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Development of a video-delivered relaxation treatment of late-life anxiety for veterans

Published online by Cambridge University Press:  08 June 2017

Christine E. Gould ,
Aimee Marie L. Zapata ,
Janine Bruce ,
Sylvia Bereknyei Merrell ,
Julie Loebach Wetherell ,
Ruth O'Hara ,
Eric Kuhn ,
Mary K. Goldstein  and
Sherry A. Beaudreau
Christine E. Gould*
Affiliation:
Palo Alto Geriatric Research, Education, and Clinical Center (GRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
Aimee Marie L. Zapata
Affiliation:
Palo Alto Geriatric Research, Education, and Clinical Center (GRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA
Janine Bruce
Affiliation:
Department of Pediatrics, Division of General Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
Sylvia Bereknyei Merrell
Affiliation:
Department of Medicine, Division of General Medical Disciplines, Stanford University School of Medicine, Stanford, CA, USA
Julie Loebach Wetherell
Affiliation:
Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA Department of Psychiatry, University of California, San Diego, CA, USA
Ruth O'Hara
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
Eric Kuhn
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA National Center for PSTD, VA Palo Alto Health Care System, Palo Alto, CA, USA
Mary K. Goldstein
Affiliation:
Palo Alto Geriatric Research, Education, and Clinical Center (GRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA Center for Primary Care and Outcomes Research (PCOR), Stanford University, Stanford, CA, USA
Sherry A. Beaudreau
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
*
Correspondence should be addressed to: Christine E. Gould, PhD, Veterans Affairs Palo Alto Health Care System, GRECC (182B), 3801 Miranda Ave., Palo Alto, CA, 94304, USA. Email: cegould@stanford.edu.
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Abstract

Background:

Behavioral treatments reduce anxiety, yet many older adults may not have access to these efficacious treatments. To address this need, we developed and evaluated the feasibility and acceptability of a video-delivered anxiety treatment for older Veterans. This treatment program, BREATHE (Breathing, Relaxation, and Education for Anxiety Treatment in the Home Environment), combines psychoeducation, diaphragmatic breathing, and progressive muscle relaxation training with engagement in activities.

Methods:

A mixed methods concurrent study design was used to examine the clarity of the treatment videos. We conducted semi-structured interviews with 20 Veterans (M age = 69.5, SD = 7.3 years; 55% White, Non-Hispanic) and collected ratings of video clarity.

Results:

Quantitative ratings revealed that 100% of participants generally or definitely could follow breathing and relaxation video instructions. Qualitative findings, however, demonstrated more variability in the extent to which each video segment was clear. Participants identified both immediate benefits and motivation challenges associated with a video-delivered treatment. Participants suggested that some patients may need encouragement, whereas others need face-to-face therapy.

Conclusions:

Quantitative ratings of video clarity and qualitative findings highlight the feasibility of a video-delivered treatment for older Veterans with anxiety. Our findings demonstrate the importance of ensuring patients can follow instructions provided in self-directed treatments and the role that an iterative testing process has in addressing these issues. Next steps include testing the treatment videos with older Veterans with anxiety disorders.

Keywords

anxietybehavioral therapypsychogeriatricsqualitative
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 10 , October 2017 , pp. 1633 - 1645
Copyright
Copyright © International Psychogeriatric Association 2017 

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Footnotes

Previous Presentation: These data were presented at the 2016 Gerontological Society of America Meeting in New Orleans, LA.

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