Improved Outcomes for Depressed Elder Abuse Victims with Video-delivered Psychotherapy During COVID-19

Overview

Journal Psychother Res

Publisher Routledge

Specialties Pharmacology
Psychiatry
Psychology

Date 2023 Dec 18

PMID 38109490

Authors

Isabel Rollandi

Samprit Banerjee

Yuqing Qiu

Olivia Fiallo

Tobi Abramson

Jaquelin Berman

Nili Solomonov

Jo Anne Sirey

Affiliations

Soon will be listed here.

Abstract

Objective: There is a lack of evidence-based scalable therapies for elder abuse victims, with no current remotely delivered tailored psychotherapy. The purpose of this manuscript is to (a) examine the effectiveness of a brief therapy for depression for elder abuse victims, and (b) to compare remote intervention delivery via phone or video to the traditional in-person delivery.

Method: PROTECT, , is a brief therapy developed in collaboration with partners at the Department for the Aging (DFTA) of New York City. During the COVID-19 outbreak, PROTECT delivery shifted from in-person to phone or video delivery. Depression severity was tracked using the Patient Health Questionaire-9 (PHQ-9). Reduction in depression severity was evaluated using a linear mixed effects model with non-inferiority test to compare the effectiveness of video vs in-person delivery of PROTECT.

Results: PROTECT reduced depression (average 5.15 PHQ-9 points). Video and phone delivery were non-inferior to in-person delivery. The video group completed therapy more quickly than the in-person group and had a more rapid improvement in depression symptoms.

Conclusions: PROTECT therapy delivered remotely reduces depression among diverse elder abuse victims. Video delivery of PROTECT could increase reach and scalability to serve more vulnerable older depressed victims.

References

Acierno R, Hernandez M, Amstadter A, Resnick H, Steve K, Muzzy W . Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: the National Elder Mistreatment Study. Am J Public Health. 2009; 100(2):292-7. PMC: 2804623. DOI: 10.2105/AJPH.2009.163089. View

Dong X, Simon M, Mendes de Leon C, Fulmer T, Beck T, Hebert L . Elder self-neglect and abuse and mortality risk in a community-dwelling population. JAMA. 2009; 302(5):517-26. PMC: 2965589. DOI: 10.1001/jama.2009.1109. View

Boserup B, Mckenney M, Elkbuli A . Alarming trends in US domestic violence during the COVID-19 pandemic. Am J Emerg Med. 2020; 38(12):2753-2755. PMC: 7195322. DOI: 10.1016/j.ajem.2020.04.077. View

Kocalevent R, Hinz A, Brahler E . Standardization of the depression screener patient health questionnaire (PHQ-9) in the general population. Gen Hosp Psychiatry. 2013; 35(5):551-5. DOI: 10.1016/j.genhosppsych.2013.04.006. View

Dujardin K, Duhem S, Guerouaou N, Djelad S, Drumez E, Duhamel A . Validation in French of the Montreal Cognitive Assessment 5-Minute, a brief cognitive screening test for phone administration. Rev Neurol (Paris). 2021; 177(8):972-979. DOI: 10.1016/j.neurol.2020.09.002. View

Choi N, Hegel M, Marti N, Marinucci M, Sirrianni L, Bruce M . Telehealth problem-solving therapy for depressed low-income homebound older adults. Am J Geriatr Psychiatry. 2013; 22(3):263-71. PMC: 3519946. DOI: 10.1097/JGP.0b013e318266b356. View

Ramsey A, Wetherell J, Depp C, Dixon D, Lenze E . Feasibility and Acceptability of Smartphone Assessment in Older Adults with Cognitive and Emotional Difficulties. J Technol Hum Serv. 2016; 34(2):209-223. PMC: 5036573. DOI: 10.1080/15228835.2016.1170649. View

Sirey J, Halkett A, Chambers S, Salamone A, Bruce M, Raue P . PROTECT: A Pilot Program to Integrate Mental Health Treatment Into Elder Abuse Services for Older Women. J Elder Abuse Negl. 2015; 27(4-5):438-53. PMC: 6528790. DOI: 10.1080/08946566.2015.1088422. View

Rosay PhD A, Mulford PhD C . Prevalence estimates and correlates of elder abuse in the United States: The National Intimate Partner and Sexual Violence Survey. J Elder Abuse Negl. 2016; 29(1):1-14. DOI: 10.1080/08946566.2016.1249817. View

10.

Epton T, Currie S, Armitage C . Unique effects of setting goals on behavior change: Systematic review and meta-analysis. J Consult Clin Psychol. 2017; 85(12):1182-1198. DOI: 10.1037/ccp0000260. View

11.

Alexopoulos G . Mechanisms and treatment of late-life depression. Transl Psychiatry. 2019; 9(1):188. PMC: 6683149. DOI: 10.1038/s41398-019-0514-6. View

12.

Posner K, Brown G, Stanley B, Brent D, Yershova K, Oquendo M . The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. 2011; 168(12):1266-77. PMC: 3893686. DOI: 10.1176/appi.ajp.2011.10111704. View

13.

Friedman A, Gervasi S, Song H, Bond A, Chen A, Bergman A . Telemedicine catches on: changes in the utilization of telemedicine services during the COVID-19 pandemic. Am J Manag Care. 2022; 28(1):e1-e6. DOI: 10.37765/ajmc.2022.88771. View

14.

Elman A, Breckman R, Clark S, Gottesman E, Rachmuth L, Reiff M . Effects of the COVID-19 Outbreak on Elder Mistreatment and Response in New York City: Initial Lessons. J Appl Gerontol. 2020; 39(7):690-699. PMC: 7288859. DOI: 10.1177/0733464820924853. View

15.

Jacobson N, Truax P . Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol. 1991; 59(1):12-9. DOI: 10.1037//0022-006x.59.1.12. View

16.

Hernandez-Tejada M, Frook G, Steedley M, Watkins J, Acierno R . Demographic-based risk of reporting psychopathology and poor health among mistreated older adults in the national elder mistreatment study wave II. Aging Ment Health. 2018; 24(1):22-26. DOI: 10.1080/13607863.2018.1509296. View

17.

Ayalon L, Chasteen A, Diehl M, Levy B, Neupert S, Rothermund K . Aging in Times of the COVID-19 Pandemic: Avoiding Ageism and Fostering Intergenerational Solidarity. J Gerontol B Psychol Sci Soc Sci. 2020; 76(2):e49-e52. PMC: 7184502. DOI: 10.1093/geronb/gbaa051. View

18.

Lachs M, Pillemer K . Elder Abuse. N Engl J Med. 2015; 373(20):1947-56. DOI: 10.1056/NEJMra1404688. View

19.

Lachs M, Williams C, OBrien S, Pillemer K, Charlson M . The mortality of elder mistreatment. JAMA. 1998; 280(5):428-32. DOI: 10.1001/jama.280.5.428. View

20.

Pugh E, Kemp E, van Dyck C, Mecca A, Sharp E . Effects of Normative Adjustments to the Montreal Cognitive Assessment. Am J Geriatr Psychiatry. 2018; 26(12):1258-1267. PMC: 6779033. DOI: 10.1016/j.jagp.2018.09.009. View