Date of Award

Spring 5-2022

Document Type


Degree Name

Doctor of Philosophy (PhD)




Virginia Consortium Program in Clinical Psychology

Committee Director

Jennifer Flaherty

Committee Member

Serina Neumann

Committee Member

Cathy Lau-Barraco

Committee Member

Richard Handel


The purpose of this study was to examine the preliminary feasibility of an online, manualized, group-based, multi-component, cognitive behavioral therapy (CBT) treatment approach for the reduction of caregiver burden among family caregivers of persons with dementia. This study had five primary hypotheses: (1) the recruitment plan, as outlined within this study, would yield the target number of participants within a 12-month period; (2) the proposed group therapy protocol would produce a positive therapeutic climate, as operationalized by increased levels of perceived social support, perceived group cohesion, positive therapeutic alliance, and positive engagement; (3) this study would maintain adequate participant retention, as operationalized by at least 80% of participants enrolled completing the entire course of treatment; (4) the online CBT group therapy would produce positive levels of satisfaction towards the therapy among group members; and (5) the proposed protocol would not create significant levels of perceived burdensomeness among participants. An additional exploratory hypothesis in this study was that the manualized protocol would produce significant reductions in overall levels of caregiver burden, anxious symptoms, depressive symptoms, and role captivity among participants.

Dementia is a growing phenomenon around the world, and more families are choosing to provide informal at-home care for their loved-ones with dementia. While this removes financial burden and strain from institutions, it places a significant amount of stress, burden, and strain (physical, psychological, and financial) on the family caregivers. Caregiver burden, also referred to as caregiver burnout, is defined as the overall impact of the physical, psychological, social, and financial demands of caregiving. Caregiver burden is often associated with increased rates of depression, anxiety, psychotropic drug use, somatic disorders, and physical health concerns. With family members becoming primary caregivers to persons with dementia at increasing rates, so too are the experiences of caregiver burden. While interventions do exist for caregivers experiencing high levels of burden, many of these interventions are either (a) not efficacious, (b) not cost-effective, or (c) not flexible enough to work within the various constraints of caregiving. It is clear that this population is in need of an efficacious and cost-effective treatment approach for the reduction of caregiver burden.

Results from this study were ultimately inconclusive for supporting feasibility of the research and treatment protocol as a whole; however, certain aspects of the data did suggest some potential areas for preliminary feasibility such as clinically significant improvement in group cohesion and caregiver burden scores across treatment time. It is strongly recommended that further studies continue to examine the preliminary feasibility of this treatment protocol and to explore areas in which accessibility to this intervention plan may be improved in order to better serve caregivers of persons with dementia.


The VIRGINIA CONSORTIUM PROGRAM IN CLINICAL PSYCHOLOGY is a joint program of Eastern Virginia Medical School, Norfolk State University, and Old Dominion University.


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