Problem-Solving Therapy for Late-Life Depression in Home Care: A Randomized Field Trial

Objective The authors present data from a pilot research program initiated to develop, refine, and test the outcomes of Brief Problem-Solving Therapy in Home Care (PST-HC) that targets the needs of older adults identified with severe depressive symptoms in an acute home care setting. Methods A pilot...

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Bibliographic Details
Published in:The American journal of geriatric psychiatry 2007-11, Vol.15 (11), p.968-978
Main Authors: Gellis, Zvi D., Ph.D, McGinty, Jean, R.N., M.S.N, Horowitz, Amy, Ph.D, Bruce, Martha L., M.P.H., Ph.D, Misener, Elizabeth, Ph.D
Format: Article
Language:English
Subjects:
Age Factors
Aged
Aged, 80 and over
depression
Depressive Disorder, Major - psychology
Depressive Disorder, Major - therapy
Educational Status
elderly
Female
Health Status
home care
Home Care Services - standards
Humans
Internal Medicine
Male
Personal Satisfaction
Pilot Projects
Problem Solving
Problem solving therapy
Psychiatric Status Rating Scales
Psychotherapy - methods
Psychotherapy - standards
randomized trial
Treatment Outcome
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Summary:Objective The authors present data from a pilot research program initiated to develop, refine, and test the outcomes of Brief Problem-Solving Therapy in Home Care (PST-HC) that targets the needs of older adults identified with severe depressive symptoms in an acute home care setting. Methods A pilot randomized clinical trial compared the impact of PST-HC to usual care (UC) in a sample of older medically ill home care patients identified with severe depressive symptoms. Forty patients were randomly assigned to either six weekly sessions of PST-HC in their home or standard home care services. Depression, quality of life, and problem-solving ability were measured at baseline, posttreatment, three-month follow-up, and six-month follow-up by blinded evaluators. Results All 40 patients provided follow-up data. No differences between the two groups were found on any demographic variables. Outcome data suggested significant improvements in depression scores over time after PST-HC, relative to UC. PST-HC patients reported higher quality of life and problem-solving ability scores relative to UC. Conclusion Results suggest that PST-HC is well tolerated and holds promise for reducing persistent depressive symptoms. The authors discuss limitations in terms of the “real-world” applicability of this psychosocial treatment for late-life depression.
ISSN:1064-7481
1545-7214
DOI:10.1097/JGP.0b013e3180cc2bd7