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Mentalizing Imagery Therapy Improves Depression, Well-Being in Dementia Caregivers
A novel intervention called mentalizing imagery therapy was superior to a support group for easing depression and anxiety, and improving mindfulness, self-compassion, and well-being, in family caregivers of patients with dementia. Researchers published their findings in the journal Psychotherapy and Psychosomatics.
“Mentalizing imagery therapy is designed to be a short-term intervention to help people reframe how they view themselves as caregivers and how they experience their loved ones,” lead study author Felipe A. Jain, MD, Massachusetts General Hospital, told The Harvard Gazette. “Support groups are longer-term interventions designed to maintain support for caregivers over the course of the disease. There is a need for both.”
The randomized controlled trial assigned 46 caregivers of a loved one with dementia to 4 weeks of either mentalizing imagery therapy or a support group. Both met weekly for 120-minute sessions. During mentalizing imagery therapy sessions, caregivers learned mindfulness and guided imagery skills to improve emotional regulation. The intervention promotes stress reduction, self-compassion, and connection with community and nature.
“This therapy pushes the boundaries of how we think about ourselves and interact with others,” Dr Jain explained in The Harvard Gazette, “and incorporates new views on self and identity.”
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Mentalizing imagery therapy significantly outperformed support groups for improving depression, anxiety, mindfulness, self-compassion, and well-being, according to the study. Effect sizes ranged from moderate to large.
During the 4 weeks of the trial, self-reported depressive symptoms showed similar improvement with either mentalizing imagery therapy or support groups. However, 1 week after the interventions ceased, the mentalizing imagery therapy group had a 41% decrease in depressive symptoms compared with baseline; the support group participants showed only a 15% decrease, the publication reported. Benefits with mentalizing imagery therapy persisted at a 3-month follow-up.
Resting-state neuroimaging showed significant increases in dorsolateral prefrontal cortex (DLPFC) connectivity in an emotion regulation network after mentalizing imagery therapy compared with support groups. The DLPFC connectivity increase correlated positively with mindfulness and negatively with depressive symptoms.
“We were able to show that there is an underlying neurobiological basis for the improvements that were reported by caregivers in the mentalizing imagery therapy group,” Dr Jain told The Harvard Gazette. “This finding helps us understand how psychotherapies work, and why it is so important that caregivers receive them. Mentalizing imagery therapy is now the first therapy to show beneficial changes in the brain circuitry of caregivers.”
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