3 - (SYM 111) A Pilot Study of a Cognitive Behavioral Therapy Skills Intervention for Informal Mental Health Caregivers in Rural Areas

Background: There are several special challenges in addressing mental health problems in rural areas. These include limited access to high quality treatment, higher levels of mental health stigma, treatment costs, and difficulty with travel. A vital resource in these areas is informal care from friends and family members. Some psychosocial interventions have been focused on improving communication among family members or targeting the wider social networks of those with mental health challenges. Cognitive behavioral therapy (CBT) skills have extensive support in the management of individual mental health concerns. Clients’ knowledge and use of CBT skills are important determinant of change in CBT, though an intervention package drawing on these strategies suited to the unique challenges faced by informal caregivers in rural areas has yet to be developed.

Methods: In this study, we pilot tested the Friends and Family for Mental Health intervention, an internet-delivered mental health skills program we developed to enhance informal care and reduce psychological symptoms among informal caregivers. Participants were 37 adults who resided in a rural county. The mean age of the sample was 29 (SD = 4.8; range = 21 – 50). Most participants identified as White (68%; n = 25), with 30% of participants identifying as Black/African American (n = 11) and one participant preferring not to answer. Almost all participants identified as male (94%; n = 35). To provide an initial test of the benefits of this program, we evaluated change in informal care attitudes and hope pre- to post-program. In a test from baseline to a one-month follow-up, we evaluated these same variables as well as changes in psychological symptoms, functional impairment, and mental health skills.

Results: Attitudes towards informal care improved pre- to post-program. At the one-month follow-up, participants reported reduced anxiety symptoms (d = .55, p = .002) and functional impairment (d = 1.80, p < .0001,). Hope (d = 0.48, p = .007) and informal care attitudes (d = .43, p = .01) significantly increased from pre-program to follow-up. Intervention feedback was also collected to inform intervention development, which will be discussed.

Conclusion: These findings provided preliminary support for the program. Intervention feedback collected in this study can be utilized to further enhance this and other interventions in rural areas. Though further research is needed, mental health skills programs appear to be both desired and beneficial in rural areas.