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

Abstract

BACKGROUND: Spanish 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. METHODS: 12 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. RESULTS: Participation 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