In honor of A new Clinical Gerontologist pilot randomized trial by Ferreira, de Faria, Kishita, and Caramelli evaluated an eight-session videoconference ACT group for 57 Brazilian family caregivers of people with dementia who were experiencing mild-to-severe anxiety. Twenty-nine caregivers received ACT and 28 were assigned to a waiting list, with assessments at baseline, post-treatment, and approximately three months later.
Caregivers offered ACT reported less anxiety on the GAD-7 at both follow-up points. However, there were no between-group differences in depressive symptoms, caregiver burden, quality of life, or psychological flexibility. A second anxiety measure improved only in the analysis limited to participants who completed treatment. Given the small sample, unblinded design, and waiting-list comparison, this is an early signal for anxiety—not evidence that ACT resolves the broader practical and emotional burden of caregiving.
Clinical Takeaway: Caregiving frequently includes both problems that can be changed and painful realities that cannot be removed. ACT can help clinicians distinguish the two.
For changeable problems, use concrete problem-solving around respite, division of responsibilities, communication with services, sleep, boundaries, and medical coordination. For unavoidable grief, uncertainty, guilt, or fear, consider defusion from rigid rules such as “I should be able to manage everything,” willingness to experience difficult emotions without abandoning self-care, and small values-guided actions that include the caregiver’s own health and relationships.
Acceptance should never be presented as resignation or as an expectation that someone tolerate an unsafe or unsustainable workload. Continue to assess the caregiver as a person with independent mental-health needs—not simply as a treatment resource for the family member with dementia.