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Abstract
Objectives: Limited data exist on outcomes of older adults receiving psychotherapy for depression in real-world settings. Acceptance and Commitment Therapy for depression (ACT-D) offers potential utility for older individuals who may experience issues of loss, reduced control, and other life changes. The present article examines and compares outcomes of older and younger Veterans receiving ACT-D nationally in the U.S. Department of Veterans Affairs health care system.
Method: Patient outcomes were assessed using the Beck Depression Inventory–Second Edition and the World Health Organization Quality of Life-BREF. Therapeutic alliance was assessed using the Working Alliance Inventory-Short Revised.
Results: Six hundred fifty-five Veterans aged 18-64 and 76 Veterans aged 65+ received ACT-D. Seventy-eight percent of older and 67% of younger patients completed all sessions or finished early. Mean depression scores declined from 28.4 (SD = 11.4) to 17.5 (SD = 12.0) in the older group and 30.3 (SD = 10.6) to 19.1 (SD = 14.3) in the younger group. Within-group effect sizes were d = .95 and d = 1.06 for the two age groups, respectively. Quality of life and therapeutic alliance also increased during treatment.
Conclusion: The findings suggest that ACT-D is an effective and acceptable treatment for older Veterans treated in routine clinical settings, including those with high levels of depression.
Acknowledgements
This project was supported by Mental Health Services, U.S. Department of Veterans Affairs Central Office.
Notes
*[χ2 (1) = 13.1, p < 0.001] **[χ2 (1) = 5.65, p = 0.017]
Note. CI = confidence interval. BDI-II = Beck Depression Inventory, Second Edition; WHOQOL-BREF = World Health Organization Quality of Life-BREF; WAI-SR = Working Alliance Inventory-Short Revised.