SIX-MONTH POSTINTERVENTION DEPRESSION AND DISABILITY OUTCOMES OF IN-HOME TELEHEALTH PROBLEM-SOLVING THERAPY FOR DEPRESSED, LOW-INCOME HOMEBOUND OLDER ADULTS: Research Article: Tele-Psychotherapy for Homebound Seniors
Open accessAbstract
BACKGROUND: Despite their high rates of depression, homebound older adults have limited access to evidence-based psychotherapy. The purpose of this paper was to report both depression and disability outcomes of telehealth problem-solving therapy (tele-PST via Skype video call) for low-income homebound older adults over 6 months postintervention. METHODS: A 3-arm randomized controlled trial compared the efficacy of tele-PST to in-person PST and telephone care calls with 158 homebound individuals who were aged 50+ and scored 15+ on the 24-item Hamilton Rating Scale for Depression (HAMD). Treatment effects on depression severity (HAMD score) and disability (score on the WHO Disability Assessment Schedule [WHODAS]) were analyzed using mixed-effects regression with random intercept models. Possible reciprocal relationships between depression and disability were examined with a parallel-process latent growth curve model. RESULTS: Both tele-PST and in-person PST were efficacious treatments for low-income homebound older adults; however the effects of tele-PST on both depression and disability outcomes were sustained significantly longer than those of in-person PST. Effect sizes (dGMA-raw ) for HAMD score changes at 36 weeks were 0.68 for tele-PST and 0.20 for in-person PST. Effect sizes for WHODAS score changes at 36 weeks were 0.47 for tele-PST and 0.25 for in-person PST. The results also supported reciprocal and indirect effects between depression and disability outcomes. CONCLUSIONS: The efficacy and potential low cost of tele-delivered psychotherapy show its potential for easy replication and sustainability to reach a large number of underserved older adults and improve their access to mental health services.
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Both telephone-delivered and in-person PST were effective for treating MDD in low-income homebound older adults.
“Both telephone-delivered and in-person PST were effective for treating MDD in low-income homebound older adults.139”
From Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder (2016) · cites this paper as [139]
The Discussion (page not available) reports that both tele-PST and in-person PST were effective for depression in low-income homebound older adults. But the Intervention section specifies that tele-PST used Skype video calls, not telephone delivery; telephone calls were a separate support-only comparison group. The Participants and Settings section defines eligibility by a depression-rating score, rather than an MDD diagnosis. (LLM, conf=0.92)
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References 49 · Cited by 156
Research works printed but not linked: 1
- [14]Choi N Morrow-Howell N Older adults’ attitudes toward depression treatment modalities: within-group differences and comparison with their caregivers Aging Ment Health 2007 11 422 433 17612806
- Authors
- Choi, N. G., Marti, C. N., Bruce, M. L., Hegel, M. T., Wilson, N. L., & Kunik, M. E.
- Affiliations
- The University of Texas at Austin (US)
- Cornell University (US)
- Dartmouth College (US)
- Michael E. DeBakey VA Medical Center (US)
- Corresponding author
- Choi, Namkee G.
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2014-02-05
- Volume
- 31
- Issue
- 8
- Pages
- 653-661
- ISSN
- 1091-4269 (ISSN-L)
- PMC
- PMC4122624
- OpenAlex
- W1909024825
- Semantic Scholar
- 1b41c423295f76e3292bf2f6b50e0c0541075dcd
- Cited by
- 156
- References
- 49
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 12 · 2023: 13 · 2022: 13 · 2021: 18 · 2020: 21 · 2019: 18 · 2018: 13 · 2017: 11 · 2016: 11 · 2015: 9 · 2014: 3 · 2012: 1
- FWCI
- 11.23
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health ((R34 MH083872))
- VA HSR&D Center for Innovations in Quality, Effectiveness and Safety (#CIN 13-413) at the Michael E. DeBakey VA Medical Center, Houston, TX
- St. David's Foundation
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Demography › Technology Use by Older Adults
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- telemedicine, problem-solving therapy, depression, disability, homebound older adults, low-income elderly, videoconferencing, treatment efficacy, sustained treatment effects, access to mental health care
- MeSH terms
- Aged, Aged, 80 and over, Depression, Disability Evaluation, Female, Follow-Up Studies, Humans, Male, Middle Aged, Poverty, Problem Solving, Psychotherapy, Time Factors, Treatment Outcome, Telemedicine, Homebound Persons
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