Efficacy of an audio-based cognitive behavioral therapy for older adults with depression

The purpose of this study was to develop and assess the efficacy of an audio-based cognitive behavioral therapy (ACBT) intervention for older adults with depressive symptoms. The process of developing this program included: (1) adaptation of a client and therapist manual developed for older adult caregivers (Dick, Gallagher-Thompson, Coon, Powers, & Thompson, 1996); (2) review of the ACBT program by older adults and cognitive behavioral therapists for acceptability; and (3) program revision. The revised program consists of 8 compact discs (CDs) and a workbook on the following topics: (1) introduction to CBT; (2) identifying and changing unhelpful thoughts; (3) addressing feelings; (4) relaxation; (5) engaging in pleasant events; (6) assertiveness; and (7) problem-solving. The next phase of this study entailed testing the efficacy of the ACBT program. Eligible participants (N = 34) were recruited from mainly medical settings and rural communities (e.g. above age 54 with a score greater than 9 on the Geriatric Depression Scale; GDS). Participants were randomly assigned to an immediate treatment group or a minimal contact delayed treatment group. The delayed treatment group waited four weeks to begin treatment while the immediate treatment group received a brief training session and 4 weeks to complete the ACBT program. Both groups received brief weekly contact calls to monitor mood. Outcome analyses assessed change in depression with the Hamilton Rating Scale for Depression (HRSD; Hamilton, 1967) and GDS. Intent-to-treat carry forward analyses revealed significant differences on only the HRSD by group and time. Analyses assessing change on the Somatization subscale of the Brief Symptom Inventory (Derogatis & Spencer, 1983) and GDS by group and time were not significant.