Tailored internet-delivered cognitive behavioral therapy with therapist support for depressed older adults: Results from a randomized controlled trial with a one-year follow-up.

OBJECTIVES

Internet-delivered cognitive behavioral therapy has been found to be effective for various populations with somatic and psychological difficulties. However, older adults are often overlooked and have received relatively less attention in research. This study aimed to test the effects of an 8-week therapist-supported internet-based cognitive behavioral therapy program for depressed older adults compared to a waiting-list control condition.

METHODS

Individuals interested in participating in the study completed self-report questionnaires online, followed by a semi-structured intake interview. Symptoms of depression were the primary outcome and were measured with the PHQ-9 and GDS-15. Secondary outcome measures included anxiety symptoms (GAD-7) and psychological well-being (WHO-5). In total, 84 help-seeking individuals 60+ years old met the inclusion criteria and were included in the study. They were randomized on a 1:1 ratio to either 8 weeks of guided internet-delivered CBT (ICBT) or to a waiting-list control group.

RESULTS

Results analysed on an intention-to-treat and completer basis after 8 weeks of intervention showed treatment effects in favor of the ICBT group compared to a waiting-list at post-treatment with moderate to large between-group effects. Treatment effects in the treatment group were maintained at 3-months and 1-year follow-ups. Treatment dropout was also associated with older age and with lower computer skills.

CONCLUSIONS

This study suggests that therapist-guided ICBT can be a feasible treatment option for older adults with symptoms of depression.

LIMITATIONS

The main limitations of this study is a small sample size and lack of control group in the follow-up assessments.