About START

STrAtegies for RelaTives (START) is an eight session manualised intervention that supports the development of coping strategies for carers of people with dementia.

Current project

START Implementation Project (2017-2020)

Following the success of the START trial, we have funding from the Alzheimer’s Society to widen access to START by adapting it for delivery in the third sector and to Minority Ethnic (ME) groups, within existing structures of the Alzheimer’s Society (AS) and the South Asian community in the first instance.

Benefits are expected in terms of improved access for family carers including those in hard to reach groups to START, as well as a template for implementation of the START intervention in the third sector and for other ME groups. Find out more on our current project page. 

Trial

Our trial showed that this intervention reduced depression and anxiety for family carers of people with dementia when measured at eight months and two years after they had received the intervention. The trial also proved to be cost effective when delivered by graduate psychologists. 

Publications

The references below contain links to the published papers about the START trial. They provide evidence about the clinical outcomes, the cost effectiveness data, what carers thought of the intervention and the full project report.

Publications

Scaling-up an evidence-based intervention for family carers of people with dementia: Current and future costs and outcomes

Knapp M, Lorenz‐Dant K, Walbaum M, Comas‐Herrera A, Cyhlarova E, Livingston G, Wittenberg R. (2024) International Journal of Geriatric Psychiatry Feb;39(2):e6059. https://doi.org/10.1002/gps.6059

Acceptability and feasibility of a Japanese version of STrAtegies for RelaTives (START-J): A manualized coping strategy program for family caregivers of relatives living with dementia

Kashimura M, Rapaport P, Nomura T, Ishiwata A, Tateno A, Nogami A, Yamashita M, Kawanishi T, Kawashima Y, Kitamura S & Livingston G (2020) Dementia https://doi.org/10.1177/1471301220919938

Clinical effectiveness of the START (STrAtegies for RelaTives) psychological intervention for family carers and the effects on the cost of care for people with dementia: 6-year follow-up of a randomised  controlled trial

Livingston G, Manela M, O’Keeffe A, Rapaport A, Cooper C, Knapp M, King D, Romeo R, Walker Z, Hoe J, Mummery C and Barber J. (2019) The British Journal of Psychiatry doi: 10.1192/bjp.2019.160

Clinical effectiveness of a manual based coping strategy programme (START, STrAtegies for RelaTives) in promoting the mental health of carers of family members with dementia: pragmatic randomised controlled trial.

Livingston G, Barber J, Rapaport P, Knapp M, Griffin M, Livingston D, Walker Z, Mummery C, Sampson E, Cooper C (2013).  BMJ 2013; 347:f276

National Institute for Health Research (NIHR) Health Technology Assessment (HTA) full report.

Livingston G, Barber J, Rapaport P, Knapp M, Griffin M, Romeo R, King D, Livingston D, Lewis-Holmes E, Mummery C, Walker Z, Hoe J, Cooper C (2014). http://www.journalslibrary.nihr.ac.uk/hta/volume-18/issue-61#abstract

Cost-effectiveness of a manual-based coping strategy programme in promoting the mental health of family carers of people with dementia: a pragmatic randomised controlled trial.

Knapp M, King D, Romeo R, Schehl, B, Barber J, Griffin M, Rapaport P, Livingston D, Mummery C Walker Z, Sampson E, Cooper C, Livingston G (2013). BMJ 2013; 347:f6342

START (STrAtegies for RelaTives) coping strategy for family carers of adults with dementia: qualitative study of participants' views about the intervention.

Sommerlad A, Manela M, Cooper C, Rapaport P, Livingston G (2014). http://bmjopen.bmj.com/content/4/6/e005273.full

Coping strategies as mediators of the effect of the START (strategies for RelaTives) intervention on psychological morbidity for family carers of people with dementia in a randomised controlled trial.

Li R, Cooper C, Barber J, Rapaport P, Griffin M, Livingston G (2014). http://ac.els-cdn.com/S016503271400439X/1-s2.0-S016503271400439X-main.pdf?_tid=5824d7ca-69b4-11e4-845f-00000aacb361&acdnat=1415718582_f11db8ad2d86db82c28d8e1c35b10bf2

Long-term clinical and cost-effectiveness of psychological intervention for family carers of people with dementia: a single-blind, randomised, controlled trial.

Livingston G, Barber J, Rapaport P, Knapp M, Griffin M, King D, Romeo R, Livingston D, Mummery C, Walker Z, Hoe J, Cooper C (2014). http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(14)00073-X/fulltext

Effectiveness of START psychological intervention in reducing abuse by dementia family carers: randomized controlled trial.

Cooper C, Barber J, Griffin M, Rapaport P and Livingston G (2015). http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=10065248&fulltextType=RA&fileId=S1041610215002033