Improved outcomes for depressed elder abuse victims with video-delivered psychotherapy during COVID-19

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, Providing Options to Elderly Clients Together, 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.

Keywords:

• elder abuse
• late-life depression
• community intervention
• behavioral therapy
• tele-health

Acknowledgements

The authors wish to thank our collaborators at the New York City Elder Justice Service and the abuse service case workers who support the research and make referrals. The authors are grateful to the study participants for their time and their trust in us. Colleagues and staff who contribute to making it possible both at the Institute of Geriatric Psychiatry and the Department of Population Health Sciences of Weill Cornell Medicine.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research is supported by funding from the New York City Department for the Aging (CT112520228800146), the National Institute of Mental Health (K23 MH123864; PI: Solomonov), as well as ALACRITY (P50 MH113838; PI: Sirey).