Leveraging Adult Protective Service Interaction to Offer Evidence-Based Treatment for Depression in Elder Neglect/Self Neglect

Purpose

The purpose of this study is to test the feasibility and acceptability of an evidence-based treatment for depression delivered over an ipad, computer, or smartphone can help Adult Protective Services (APS) clients with their activities of daily living to evaluate whether reductions on measures of depression and apathy (a) mediate reduced Elder Neglect/Self Neglect (EN/SN) behaviors; and (b) whether secondary posited mediating mechanisms are also active in impacting depression and apathy

Condition

  • Depression in Old Age

Eligibility

Eligible Ages
Over 65 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • APS Case in APS Region VI- Must have open case - PHQ 9 score- Must have score of nine (9) or more

Exclusion Criteria

  • Previous mental health diagnosis of bipolar disorder, psychotic disorders, and moderate to severe dementia - Assessment of Consent Proxy- Those who need assessment of consent proxy - Suicidal Intent (as indexed by PhQ-9 question 9)- Those scoring 2 or 3 - Current Alcohol and Drug Dependency- As evidenced by Cut down, Annoyed, Guilty, and Eye-opener (CAGE) score of 3 or more

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Active Comparator
APS Treatment as Usual
  • Behavioral: APS Treatment as Usual
    APS agencies conduct in-home investigations of alleged abuse and neglect against disabled and older adults. Investigations result in short-term stop-gap measures, primarily brief case-management centering on referral linkage to community-based services and provision of resource allocation. No direct psychological services or treatments are provided by APS, however referral to other services is also standard.
Experimental
Intervention-Behavioral Activation (BA)
  • Behavioral: Intervention-Behavioral Activation (BA)
    Participants will be will be guided through 8 one-hour sessions via home telehealth by the study community health worker. Each weekly < 60 minute BA session will include modules focusing on 1) Psychoeducation for depression and techniques for self-management, including pharmacologic and psychosocial treatment options; 2) Introduction of BA and guided problem-solving techniques to enhance self efficacy for managing depression and other chronic illnesses; 3) BA and problem-solving techniques to support medication management and adherence strategies; 4) BA to develop strategies and techniques for communicating with health providers and/or support resources to foster positive mood and self management; and 5) Developing a relapse prevention plan, which includes identifying triggers for lower functioning, support resources, and practice of BA techniques.

Recruiting Locations

More Details

Status
Recruiting
Sponsor
The University of Texas Health Science Center, Houston

Study Contact

Leila Wood, PhD, MSSW
(713) 486-2700
Leila.G.Wood@uth.tmc.edu

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