An online CBT-based life skills course for carers of children with chronic and life limiting conditions: a feasibility trial

Manuel, Lauren Frances (2018) An online CBT-based life skills course for carers of children with chronic and life limiting conditions: a feasibility trial. D Clin Psy thesis, University of Glasgow.

Abstract

Background: Caring for a child with a chronic health condition is often associated with high levels of anxiety, depression and stress (Burton et al., 2003). Demanding caring duties, a lack of time and social isolation create barriers for carers accessing mental health support. The internet may be useful way for carers to access psychological supports but to date no research has explored this.
Aims: To identify common difficulties which carers face and adapt a pre-existing computerised CBT (cCBT) based course to reduce carer stress. To determine the feasibility of providing mental health support to carers through an online course and assess its potential effectiveness and accessibility.
Methods: Focus groups and questionnaires completed by hospice staff provided information regarding common stressors encountered by carers. Thematic analysis (Braun and Clarke, 2006) was used to identify topics which were then used to adapt a pre-existing cCBT course which consisted of 6 primary modules and additional online materials/modules plus the offer of weekly email support for 6 weeks from a support worker to encourage use. A single arm feasibility trial of the tailored cCBT was conducted using carers of children with chronic conditions recruited through advertisements and local hospice staff. Participants were provided with access to the cCBT course for 6 weeks and received weekly personalised support emails. Self-report measures of anxiety, depression and daily functioning were measures at baseline and at post-treatment. Questionnaires administered online explored participant satisfaction and course use which were then analysed.
Results: 19 hospice workers were recruited to complete questionnaires regarding common difficulties faced by carers. Several themes emerged from thematic analysis of the data including: physical and interpersonal difficulties, external pressures, time constraints, limited support, responding to the child’s illness and difficulties accessing appropriate care for their child.
29 carers were recruited to trial the online course, with 55.6% recruited through social media. 12 (30.8%) carers logged onto the course and 6 (15.4%) completed follow-up measures at 8 weeks post intervention. Of the participants that started the course only 2 (18.2%) completed all 6 course modules. Exploratory analyses showed no statistically significant differences in depression, anxiety or functional impairment. However, results indicated a general reduction in clinically significant anxiety symptoms and functional impairment. Satisfaction questionnaires completed by carers post-intervention indicated a high level of satisfaction with the course. Qualitative results showed that participants valued the email support they received and the flexibility that an online approach provided. Some carers still struggled to find time to complete the course and suggestions were made to amend the course to enable it to be accessed offline and on portable devices.
Conclusion: Computerised courses may be an acceptable way of offering mental health support to some carers. Difficulties in retention and recruiting suggest that further adaptations to the course are needed to improve engagement (i.e. delivering the course via apps, or moving to stand alone course topics rather than a recommended course). Alternative methods of delivering psychological support should be explored to avoid excluding those who do not have internet access.

• Item Type: Thesis (D Clin Psy)
• Qualification Level: Doctoral
• Keywords: Internet, intervention, CBT, caregivers, children, chronic.
• Subjects: B Philosophy. Psychology. Religion > BF Psychology; R Medicine > RJ Pediatrics; R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Supervisor's Name: Williams, Professor Christopher and McLeod, Professor Hamish
• Date of Award: 2018
• Depositing User: Dr Lauren Frances Manuel
• Unique ID: glathesis:2018-30879
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 11 Oct 2018 14:46
• Last Modified: 07 Nov 2018 11:41
• URI: https://theses.gla.ac.uk/id/eprint/30879