Abstract
BackgroundGeneralized Anxiety Disorder (GAD), characterized by excessive and uncontrollable worry, has a negative impact on the health, well-being, and functioning of older adults. Cognitive behavioral therapy has demonstrated efficacy in reducing anxiety and worry in older adults, but the generalizability of these findings to community-dwelling older adults is unknown. The aim of the current study is to examine the efficacy of a cognitive-behavioral intervention delivered by telephone in reducing anxiety and worry in rural community-dwelling older adults with GAD.Methods/DesignWe propose a randomized controlled trial comparing telephone-delivered cognitive behavioral therapy (CBT-T) with nondirective supportive therapy (NST-T). One hundred seventy six adults 60 years and older diagnosed with GAD will be randomized to one of the two treatment conditions. The primary outcomes are self-report worry and clinician-rated anxiety. Secondary outcomes include depressive symptoms, sleep, quality of life, and functional status.DiscussionIt is hypothesized that CBT-T will be superior to NST-T in reducing anxiety and worry among older adults with GAD. Further, CBT-T is hypothesized to be superior to NST-T in reducing problems with depressive symptoms, sleep, functional status and quality of life. If this program is successful, it could be implemented as a low-cost program to treat late-life anxiety, especially in rural areas or in circumstances where older adults may not have access to qualified mental health providers.Trial registrationclinicaltrials.gov Identifier: NCT01259596
Highlights
Generalized Anxiety Disorder (GAD), characterized by excessive and uncontrollable worry, has a negative impact on the health, well-being, and functioning of older adults
It is hypothesized that Cognitive behavioral therapy (CBT)-T will be superior to nondirective supportive therapy (NST-T) in reducing anxiety and worry among older adults with GAD
CBT-T is hypothesized to be superior to NST-T in reducing problems with depressive symptoms, sleep, functional status and quality of life
Summary
In this RCT, we compare telephone-delivered CBT with NST as a treatment for Generalized Anxiety Disorder in rural older adults. NST as a comparison group allows for the demonstration of the superiority of CBT to a structurally equivalent comparison It provides all participants with an opportunity to receive treatment. Implications for practice Telephone-delivered psychotherapy is one method of providing treatment to individuals limited by practical barriers This method may be appropriate for older adults living in rural settings as they are less likely to have access to the internet [45]. Should we demonstrate the efficacy of the CBT-T intervention over NST-T, this low-cost treatment could be implemented widely and could potentially reach large numbers of patients in rural areas, primary care settings, and specialty settings, or in circumstances when older adults have barriers to seeking care.
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