From Resource Activation to Utilization: A Process-Outcome Analysis in Telephone-Based Cognitive-Behavioral Therapy...

This study aimed to assess whether resource activation (i.e., fostering strengths and healthy aspects of the patient), aggregated across therapy sessions during telephone-based cognitive-behavioral therapy (TEL-CBT), is associated with post-therapy psychosocial resource utilization (i.e., the extent to which individuals utilize resources to achieve motivational goals) among family caregivers of people with dementia, controlling for baseline resource utilization. Additionally, we analyzed the trajectory of resource activation and investigated predictors of interindividual differences in growth patterns, as well as phase-specific associations with post-therapy resource utilization.

One hundred and twenty family caregivers received 12 sessions of TEL-CBT. Caregivers and therapists rated resource activation after each session. Caregivers rated utilization of resources related to well-being, coping with daily hassles, and social support before and after therapy.

Multiple linear regression analyses indicated that mean resource activation aggregated across therapy sessions, as reported by caregivers but not therapists, was significantly associated with post-therapy resource utilization after adjusting for baseline levels. Using piecewise latent growth curve models, we found that caregiver-rated resource activation at the beginning of therapy was significantly associated with post-therapy resource utilization related to well-being and social support. Pre-therapy utilization of social support resources was negatively associated with caregiver-rated resource activation in the final therapy phase, and utilization of well-being resources before therapy was positively related to therapist-rated resource activation at the beginning of therapy.

The findings are consistent with the interpretation of resource activation experienced by patients as a candidate mechanism of change. Early resource activation during therapy appears particularly relevant.