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Preliminary efficacy of an online intervention based on Acceptance and Commitment Therapy for family caregivers of people with dementia: a feasibility study
Golnaz Atefi, Rosalia J. M. van Knippenberg, Sara Laureen Bartels, Andrés Losada‐Baltar, María Márquez‐González, Frans R.J. Verhey, Marjolein Elizabeth de Vugt. Cognitive Behaviour Therapy, 2025-03-27
Topic: Risk, prevention and care in population studies
With the rising number of dementia cases, supporting family caregivers to maintain their well-being is crucial. Acceptance and Commitment Therapy (ACT) shows promise in promoting psychological flexibility and positive behaviour change. However, it is still developing in caregiving contexts. This study evaluated the preliminary efficacy of a fully online ACT intervention for caregivers of people with dementia. This study employed a pre-post design with two follow-up assessments at 3 and 6 months. A 9-week web-based self-help ACT program, including individual goal setting prior to the intervention, and minimal contact motivational coaching, was provided to 30 family caregivers in the Netherlands. Linear mixed-effect models based on a complete-case analysis showed significant changes in depressive symptoms (mean difference: −3.34, d = −0.78). Significant and sustained improvements were observed in stress (mean difference: −6, d = −1.13) and anxiety (mean difference: −5.55, d = −1.38), both of which were clinically significant. Sense of competence increased (mean difference: 1.1, d = 0.45). ACT-specific measures, including psychological flexibility, engaged living, and inflexibility, also showed significant improvements with medium-to-large effect sizes. This online intervention demonstrated promising preliminary evidence of ACT’s potential efficacy on caregivers’ well-being, warranting further research in larger-scale controlled trials.
Key findings
- Linear mixed-effect models based on a complete-case analysis showed significant changes in depressive symptoms (mean difference: −3.34, d = −0.78).
- Significant and sustained improvements were observed in stress (mean difference: −6, d = −1.13) and anxiety (mean difference: −5.55, d = −1.38), both of which were clinically significant.
- ACT-specific measures, including psychological flexibility, engaged living, and inflexibility, also showed significant improvements with medium-to-large effect sizes.
- This online intervention demonstrated promising preliminary evidence of ACT’s potential efficacy on caregivers’ well-being, warranting further research in larger-scale controlled trials.
Why it matters
In this small feasibility study of 30 family caregivers, an online Acceptance and Commitment Therapy program was linked to significant improvements in depressive symptoms, stress, anxiety, and sense of competence. These are preliminary findings about caregiver well-being, not about treating, curing, or preventing Alzheimer's disease itself.
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Study details
- Evidence strengthLow
How this study scored 41/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Cognitive Behaviour Therapy) |
| Journal's citation record | 1 / 4 | Cognitive Behaviour Therapy: journal h-index 100 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 7 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 4 / 6 | Cited 8.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 7 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Marjolein Elizabeth de Vugt: h-index 57 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Karolinska Institutet: institution h-index 1,477 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40145681) |
| Free to read | 2 / 2 | Free to read |
| Total | 41 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1080/16506073.2025.2477600
- PubMed: 40145681
- Original source →
- Free full text: Cognitive Behaviour Therapy →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Atefi, G., van Knippenberg, R. J. M., Bartels, S. L., Losada‐Baltar, A., Márquez‐González, M., Verhey, F. R., et al. (2025). Preliminary efficacy of an online intervention based on Acceptance and Commitment Therapy for family caregivers of people with dementia: a feasibility study. Cognitive Behaviour Therapy. https://doi.org/10.1080/16506073.2025.2477600
Vancouver
Atefi G, van Knippenberg RJM, Bartels SL, Losada‐Baltar A, Márquez‐González M, Verhey FR, et al. Preliminary efficacy of an online intervention based on Acceptance and Commitment Therapy for family caregivers of people with dementia: a feasibility study. Cognitive Behaviour Therapy. 2025. doi:10.1080/16506073.2025.2477600. PMID: 40145681.
BibTeX
@article{atefi2025-40145681,
author = {Atefi, Golnaz and van Knippenberg, Rosalia J. M. and Bartels, Sara Laureen and Losada‐Baltar, Andrés and Márquez‐González, María and Verhey, Frans R.J. and de Vugt, Marjolein Elizabeth},
title = {{Preliminary efficacy of an online intervention based on Acceptance and Commitment Therapy for family caregivers of people with dementia: a feasibility study}},
journal = {Cognitive Behaviour Therapy},
year = {2025},
doi = {10.1080/16506073.2025.2477600},
pmid = {40145681},
url = {https://doi.org/10.1080/16506073.2025.2477600}
}
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