenges faced by family members, providing stepwise therapeutic strategies to address them. These strategies are based on cognitive behavioral therapy and illustrated with excerpts of dialogue between therapists and family caregivers from real sessions. The text starts with acknowledging the need to depathologize counseling among caregivers and establish appreciation and validation of caregivers’ effort.

The framework of the therapy program is outlined by breaking down session topics into different modules covering relationship-building with emphasis on a positive therapeutic alliance to help caregivers deal with and change dysfunctional appraisals and thoughts. Modules also cover strategies on stress management and emotional regulation; self-care and scheduling pleasant and valued activities; and dealing with change, loss, and grief. The chapter focused on encouraging the use of informal and professional support (Chapter 13) is intended to help caregivers seek the support and assistance available to them. Allowing the caregiver to acknowledge the limits to caregiving at home is intended to help with acceptance of and decision-making for intolerable caregiving situations. The final session entails reinforcing the goals caregivers would like to continue to work toward in the future.

At the end of the book are multiple handouts providing interventions for challenges associated with daily activities such as eating and drinking, visiting the doctor, and driving. The handouts also cover helpful safety precautions and behavior experiment protocol. In a helpful supplement, these behavior experiment protocols outline exercises with scenarios, such as being in a social setting with the family member who has dementia, and suggest short exercises for coping with acute stress. Serving as a valuable reminder for the caregiver, one worksheet suggests pleasant activities and self-care.

The book’s content is easy to follow, well-outlined, and in a style that is effective for clinical use. The real scenario conversation pieces reflect high value content that provides clear insight for the reader regarding the content of each chapter. For busy clinicians in primary care clinics, this book can be a long read; a small pocketbook version might deliver more value.

This book is helpful for understanding the impact of the burden of caring for people with dementia. For family physicians providing care to people with dementia and their family caregivers, this book serves as a helpful resource by equipping them to provide evidence-based counseling techniques. The book also could be usefully integrated into a family medicine residency training program as an effective learning tool to build cognitive behavioral therapy based communication skills pertaining to the topic.