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The PROMOTE Study: Behavioural activation written self-help to
improve well-being in people with memory difficulties ,supported by
family and friends. Farrand, P., Woodford, J., Anderson, M., Venkatasubramanian, S., Llewellyn, D., Ukoumunne., O., Adlam, A., & Dickens, C.
Introduction
At least one-in-three people with memory difficulties experience poor wellbeing.
Family members and friends of people with memory difficulties often experience
difficulties knowing how to support people with memory difficulties who are struggling
with their wellbeing.
However, access to traditional psychological services for people with memory
difficulties is limited.
To increase access across England cognitive behavioural therapy (CBT) based self-
help approaches, supported by trained psychological wellbeing practitioners, have
been developed.
Whilst the acceptability and effectiveness of these CBT self-help approaches has
been demonstrated across a wide range of people, little is known about use in those
with memory difficulties.
The PROMOTE study team have run a series of studies to examine the acceptability
of a new CBT self-help approach. The approach is based on a technique called
“behavioural activation” and is delivered through a workbook for the person with
memory difficulties, and another workbook for a family memory or friend.
It is designed to be guided by psychological wellbeing practitioners, but also
supported in the home by family members or friends.
The next step is to run a new study to examine the effectiveness and acceptability of
the new approach.
Study One: Acceptability Questionnaire 60 family members and friends completed questionnaires to examine whether they
would be willing to support the new intervention.
60% were willing to support intervention.
A further 38% ‘maybe’ willing but wanted further information.
Family members and friends also reported how they thought the new intervention
should be delivered:
Study Two—Interviews
Ten face-to-face semi-structured interviews held with people with memory difficulties
across Cornwall.
The interviews focused around the acceptability of the behavioural activation
intervention.
High acceptability was found for the proposed intervention and accompanying
workbook.
However, low acceptability was reported for terms such as ‘psychological’;
‘depression’; ‘low mood’ and a more ‘positive’ approach preferred.
People with memory difficulties also felt a family memory or friend would be essential
in helping support use workbook at home.
For further information please contact:
Dr Joanne Woodford, University of Exeter , Clinical Education, Development and Research Group, Psychology, College of Life and Environmental Sciences, Room 307, Washington Singer Laboratories , Perry Road , Exeter, EX4 4QG
Telephone: 01392 725780; Email: [email protected]
Next Steps
From January 2016 the study team will be running a single arm feasibility phase II
(Craig et al., 2008) study examining written behavioural activation to target low
mood and improve wellbeing in people with memory difficulties, supported by their
informal family members or friends and guided by PWPs.
The study will examine main feasibility questions concerning: methodological,
procedural and clinical uncertainties and asks if this study “can be done”. For
example:
Can we recruit people with memory difficulties and their family members and
friends?
What barriers may stop people with memory difficulties and their family
members and friends sign up to the study?
How acceptable is the new intervention to those receiving it?
How acceptable is the new intervention to Psychological Wellbeing
Practitioners?
If good levels of feasibility (including acceptability) are found the results will be
used to plan and design a pilot study and definitive trial to examine effectiveness.
Study Two—Focus Groups
Two focus groups were run over two sessions at Lostwithiel Memory Café with family
members and friends of people with memory difficulties.
Family member and friends reported high acceptability for proposed behavioural
Activation intervention.
However, much like people with memory difficulties themselves , they reported low
acceptability for terms such as ‘low mood’; ‘depression’; ‘psychological’ and
‘recovery’. High stigma was reported especially for the terms ‘dementia’ and
‘depression’.
Family members and friends had a preference for language adopting a positive
approach, for example promoting ‘wellbeing’; ‘living well’ and ‘making more out of
every day’.
Intervention Development Two workbooks have been developed from results of the previous studies, following
“DEEP” guidance for writing dementia friendly materials :
