How Family Dementia Caregivers Perceive Benefits of a 4-Week Mentalizing Imagery Therapy Program: A Pilot Study

Background: Family caregivers of dementia patients experience high levels of interpersonal stress that often results in elevated anxiety, and depression, and negative impacts on interpersonal relationships. Changes in behaviors and the structure of relationships with the care recipient and others in the social milieu challenge the caregivers' ability to mentalize or understand the links between mental states and behaviors. This study investigates the experiences and perceived benefits of family dementia caregivers who underwent Mentalizing Imagery Therapy (MIT), a treatment aiming to improve balanced self-other mentalizing and reduce psychological symptoms. Method: Purposeful sampling was used to select 11 family dementia caregivers who underwent a 4-week pilot trial of MIT. Semistructured interviews were completed postintervention to identify subjective benefits, putative psychological mediators, and perceived active components. Results: Caregivers reported improvements in well-being, mood, anxiety, and sleep, and a majority stated MIT helped with forming and maintaining healthier relationships. Some participants noted benefits extending to how they reacted to their social environment and perceived themselves more objectively from others' perspectives. Specific elements of MIT, including self-compassion, self-care, and the ability to reflect on emotionally arousing challenges, might have mediated these improvements. Conclusion: Family dementia caregivers perceived the salutary benefits of MIT on multiple domains of well-being. The self-reports suggest MIT holds promise for improving well-being, reducing nonmentalizing patterns of thought, and facilitating improvements in balanced mentalization within the caregivers' relationships. Public Significance Statement This study is the first to report how family dementia caregivers perceive the benefits of a 4-week group Mentalizing Imagery Therapy program, which includes mindfulness and guided imagery exercises to improve mood and promote understanding of self and others. The reports indicate that caregivers find benefits for reducing negative psychological symptoms such as stress and depression, improving self-compassion and mindfulness, and increasing their ability to address relationship challenges.