Barrera Terri L, Cummings Jeremy P, Armento Maria, Cully Jeffrey A, Bush Amspoker Amber, Wilson Nancy L, Mallen Michael J, Shrestha Srijana, Kunik Mark E, Stanley Melinda A
a Houston VA HSR&D Center for Innovations in Quality , Effectiveness and Safety, Michael E. DeBakey VAMC , Houston , Texas , USA.
b Baylor College of Medicine , Houston , Texas , USA.
Clin Gerontol. 2017 Mar-Apr;40(2):114-123. doi: 10.1080/07317115.2016.1254133. Epub 2016 Nov 4.
Rural, homebound older adults are at increased risk for anxiety and depression and have limited access to mental health services. These individuals face many barriers to receiving evidence-based mental health treatment and would benefit from interventions that increase access to and efficiency of care. The aim of this study was to evaluate use of a telephone-delivered, modular, cognitive behavioral therapy (CBT) intervention for both late-life depression and anxiety delivered to rural, homebound Veterans.
Three cases are presented to illustrate the flexible adaptation of the intervention for use among older Veterans enrolled in home-based primary care, with varying symptom presentations and functional limitations. The Veterans received 7 to 9 sessions of the CBT intervention, with ordering of skill modules based on symptom presentation and determined collaboratively between patient and therapist.
The three Veterans showed improvement in depression and/or anxiety symptoms following treatment and provided positive feedback regarding their experiences in this program.
These results suggest that telephone-delivered CBT is acceptable to older adults and can be tailored to individual patient needs.
Clinicians should consider telephone-delivered CBT as an alternate mode of therapy to increase access to mental health care for rural, homebound individuals with depression and anxiety.
居家的农村老年人焦虑和抑郁风险增加，且获得心理健康服务的机会有限。这些个体在接受循证心理健康治疗方面面临诸多障碍，若能获得可增加护理可及性和效率的干预措施，他们将从中受益。本研究旨在评估一种通过电话提供的模块化认知行为疗法（CBT）干预措施对居家农村退伍军人晚年抑郁和焦虑的治疗效果。
呈现三个案例，以说明该干预措施如何灵活调整，用于参加居家初级保健的老年退伍军人，这些退伍军人症状表现各异且存在功能限制。退伍军人接受了7至9次CBT干预疗程，根据症状表现安排技能模块顺序，并由患者和治疗师共同确定。
三名退伍军人在治疗后抑郁和/或焦虑症状有所改善，并对他们在该项目中的经历给予了积极反馈。
这些结果表明，通过电话提供的CBT对老年人是可接受的，并且可以根据个体患者的需求进行调整。
临床医生应考虑将通过电话提供的CBT作为一种替代治疗方式，以增加为患有抑郁和焦虑的居家农村个体提供心理健康护理的机会。
