Behavioral problems are among the most challenging aspects of caring for a person with Alzheimer's disease. A sample of 406 spouses-caregivers of patients with Alzheimer's disease was randomized to an active multicomponent counseling and support intervention condition or to a usual care condition. Caregivers reported on the frequency of troublesome patient behaviors and their reactions to them at baseline and at regular follow-up interviews. Random-effects regression models over the first 4 years after randomization revealed that, although the intervention did not affect the frequency of patient behavioral problems, it did significantly reduce caregivers' reaction ratings. Because caregiver appraisals have been found to mediate the impact of caregiving stress on depression and to predict nursing home placement rates, they deserve greater attention as an important target of intervention services.