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Development of an Evidence-based Extended Programme of Maintenance Cognitive Stimulation Therapy (CST) for People with Dementia

Aguirre, E., Spector, A., Hoe, J. , Streater, A., Woods, B., Russell, I. & Orrell, M. (2011). Development of an Evidence-based Extended Programme of Maintenance Cognitive Stimulation Therapy (CST) for People with Dementia. Non-pharmacological Therapies in Dementia, 1(3), pp. 197-216.


Psychosocial interventions for dementia have often been developed without a sound theoretical, empirical and clinical basis, and most evaluations of these interventions have had serious methodological limitations. This highlights the need to link intervention development with evaluation and design issues during the early stages of phase 1 or development of an intervention. Best practice is to develop interventions systematically, using the best available evidence and appropriate theory. This study focuses on the developmental stage of the Medical Research Council (MRC) guidelines (2008) to develop an evidence-based Maintenance Cognitive Stimulation Therapy (MCST) programme for dementia.

The intervention was developed based on a mixed methods approach, using evidence obtained from the Cochrane review of Cognitive Stimulation for dementia followed by a Delphi consultation process with key stake-holders. Four techniques were used: (1) Cochrane review of cognitive stimulation for dementia, (2) a consultation with key stake holders using a Delphi Consensus Process (including an expert consensus conference), (3) focus groups with the target population and (4) a Delphi survey. These techniques were used to complete the theoretical preclinical and phase I modelling of the MRC framework for developing the MCST intervention for dementia.

It was feasible and effective to use a systematic development process to produce successive modifications of the draft manual for an evidence based maintenance CST programme for dementia. Close involvement of users and carers ensured that the manual was well targeted on the preferences and abilities of people with dementia.

The final Maintenance CST programme and manual is currently being tested as part of a large multicentre, randomised controlled trial.

Publication Type: Article
Subjects: R Medicine > RC Internal medicine
Departments: School of Health & Psychological Sciences
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