Whether for a family member, friend, or neighbour, caring for loved ones and members of our community is a fulfilling and important act carried out by many Canadians and people around the world. In Canada alone, nearly one-quarter of those aged 15 and over provide care for adults living with chronic conditions or disabilities. What’s more, over 90% are informal caregivers, meaning they provide unpaid care (1).
While providing care is a “labour of love,” like many things in life, it comes with its own set of challenges and hardships. Timewise, informal caregivers for care-dependent adults in Canada spend anywhere between four to twenty hours a week on caregiving-related activities, with the average being eight hours a week (1). Caregiving responsibilities can interfere with a caregiver’s career and finances, reduce the ability to appropriately balance work and life and identify when they need help, and increase the risk of psychological burden, feelings of overwhelm, and symptoms of depression and anxiety (1-10). As you can imagine, these issues can lead to a decrease in the quality of care a person receives and a reduced quality of life for both the caregiver and the person they provide care for (2; 11-13).
Luckily, caregivers don’t have to do it alone. There are a variety of supports and services they can access to help them along their care journey. Acceptance and commitment therapy (aka ACT) is one of these strategies. While traditional forms of cognitive behavioural therapy place more focus on trying to identify and alter negative thoughts, ACT opts to encourage acceptance of negative thoughts and feelings and then the use of healthy activities to manage one’s experiences. To further investigate ACT, a recent systematic review looked at its effect on the psychological health of informal caregivers taking care of family, friends, or neighbours living with chronic health conditions (2).
So, is ACT effective or all an “act”?
What the research tells us
The review found multiple positive results when it compared ACT, which was generally delivered by trained psychiatrists, psychologists, counselors, nurses, or social workers, to usual care or active controls (aka control group engaging in some other type of activity).
For example, ACT was able to impact several outcomes immediately after therapy and after one to six months. These included reductions in (2):
symptoms of depression and anxiety by large amounts;
symptoms of stress by moderate amounts right after therapy and large amounts after one to six months;
caregivers’ unwillingness to be exposed to painful feelings by a large amount, which is important because this unwillingness can result in caregivers avoiding hard things like their role as caregivers, as well as other aspects of life (2;14); and
getting stuck in one’s thoughts by a moderate amount.
But the good news doesn’t stop there! ACT was also shown to improve both value-based living and mindfulness by large amounts after one to six months. Here, value-based living refers to people expressing and representing what they’ve identified to be purposeful and meaningful action, while mindfulness refers to full awareness of where one is and what they are doing.
You might be thinking, “great, ACT is effective but what features of ACT should I be looking for?”. Well, the review was able to help answer this too. It appears that ACT may be more effective when it’s delivered through a mix of both individual and group formats, and when it’s face-to-face versus other methods like telephone, email or online. Receiving ACT over a larger number of sessions may also be more beneficial (2).
Caring for your own psychological health and well-being is an important part of being a caregiver. ACT is one tool that caregivers can add to their support toolkit. Caregivers can access ACT on their own by reaching out to a professional who specializes in this type of therapy or speaking with their healthcare team about how to access it in their community.
