Feasibility and acceptability of a virtual adaptation of mentalizing imagery therapy for Spanish language family dementia caregivers

Abstract

AbstractBackgroundSpanish speaking family dementia caregivers have limited supportive resources in Spanish, and there are few scientifically validated, culturally acceptable approaches for alleviating their distress. We investigated the feasibility of a Spanish language adaptation of Mentalizing Imagery Therapy (MIT), which provides guided imagery and mindfulness training to reduce depression, increase interpersonal understanding, and promote well‐being.Methods12 female Spanish‐speaking dementia caregivers enrolled in a 4‐week virtual MIT program consisting of weekly videoconference group meetings and home practice using audiovisual recordings. Caregivers were 52±8 (mean±SD) years of age [range 38‐61] and had been caregivers for 6±3 years. 60% had no more than a high school education, and MMSE was 27.7±2.0 [range 25‐30]. Validated Spanish‐language questionnaires were administered before and after MIT (at 5 weeks), assessing hedonic well‐being, perceived cognitive function, dispositional mindfulness, and interpersonal support. Depressive symptoms were assessed before each group session and at follow‐up, and satisfaction with MIT components was assessed after MIT. Depressive symptoms were analyzed with a mixed linear model with time as the fixed effect and a random factor for participant. Pre to post questionnaires were analyzed with one‐sided paired t‐tests, hypothesizing pre‐post improvement. Effect sizes pre to post MIT were calculated using Cohen’s d.ResultsParticipation in the four weekly group meetings was 100%. Caregivers completed home practice of 4±1 meditation session per week. Satisfaction with MIT reached 19±2 of a possible 20 points. Reduction in depression from baseline was observed by week 3 (d=.7, p=.01) and maintained through follow‐up at 5 weeks (d=.6, p<.005). There were significant pre to post increases in perceived cognitive function (d=.6, p<.05), hedonic well‐being (d=.5, p=.05), dispositional mindfulness (d=.6, p<.05), and interpersonal support (d=.7, p<.05).ConclusionsMentalizing Imagery Therapy (MIT) was successfully adapted and culturally tailored for Spanish language family dementia caregivers within a virtual group environment. MIT is feasible and acceptable and may help reduce depressive symptoms and improve subjective well‐being. Larger, randomized controlled trials should determine duration of effects and validate specific efficacy of MIT.