The Experience of People With Dementia in Accessing and Engaging in Talking Therapies for Mental Health Difficulties: A Systematic Review and Thematic Meta-Synthesis

People with dementia often experience psychological distress, and may experience difficulty in navigating changes to their cognition, identity and quality of life, yet experience challenges in accessing and engaging in talking therapies. This study aims to conduct a systematic review and thematic meta-synthesis to explore the experiences of people with dementia in accessing talking therapies by incorporating the perspectives of people with dementia, caregivers and dementia care professionals. We searched PsychINFO, CINAHL and Web of Science in March 2024 and included empirical peer reviewed studies that had qualitative data focussing on accessing, delivering or participating in talking therapies, from the perspective or people with dementia, their caregivers, or professionals. Only English language studies were included. 15 studies were included. Across the studies, qualitative data was collected from 88 people with dementia, 96 caregivers/family members/supportive others, 38 professionals and seven community stakeholders. Quality assessment was conducted using a revised version of the Critical Appraisal Skills Programme checklist for qualitative research. Talking therapies can help people with dementia to address, process, and accept difficult life situations, whilst also improving their knowledge on dementia and positively impacting their relationships with significant others. However, to maximise benefits, several adjustments are necessary, including, adjusting the length of therapy sessions, increased therapy reminders and follow-up, tailored communication, use of group sessions and improving staff's dementia knowledge. Additionally, the use of dementia-specific tools, alongside outcome measures that measure broader wellbeing constructs are recommended. Involving people with dementia, caregivers and dementia professionals in therapy planning and delivery can also improve outcomes. Talking therapies for people with dementia are effective, though adaptations to address their unique support needs are essential. Several studies explored multicomponent interventions, making it difficult to ascertain which specific elements of psychological intervention were most effective. Additionally, individuals from ethnically diverse backgrounds were consistently underrepresented across the studies.