Feasibility of a Telehealth Intervention for Dementia Carers: Therapist Perspectives

Objectives

The STrAtegies for RelaTives (START) programme was designed in the United Kingdom to support informal dementia carers. This study was designed to assess therapists' perspectives on the feasibility of START in the Australian healthcare context in terms of its acceptability to therapists (i.e., confidence in delivery, perceived client rapport, and perceived change in client outcomes), its adaptation for delivery via telehealth, and integration with telehealth technologies.

Methods

Fourteen therapists were randomly allocated to deliver START or cognitive behavioural therapy (CBT) and commenced treatment with 18 carers (START: n = 13 overall, n = 7 via telehealth; CBT: n = 5 overall, n = 3 via telehealth). Mixed methods surveys were used to collect therapists' perspectives on acceptability and integration. Quantitative comparisons were made using independent sample t-tests, and qualitative responses were analysed using a theoretical semantic approach.

Results

Postsession confidence in intervention delivery, but not client rapport or perceived change in client outcomes, was higher for START than CBT (p = 0.034). Postsession change in client outcomes, but not therapist confidence or client rapport, was lower for telehealth delivery (p = 0.043). START was a beneficial experience for therapists, with content fostering carer engagement; however, concerns included a high volume of programme content. While technological issues were thought to have a negative impact on client rapport, telehealth enabled access to care.

Conclusions

START was acceptable to therapists and can be effectively delivered via telehealth. Recourse to telephone-only-based care may reduce the impact of technological issues on acceptability outcomes for therapists.