Comparative Effectiveness of Clinician- Versus Peer-Supported Problem-Solving Therapy for Rural Older Adults With Depression.

TitleComparative Effectiveness of Clinician- Versus Peer-Supported Problem-Solving Therapy for Rural Older Adults With Depression.
Publication TypeJournal Article
Year of Publication2024
AuthorsHollister, B, Crabb, R, Areán, P
JournalPsychiatr Serv
Volume75
Issue9
Pagination925-928
Date Published2024 Sep 01
ISSN1557-9700
KeywordsAged, Aged, 80 and over, California, Case Management, Depression, Depressive Disorder, Female, Humans, Male, Middle Aged, Peer Group, Pilot Projects, Problem Solving, Psychotherapy, Rural Population
Abstract

OBJECTIVE: Self-guided and peer-supported treatments for depression among rural older adults may address some common barriers to treatment. This pilot study compared the effect on depression of peer-supported, self-guided problem-solving therapy (SG-PST) with case management problem-solving therapy (CM-PST) among older adults in rural California.

METHODS: Older adults with depression (N=105) received an introductory PST session with a clinician, followed by 11 sessions of CM-PST with a clinician (N=85) or SG-PST with a peer counselor (N=20).

RESULTS: Both interventions resulted in clinically significant improvement in depression by week 12. Depression scores in the CM-PST group dropped by 4.1 points more than in the SG-PST group between baseline and week 12 (95% CI=0.99-7.22, p<0.001, Hedges's g=1.08).

CONCLUSIONS: The results suggest that peer-supported SG-PST is a viable, acceptable option for rural older adults with depression as a second-line treatment if access to clinicians is limited.
DOI10.1176/appi.ps.20230027
Alternate JournalPsychiatr Serv
PubMed ID38650489
PubMed Central IDPMC11366500
Grant ListR01 AG043584 / AG / NIA NIH HHS / United States