Avani Shah

Effects of Home-Delivered Cognitive Behavioral Therapy (CBT) for Depression on Anxiety Symptoms among Rural, Ethnically Diverse Older Adults

ABSTRACT Background: We examined the effects of home-delivered cognitive-behavioral therapy (CBT) for depression on anxiety symptoms in an ethnically diverse, low resource, and medically frail sample of rural, older adults. Method: This was a secondary analysis of a randomized clincial trial with 134 rural-dwelling adults 65 years and older with decreased quality of life and elevated psychological symptomatology. Anxiety symptoms were assessed with the anxiety and phobic anxiety subscales of the Symptom Checklist-90-Revised (SCL-90-R). Results: Compared to a minimal support control condition, CBT for depression resulted in significantly greater improvements in symptoms of anxiety and phobic anxiety from pre-treatment to post-treatment. Conclusion: Home-delivered CBT for depression can be an effective treatment for anxiety in a hard-to-reach older populations. Clinical Implications: Additional research should explore integrated anxiety and depression protocols and other treatment modalities, including bibliotherapy or telehealth models of CBT, to reduce costs associated with its in home delivery. Flexibility in administration and adaptations to the CBT protocol may be necessary for use with vulnerable, rural older adults.

Adapting an Interprofessional Training Model for Social Work Field Placements: An Answer for Better Mental Health Care Outreach for Older Adults in Primary Care.

ABSTRACTProfessional shortages of geriatrically trained social workers pose a barrier to mental health care for older adults. Integrating graduate social work interns into primary care settings may...

Audio and Computer Cognitive Behavioral Therapy for Depressive Symptoms in Older Adults: A Pilot Randomized Controlled Trial

The purpose of this study was to develop and explore the feasibility of audio-based (ACBT) and computer-based (CCBT) cognitive behavioral therapies for older adults with depressive symptoms. The audio program consisted of 8 compact discs and a workbook while the computer program consisted of 11 modules of similar duration provided on a tablet PC. Both interventions consisted of the following topics: identifying and changing unhelpful thoughts, addressing feelings, relaxation, engaging in pleasant events, assertiveness, and problem-solving. Fifty-one older adults were recruited from medical settings and rural communities. Participants were randomly assigned to immediate treatment (ACBT or CCBT) or delayed treatment control condition. Analyses were conducted to examine change on interviewer-based and self-reported depression. A significant interaction effect between time and condition was found on the interviewer-based depression scale. This suggests that both types of treatments decreased depressive symptoms over time when compared to a delayed treatment control. Computer-based and audio-based cognitive behavioral treatments may be valuable low-cost modalities to deliver psychotherapy to older adults with depressive symptoms.

Developing Digital Intervention Games for Mental Disorders: A Review

There is limited research on mental health interventions delivered in a digital game format and even less to guide developers on how to develop such games. This review focuses on understanding how to develop therapeutic digital games based primarily on mental health intervention games that have been empirically tested. The review was generated through database searches and backward search techniques for digital game-based interventions for specific mental disorders. We evaluated digital games that were based on validated psychological treatments. We located 24 studies and 18 games that met our search criteria. These games and their outcomes have been summarized. This review showed that these types of games have the potential to make an impact on mental health concerns but that there are currently few digital games available for the treatment or prevention of mental disorders. In addition, guidelines for digital mental health intervention game development have been presented. The consolidation of guidelines addressing multiple game development factors (e.g., time, cost, engagement) may help those interested in developing new therapeutic games that target a greater variety of disorders, thereby expanding access to larger populations.

Diabetes, Depression, and Cognition: a Recursive Cycle of Cognitive Dysfunction and Glycemic Dysregulation

Purpose of ReviewThe study aims to examine the effects of diabetes and depression on executive functioning (EF) and to review the effects of EF deficits on diabetes management.Recent FindingsBoth type 2 diabetes and depression influence EF, and in turn, EF has an impact on diabetes management.SummaryIndividuals with both comorbidities (i.e., diabetes and depression) experience greater deficits in EF than individuals with just one of the morbidities (i.e., depression or diabetes). The disruption in EF results in poor diabetes management and poor emotion regulation which ultimately increases the probability of a recursive cycle of depression and hyperglycemia. This recursive cycle can ultimately lead to diabetes-related complications.