Adapting cognitive behavioural therapy for people with dementia

Lead Investigator: Dr Joshua Stott

Institution: University College London 

Grant type: Clinical Training Fellowship

Duration: 42 months

Amount: £201,286

Scientific Title: Adapting cognitive behavioural therapy for people with dementia

Why did we fund this project?

Comments from members of our Research Network:

'This is a very welcome proposal, especially as it is non-drug based. The rationale and methodology appear sound, and the practice knowledge and experience of the researcher will provide very valuable underpinning for the work' 

 'CBT adapted for people with dementia could be most valuable, given the prevalence of anxiety and depression'

'A well-structured proposal for a research project that should directly benefit people with dementia'

What do we already know?

It is estimated that 50% of people with dementia experience some symptoms of depression, which can decrease quality of life, worsen dementia symptoms and increase carer stress. Anxiety is also common in people with dementia and has a similarly negative impact. Results of trials into the effectiveness of anti-depressant and anti-anxiety drugs in dementia have proven inconclusive. Therefore, there is a pressing need to find effective treatments for depression and anxiety for people affected by dementia.

Cognitive behavioural therapy (CBT) is a widely used psychological therapy. It was initially developed to treat depression in adults without dementia and can be effective in treating both anxiety and depression in this group. CBT in its current form cannot be used to help people with dementia as it requires thinking and memory abilities that may be affected by the condition. 

There has been some research into adapting CBT to help those with dementia, but this is still in the early stages. Dr Stott has already undertaken some preliminary work on this project, including consulting with experts in CBT and people affected by dementia to determine the aims of the project.

What does this project involve?

Dr Stott aims to better understand the skills that people with dementia need in order to take part in CBT. He hopes that this knowledge can be used to draw up guidelines for therapists to assess whether someone with dementia who has depression or anxiety could benefit from the adapted CBT techniques.

The project will involve reviewing the available literature to determine what skills will be needed when offering CBT to people with dementia. The project hopes to adapt existing tools for CBT and will test these techniques on volunteers with dementia. The information from this project will be used to help with the development of guidelines for CBT practitioners to support people with dementia who also have anxiety and/or depression.

How will this benefit people with dementia?

If the results of this study show that CBT techniques can be adapted for use in people affected by dementia, it could pave the way for larger trials of the technique to determine its effectiveness for treating depression and anxiety in these cases. The development of guidelines for CBT practice in dementia will allow current practitioners to expand their expertise to help those with dementia where possible. 

Research into using anti-depressant and anti-anxiety drugs in people with dementia has so far given variable results. Finding an alternative method that can treat or reduce symptoms of depression and anxiety in people with dementia will be of benefit to those affected by these conditions. It may also help to reduce carer stress and will provide a wider choice of treatment options for depression and anxiety in people affected by dementia.