Patient perspectives on the benefits of psychotherapy for late-life depression.

OBJECTIVES

The future of psychotherapy research lies in the development of easy-to-use, efficient treatments that target specific characteristics and needs of patients with a given disorder. Meeting this aim will involve understanding why people seek psychotherapy and the therapeutic features that they feel are most helpful in their recovery. Identifying key features of treatment that patients feel lead to improvement may help identify the active ingredients of psychotherapy and further refine treatment.

DESIGN

We selected 22 older adults who participated in a larger randomized trial of psychotherapy for late-life depression to participate in individual, semistructured qualitative interviews.

SETTING

Interviews took place at the University of California, San Francisco or in the participant's home.

PARTICIPANTS

All participants were age 60 years or older with major depression and co-occurring executive dysfunction.

MEASUREMENTS

Participants were asked about their depression experience, their expectations for treatment, most and least helpful aspects of treatment, effects of treatment, and recommended improvements to treatment. Data were transcribed, coded, and analyzed using NVivo (QSR International, Cambridge, MA).

RESULTS

The most commonly noted causes for seeking treatment were depression related to interpersonal relationships, health conditions, grief/loss, finances, housing, and challenges due to executive dysfunction. Participants had few expectations about treatment and they found support, the problem-solving therapy process, and focus on interpersonal relationships to be the most helpful processes in treatment.

CONCLUSION

Suggestions for psychotherapy include increasing the number of sessions, discussing problems in a more proactive way, and considering participant choice in treatment. This research demonstrates the value of mixed-methods approaches, in that qualitative approaches assist in contextualizing and interpreting quantitative data.