Mentalizing Imagery Therapy Mobile App to Enhance the Mood of Family Dementia Caregivers: Feasibility and Limited Efficacy Testing

Abu Taher Sikder; Francis Cheng Yang; Rhiana Schafer; Glenna A Dowling; Lara Traeger; Felipe Ananda Jain

doi:10.2196/12850

Mentalizing Imagery Therapy Mobile App to Enhance the Mood of Family Dementia Caregivers: Feasibility and Limited Efficacy Testing

JMIR Aging. 2019 Mar 21;2(1):e12850. doi: 10.2196/12850.

Authors

Abu Taher Sikder¹, Francis Cheng Yang¹, Rhiana Schafer², Glenna A Dowling³, Lara Traeger⁴, Felipe Ananda Jain⁵

Affiliations

¹ University of California, Berkeley, Berkeley, CA, United States.
² Department of Neurology, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States.
³ Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA, United States.
⁴ Department of Psychiatry, Harvard Medical School, Boston, MA, United States.
⁵ Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.

PMID: 31518275
PMCID: PMC6715046
DOI: 10.2196/12850

Abstract

Background: Family caregivers of patients with Alzheimer disease and related dementias (AD and ADRD) often experience high stress and are at high risk for depression. Technologically delivered therapy is attractive for AD and ADRD caregivers because of the time demands associated with in-person participation.

Objective: We aimed to study the feasibility and conduct limited efficacy testing of a mobile app intervention delivering mentalizing imagery therapy (MIT) for family caregivers.

Methods: A 4-week trial of the MIT app for family AD and ADRD caregivers was conducted to assess the feasibility of use and investigate changes in depression symptoms, mood, and caregiving experience. Semistructured interviews were conducted to characterize participants' perceived feasibility and benefits.

Results: A total of 17 of the 21 (80%) consented participants (mean age 67 years, range 54-79) utilized the app at least once and were further analyzed. Average usage of audio recordings was on 14 (SD 10) days out of 28 possible and comprised 29 (SD 28) individual sessions. There were improvements in depression with a large effect size for those who used the app at least moderately (P=.008), increases in positive mood postintervention (P<.05), and acute increases in mood following daily guided imagery practice (Stretching and Breathing, P<.001; Eye in the Center, P<.001; Nesting Doll, P=.002; Situation Solver, P=.003; and Life Globe, P=.006). Semistructured interviews revealed perceived benefits such as greater ability to remain "centered" despite caregiving challenges and positive reframing of the caregiver experience.

Conclusions: App delivery of MIT is feasible for family AD and ADRD caregivers, including aging seniors. Results showed moderate to high usage of the app for a majority of users. Limited efficacy testing provides justification for studying the MIT app for AD and ADRD caregivers to improve mood and reduce depression in larger, controlled trials.

Keywords: depression; family caregivers; mindfulness; mobile apps; psychotherapy.

©Abu Taher Sikder, Francis Cheng Yang, Rhiana Schafer, Glenna A Dowling, Lara Traeger, Felipe Ananda Jain. Originally published in JMIR Aging (http://aging.jmir.org), 21.03.2019.

Grants and funding

R21 AG051970/AG/NIA NIH HHS/United States