Cognitive behavioural therapy for older adults with depressive symptoms living in residential aged care: A pilot study of a systemic treatment model

OBJECTIVES: Older adults in residential aged care have disproportionately high rates of depression compared to community settings, but access to mental health services is poor. The study aimed to evaluate the feasibility and acceptability of a novel outreach student-delivered systemic therapy program (ELders AT Ease [ELATE]) for addressing depressive symptoms in residential aged care. DESIGN: Single-arm pre- and post-intervention design. METHODS: The program integrates evidence-based cognitive, behavioural and reminiscence techniques. Sixteen individual face-to-face therapy sessions with residents over 5 months were delivered by supervised postgraduate psychology students on placement. Family and staff were invited to join resident therapy sessions and monthly psychoeducational group sessions. Aged care residents with depressive symptoms and no or mild cognitive impairment were recruited. Participants completed measures of depression, anxiety and quality of life at four timepoints. Program satisfaction and treatment integrity were assessed post-treatment. Study uptake, treatment uptake and retention rates were calculated. RESULTS: Fifty-four residents were referred; 16 were eligible, and 15 participated (12 female, 87.3 ± 6.3 years). Overall, 14 participants completed at least 12 of 16 treatment sessions. Treatment satisfaction was high, with 90.9% of residents rating the treatment as 'good' or 'excellent'. Preliminary clinical outcomes suggested an average decrease post-treatment in depression and anxiety, with small-to-medium effect sizes. Staff and family session involvement was lower than expected. CONCLUSIONS: The pilot suggested that recruitment, screening and 5-month treatment procedures were feasible and acceptable. The results warrant a larger study to examine the effectiveness of the student-delivered outreach approach in residential aged care.