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PROTECT: a novel psychotherapy for late-life depression in elder abuse victims

Published online by Cambridge University Press:  30 April 2021

Jo Anne Sirey ,
Nili Solomonov ,
Arielle Guillod ,
Paula Zanotti ,
Jihui Lee ,
Mohamed Soliman  and
George S. Alexopoulos
Jo Anne Sirey*
Affiliation:
Department of Psychiatry, Weill Cornell Medicine, White Plains, NY10605, USA
Nili Solomonov
Affiliation:
Department of Psychiatry, Weill Cornell Medicine, White Plains, NY10605, USA
Arielle Guillod
Affiliation:
Department of Psychiatry, Weill Cornell Medicine, White Plains, NY10605, USA
Paula Zanotti
Affiliation:
Department of Psychiatry, Weill Cornell Medicine, White Plains, NY10605, USA
Jihui Lee
Affiliation:
Department of Population Health Sciences, Weill Cornell Medicine, White Plains, New York, NY10605, USA
Mohamed Soliman
Affiliation:
Department of Psychiatry, Weill Cornell Medicine, White Plains, NY10605, USA
George S. Alexopoulos
Affiliation:
Department of Psychiatry, Weill Cornell Medicine, White Plains, NY10605, USA
*
Correspondence should be addressed to: Jo Anne Sirey, Department of Psychiatry, Weill Cornell Medicine, 21 Bloomingdale Road, Box 94, White Plains, NY10605, USA. Phone +914 997 4333. Email: jsirey@med.cornell.edu.
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Abstract

Elder abuse is prevalent, and victims have high rates of depression and low quality of life. We established an academic–community partnership to test the feasibility, acceptability, and impact of a brief psychotherapy for depression (PROTECT) among elder abuse victims with capacity to make decisions. Elder abuse service providers referred depressed (Patient Health Questionnaire-9 [PHQ-9] ≥ 10) older victims (age ≥ 55 years) for potential pilot study participation. Forty eligible victims who consented were randomized to PROTECT psychotherapy (N = 25) or a Usual Care (N = 15) condition involving a community psychotherapy referral. Follow-up research assessments were conducted at 6 weeks (mid-treatment) and 9 weeks (end of treatment) after study initial assessment. We used mixed-effects regression models to examine treatment effects on depression severity and quality of life over time. Most victims (75%) reported two or more types of abuse. The a priori acceptability benchmark was met at the end of PROTECT therapy. All PROTECT participants initiated therapy; this engagement rate is greater than the a priori 75% standard set for feasibility. We found a significant reduction in depression severity (Montgomery–Åsberg Depression Rating Scale [MADRS]), with PROTECT leading to greater benefits compared to Usual Care. Both study groups had a similar improvement in quality of life. The pilot project results found that PROTECT psychotherapy is feasible, acceptable, and effective in reducing depression. With the support of our partnership, we found that PROTECT could be delivered alongside elder abuse services with victims willing to initiate therapy that leads to meaningful treatment effects.

Keywords

late-life depressionpsychotherapy outcomeelder abusecommunity interventionagingbehavioral therapy
Type
Brief Report
Information
International Psychogeriatrics , Volume 33 , Special Issue 5: Issue Theme: Loneliness and Social Connectedness , May 2021 , pp. 521 - 525
Copyright
© International Psychogeriatric Association 2021

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References

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