Technology assisted intervention for improving mood: a portable computer-assisted therapy program for treating depression in older adults

Abstract

The dissertation examined the effectiveness of a newly developed intervention to treat symptoms of depression among a sample of older adults. The study contained in this dissertation furthered the line of research involving self-administered treatments for depressed older adults. The intervention used in this study was developed for the purpose of creating a portable, computer-based self-administered treatment, which could later be explored as a possible intervention in overcoming barriers to mental healthcare access for older adults. This computer-based intervention was developed using a slate-PC as the platform and series of eleven sessions based on the manual Cognitive-Behavioral Therapy for Late Life Depression (Dick, Gallagher-Thompson, Coon, Powers, & Thompson (1995). Thirty-four, older adult participants were randomly assigned to either an immediate treatment group or a one-month waitlist control group. Outcome measures included both a clinician-rated measure of depression (Hamilton Rating Scale for Depression; HRSD) and a self-report measure of depression (Geriatric Depression Scale; GDS-30). Possible mediators were examined using the Dysfunctional Attitudes Scale (DAS) and the California Older Persons Pleasant Events Scale (COPPES). Treatment receipt and treatment enactment were also constructs of interest; measured by CBT knowledge tests, and the number of sessions and percentage of completed homework assignments completed by the participants. Finally, a measure of intervention benefit was administered to evaluate older adults' acceptance of the computer-based intervention used in this study. Results suggested that the older adults in the experimental condition displayed a significant decrease in depressive symptoms compared to those in the control condition. Analyses of clinical significance also suggested that older adults improved in a clinically meaningful way following the intervention. Meditational relations between condition and outcome were not found using the DAS and the COPPES. Additional, uncontrolled, analyses suggested significant relations between post-treatment depression and measures of treatment receipt and treatment enactment. Finally, feedback from the participants indicated that they considered the intervention easy to use, enjoyable, and useful for learning techniques to improve their mood. The implications of this study were discussed as they relate to the treatment of depression for older adults. New technology-based applications for the treatment of depression among older adults may follow the results found in this dissertation.