Kia ora ai te Iwi - Whanau Oranga (wellbeing of the whole family): Supporting Maori with cultural-adapted psychological interventions to cope with the impact of Mate Wareware (Dementia).

A culturally-adapted evidence-based psychological program will be implemented and evaluated with Maori impacted by Dementia. Participants include primary caregivers and relatives of those diagnosed with this neurodegenerative condition. Specific interventions will include cognitive behavioural therapy (CBT) culturally adapted for Maori 'Poutama Hinetore' (Bennett, 2012), distress tolerance skills, mindfulness, and emotion regulation skills delivered within a kaupapa Maori framework incorporating tikanga Maori (Maori cultural practices) and te reo Maori (Maori language). Physical information used will include summary notes and diagrams following sessions supporting specifically related to new skills learnt. These sessions notes will be made available online for participants also. The materials will be culturally adapted CBT thought records (Beck, 2011) and (Dialectical Behavioural Therapy (DBT) skills worksheets (Linehan, 2014). Relevant Maori proverbs (whakatauki), myths and legends will be incorporated into this content. The intervention/therapy will be developed based upon the needs of the family and individual. This will be assessed using the Meihana model, a Maori clinical assessment tool that incorporates a holistic understanding of wellbeing. Specific therapies may include: CBT (processing grief, loss and negative emotions), DBT skills sessions, and mindfulness (including Maori modulation skills drawing upon traditional skills such as kapa haka (Maori cultural dance and song)). The intervention will be delivered by the lead investigator who is an experienced registered clinical psychologist. She is of Maori descent and accesses both clinical and cultural supervision. A rangahau whanau (research advisory group) will also provide oversight. The intervention will be delivered as group/family and individual sessions. This will be determined by the participants. The intervention will be delivered fortnightly over a 4 month period. This may be extended by 1-2 months should the need arise from participants. For example, if whanau require additional support. The decision would be made by the lead clinical psychologist in consultation with clinical supervision. The intervention will be implemented in a private environment of the participants choice. This may include their home, a marae (Maori cultural place of meeting), or an alternative space provided by the researcher. The intervention is not intended to be a manualised treatment intervention. The intervention, like therapy, will be determined based upon the needs of the participants.