Forde, Lycia; (2020) The impact of individual Cognitive Stimulation Therapy (iCST) on quality of life and emotional and psychological symptoms for people with dementia: a randomised control feasibility trial. Doctoral thesis (D.Clin.Psy), University College London.

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Abstract

Aims Cognitive Stimulation Therapy (CST) is a well-established psychosocial intervention for individuals with dementia that improves cognition and quality of life. However, a large clinical trial on individualised CST (iCST) delivered by family carers found iCST to be ineffective. The current study aimed to explore whether it is feasible for healthcare professionals to deliver iCST. Feasibility criteria included; (1) ease of recruitment, (2) attendance and (3) drop out/attrition. It also aimed to explore whether the intervention improves quality of life and the psychological and emotional symptoms of dementia. Method Twenty-nine participants were randomly allocated to the iCST group or control (treatment as usual) group. The iCST group participants were offered 14 twice-weekly 45-minute iCST sessions delivered by trainee clinical psychologists. The following measures were administered for all participants pre- and post-intervention: self- and proxy-reported Quality of Life Alzheimer’s Disease scale, (QoL-AD) Positive Psychology Outcome Measure (PPOM) and Engagement and Independence in Dementia Questionnaire (EIDQ). Results The feasibility criteria for delivery of iCST by non-family carers (healthcare professionals) were fulfilled. There were no barriers to recruitment as care homes and eligible residents readily expressed interest and were willing to consent to take part. Engagement was high with a 0% dropout for participants who received the iCST and 97% session attendance. There were no significant differences between participants who received iCST and treatment as usual in self- and proxy-reported quality of life and self-reported psychological wellbeing. Conclusion This study suggests that it is feasible for non-family carers (healthcare professionals) to deliver iCST by non-family carers. The absence of barriers to recruitment suggests this therapy would be popular and the low dropout and high attendance rates indicate good engagement by participants. The study does not support iCST improving quality of life or the psychological and emotional symptoms of dementia. The lack of findings regarding improved quality of life and the psychological and emotional symptoms of dementia could be explained by insufficient statistical power due to the small sample size. It is also possible that the group component of CST is a key factor in its effectiveness and hence the lack of findings from iCST with its one-to-one format.

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