Psychotherapy with a Caregiver of a Spouse with Parkinson's Disease: Integrating Systems and Individual Approaches.

Abstract

Family caregivers of persons with neurocognitive disorders sometimes experience heightened emotional burden (i.e., caregiver burden), presenting with symptoms of depression and anxiety. The stress of caregiving may be heightened among those who identify as women, who experience disproportionate rates and consequences of the caregiving role. This case study highlights the use of Caregiver Family Therapy (CFT; i.e., a systems-directed approach targeting the caregiver role and network) and Cognitive Behavioral Therapy (CBT; i.e., an individual-directed approach targeting maladaptive cognitions) with a cisgender White woman caregiving for her spouse, a cisgender man with Parkinson's disease. The patient reported elevated caregiver burden, depression, and anxiety at intake. Treatment targeted modifications to the caregiving role, maladaptive cognitions, and behavioral activation, often with a focus on the role of gender in shaping the caregiving role and core beliefs about caregiving. Over 20 sessions, the patient reported reductions in anxiety (Geriatric Anxiety Inventory = -6), depression (Geriatric Depression Scale-30 = -10), and caregiver burden (Zarit Burden Interview-12: -20), which were maintained over two booster sessions (6 weeks). This case highlights the benefit of integrating systems- and individual-focused psychotherapies with caregivers as well as the important role of gender in addressing caregiving-related psychological distress.