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Improving coping skills for carers

The need for effective interventions to support carers in their challenging role is well recognised. But there is little reliable evidence on the effectiveness of different kinds of support.

The NIHR funded a trial to find out if a psychological intervention, carefully specified in a manual and delivered to family carers by trained psychology graduates, would reduce their depression and anxiety. It also tested whether it would be cost-effective to roll out across the NHS. In this study, 260 carers were randomly allocated to the new programme or care as usual.

The new programme covered topics such as managing difficult behaviour, accessing support and planning for the future. This was adapted from a US programme and was delivered to individuals across eight sessions. The features - individual rather than group therapy, more than six sessions - were highlighted as important factors for success in the evidence. Those providing treatment as usual were expected to follow NICE guidelines, which included some form of talking therapy and support for carers.

Results showed that those without the support programme were seven times as likely to be depressed two years later. It was also cost-effective; the implementation costs for this manual-based training programme, if rolled out to the wider service, compare favourably with equivalent costs of providing talking therapy courses for carers by more expensive clinical psychologists.

Providing effective support to help carers cope is important. This is needed to make daily life easier or more bearable for carers and to keep people with dementia safely at home. This was one of the largest study of carers in an experimental study of this kind. It shows encouraging results and will strengthen the body of knowledge in this area, which is limited at present.

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