Table 1

Contents of the 10-week multi-modal treatment, comprising five cognitive behavioural therapy modules alternated with five Carers NSW Talk-Link group counselling sessions

Name of the CBT moduleCBT module inclusionsTalk-Link session
Session One
Psychoeducation: AMD education and introduction to CBT
  • Information regarding AMD

  • Misconceptions regarding AMD

  • Information regarding the therapeutic intervention, leading to goal setting and expectations

  • Go through group guidelines and structure to promote safety in the group

  • Introduction, getting to know one another, sharing individual caring stories

  • Identifying what members would like to gain from the group most

Session Two
Stress response and mood
  • Education of stress response and mood

  • Mindfulness, structured relaxation

  • Relief of anxiety, stress, tension

Coping with stress
  • Exploring how stress is individually manifested and discussion around individual coping strategies

  • Encouraging the awareness of individual warning signals that point to the experience of stress

  • Exploring the concept of mindfulness as a method of stress reduction

Session Three
Sleep, general well-being and scheduling pleasant events
  • Basic information and tips regarding nutrition, exercise, socialising and sleep

  • Specifically sleep education hygiene, routine

  • Encouraging caregivers to take time to engage in enjoyable/pleasant activities

  • Designating times to engage in pleasant events

  • Discussing the importance of self-care and individual self-care strategies

  • Discussion of the importance of our mindset on sleep, relaxation, nutrition and exercise

Session Four
Identifying and challenging negative thoughts
  • Negative thinking/cognitive distortions

  • Identifying negative thoughts, feelings

  • Thought recording

  • Thought challenging

Loss, grief and gain
  • Coping with difficult feelings related to the grief and loss experience and exploring what carers can ‘gain’ in the process

  • Education about models of grief and loss and discussion of individual experiences

  • Normalising feelings of anger and sadness

  • Discussion of individual options for support

  • Discussion of resilience as positive coping mechanism

Session Five
Problem solving, resiliency and self-efficacy
  • Identifying the problem

  • Identifying and evaluating potential solutions

  • Problem solving strategy—identifying the best course of action

  • Interpersonal and communication skills (ie, assertiveness)

  • Immediate beliefs and rules

  • Assumptions around caring

  • Restructuring core beliefs

  • Modelling

  • Identifying different communication styles

  • Communication within the caring role

  • Discussion of what is going well and what are the difficulties within individual care circumstances

  • Where to next—resources for further support

  • AMD, age-related macular degeneration; CBT, cognitive behavioural therapy.