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Table 1 Content of the ACT-based internet intervention

From: CareACT - internet-based intervention for enhancing the psychological well-being of elderly caregivers – a study protocol of a controlled trial

Topic of the module Content Home assignment (every 2 weeks)
Introduction Introduction to the program
Video: A caregiver telling about his role as a caregiver
Exercise: Find joy in everyday life
Step 1. Your Life (Values) Text: What is important in caregiving? How can I take care of myself?
Video: What are values?
Curtains in the window
The most important things in life
Value domains
What makes your life worth living?
How do you need to take care of yourself? Do you do things that bring you strength and joy?
If some of your dreams were to come true, what would they be?
Step 2. From Words to Actions (value-based actions and barriers) Text: Even small steps count, loneliness, cherish your friendships
Do it now!
Obstacles on your path
Listen to the exercise Take action and reflect on what small steps you could take now to improve your own wellbeing and the wellbeing of other people close to you. What could you do today, tomorrow or next month?
Apply the Obstacles-exercise when you notice that your thoughts prevent you from doing something. What do you observe?
If you wish, you can also reflect on what loneliness means to you? What do you do to alleviate it?
Step 3. Feelings: Learn to notice your feelings and be more accepting towards them (present moment) Text: Feelings in caregiving: learn to be more aware of your feelings. Learn to notice them and to cope with them.
Video: Present moment
Follow your breathing
Mindful listening
Mindful eating
Mindful walking
Mindful sitting
Choose a chore or task every day and do it this time mindfully, with more awareness and concentration. Choose something that brings you joy or something you don’t like, such as washing the dishes, cleaning, listening to music, drinking coffee or tea, eating, going for a walk etc.
What small steps can you take during the next two weeks?
Continue with noticing your thoughts and feelings. Have the following questions on hand and ask them of yourself when you notice unwanted private experiences:
Feelings: What do I feel right now?
Thoughts: What thoughts are related to these feelings?
Body sensations: What sensations do I feel in my body?
Situations: In what situations do I have these feelings?
Actions: What do I do when I have these feelings? Do I try to change it or suppress it?
Acceptance: Can I just let those feelings be without trying to push them away? I can experience all kinds of feelings and it is normal.
Step 4. Mind is a storyteller (Defusion and Self-as-Context) Text: Observing your thoughts without being caught up in them.
Video: Watch your thinking
Weather and sky
Don’t think of …
Make room for your thoughts and emotions
Find Yourself
When you notice that you are worrying try some of the following:
Treat your mind as a separate person. Thank your mind when you notice it worrying: “Thank you for your contribution.” “What have you come up with now?” “Well, what an interesting thought!” Take an observer stance by trying out the Observer-exercise.
What is your value-based action during this step? Describe what you did and what the experience was like.
If you have time, choose a couple of the exercises provided and try them out. Notice how you can now see your thoughts in a new light and realize that you don’t have to obey them.
Step 5. Acceptance Text: Learn to live with your unwanted guest: the illness of your nearest, the situation where you are in right now. Accept what you cannot change, accept your feelings and thoughts
Video: What is acceptance?
The broken machine
Observer (short version)
Bird nest
Reflect on whether there is anything in your life which you are currently struggling with. Is there something related to caregiving that you would need to practice so that you would open up and accept it? Choose one such thing and practice it. See what happens and describe it.
What step could you take this time? Do it and describe your experiences.
Step 6. Compassion Compassion towards yourself (self-compassion) and towards others, gratitude for small things in life Keep a gratitude diary for a week. Do both or one of the following:
Compassion: Try to remind yourself of things that made you feel down or moments when you criticized yourself. Write them down. Take them one by one and practice taking an accepting and friendly stance towards them. Feel compassion towards yourself.
Gratitude: Write down three things that you are thankful for during the day or in your life in general. It can be a tiny thing, a good day with your care-recipient, a nice, relaxing moment having coffee, a beautiful song, sunshine or a nice word from someone. Try to find something every day.
Closing words The journey continues
Online questionnaire (well-being)
The next steps