Evaluating our Counselling Program

After launching a Tele-Counselling & Psychotherapy program for care partners of people living with dementia in 2021, we were excited to have the opportunity to conduct a full evaluation of the program. Our Executive Director, Chandra MacBean, and Licensed Counselling Therapist-C, Nicole Cormier, worked with Dr. Pamela Durepos and other researchers to evaluate the effectiveness of the program. The objective of the study was two-fold. We wanted to evaluate:

1. The feasibility and acceptability of a tele-counselling program developed for caregivers of people with dementia using Acceptance and Commitment Therapy (ACT) and,
2. The potential effects of ACT tele-counselling on caregiver depression, anxiety, burden, acceptance and meaningful engagement.

Through this evaluation, we learned this program has a significant impact on improving depression, anxiety, burden, acceptance and meaningful activity.

Project Design

This study was a randomized-control trial (RCT). Participants were randomly assigned to either the ACT program or Usual Care group. Those in the ACT program received between 6 to 8 x 1-hour ACT sessions over 18-32 weeks from a bilingual Licensed Counselling Therapist-C via text, telephone or videoconference, whereas those in the Usual Care group received support from other programs at the ASNB and from other community resources (excluding support from our counselling program).

Feasibility outcomes were assessed on recruitment and retention rates, client satisfaction and perceived usability. Potential efficacy outcomes were assessed at baseline and post-ACT/Usual Care were depression, anxiety, stress, engagement in meaningful activities, caregiver burden, acceptance and commitment to action scores.

Study Participants

Between May and November 2022, 51 referrals were received for the ACT program. Of these, 30 agreed to be screened for the project and all were subsequently enrolled in the project. 1 participant withdrew after one session due to their presenting concerns falling outside the scope of the program.

We were pleased to have diverse participants involved in the study, including people caring for people with dementia at different stages of the disease, people with different living situations, and people in both rural and urban settings (53% rural and 47% urban).
 

Results

• We exceeded our targeted enrollment rate, and significantly surpassed our target retention rate (97%).
• The usability score for the means of offering sessions was very high (95%) and above average, which means participants found delivering sessions via video and telephone to be accessible, easy to use, and extremely beneficial.
• Data showed that the intervention is acceptable and accessible to those in rural NB.
• The more sessions a participant had, the better the reduction impact on depression, anxiety, burden, and the more there was acceptance and meaningful activity. 
• 100% of participants indicated the program helped them to deal with their problems.

Voices of participants

“The [telephone] was definitely…the right choice…just the convenience. I love it… not having to go anywhere like last time, missing work and making transportation arrangements to drive somewhere”.

“The way it was delivered….It's wonderful to know that you can make that connection…from home …just over the phone or video which ever you know whatever is more comfortable for the person”.

“It worked really well. It was so much better to be on the phone that I didn't have to worry about being away and the phone was so easy”.

Recommendations and Next Steps

As a part of this study, a series of recommendations were created based on the feedback of participants. These recommendations included:

• Increase awareness of the program
• Expand the program outside of New Brunswick
• Offer additional program formats (groups, in-person)
• Increase availability for follow-up and communication between sessions

Our next steps are to expand the program, reduce the waitlist, and work towards implementing the other above recommendations. 

This project was funded by the Mental Health Research Canada and New Brunswick Health Research Foundation through the New Brunswick Mental Health Impact Grant. In addition, this project would not be possible without the support of the following organizations: the University of NB, Alzheimer Society of NB, Mount Allison University, McMaster University, University McGill, and the University of Ottawa.