Behavioral Intervention For Depression Research Articles

A Behavioral Intervention for Depression and Chronic Pain in Primary Care (Relief-Hybrid)

A Behavioral Intervention for Depression and Chronic Pain in Primary Care (Relief-Hybrid)

Treatment fidelity evidence for BE-ACTIV – a behavioral intervention for depression in nursing homes

Objectives: Evidence-based depression therapies are difficult to implement in nursing homes. We present data for BE-ACTIV, a 10-week depression treatment designed for implementation in nursing homes, to address questions of treatment fidelity (delivery, receipt, and enactment) in that context.Method: Participants were 41 patients from 13 nursing homes in the treatment arm of a clinical trial, treated by graduate student therapists. Therapists and their supervisor rated their audio-recorded sessions for adherence to treatment protocol and session quality.Results: Delivery of core program elements averaged from 80–94% across all sessions; mean quality was 5.6 (SD 0.61) out of 6 points. Delivery of core components to nursing home activities staff who collaborated in the treatment was similarly high. Patients received an average of 7.32 sessions (SD 3.39); 17 completed 10 sessions. The theoretical basis of BE-ACTIV is behavioral activation; therapist-client dyads planned new pleasant events weekly, from a mean of 3.66 (SD 1.35) after the first session to a mean of between 5 and 6 activities a week across sessions 6–9, with a similar progression in percent activities completed. Activities enactment was significantly related to the likelihood of remission at post-treatment, and of maintaining improvement at 3-month follow-up. Treatment receipt and enactment were also related to improved mood from baseline to 3 months.Conclusion: Results demonstrate delivery, receipt, and successful enactment of BE-ACTIV core components in diverse nursing homes and patients, and support the theoretical premise of the intervention. These findings support further implementation work for the BE-ACTIV intervention.

BE-ACTIV for Depression in Nursing Homes: Primary Outcomes of a Randomized Clinical Trial

To report the primary outcomes of a cluster randomized clinical trial of Behavioral Activities Intervention (BE-ACTIV), a behavioral intervention for depression in nursing homes. Twenty-three nursing homes randomized to BE-ACTIV or treatment as usual (TAU); 82 depressed long-term care residents recruited from these nursing homes. BE-ACTIV participants received 10 weeks of individual therapy after a 2-week baseline. TAU participants received weekly research visits. Follow-up assessments occurred at 3- and 6-month posttreatment. BE-ACTIV group participants showed better diagnostic recovery at posttreatment in intent-to-treat analyses adjusted for clustering. They were more likely to be remitted than TAU participants at posttreatment and at 3-month posttreatment but not at 6 months. Self-reported depressive symptoms and functioning improved in both groups, but there were no significant treatment by time interactions in these variables. BE-ACTIV was superior to TAU in moving residents to full remission from depression. The treatment was well received by nursing home staff and accepted by residents. A large proportion of participants remained symptomatic at posttreatment, despite taking one or more antidepressants. The results illustrate the potential power of an attentional intervention to improve self-reported mood and functioning, but also the difficulties related to both studying and implementing effective treatments in nursing homes.

The Origins and Current Status of Behavioral Activation Treatments for Depression

The past decade has witnessed a resurgence of interest in behavioral interventions for depression. This contemporary work is grounded in the work of Lewinsohn and colleagues, which laid a foundation for future clinical practice and science. This review thus summarizes the origins of a behavioral model of depression and the behavioral activation (BA) approach to the treatment and prevention of depression. We highlight the formative initial work by Lewinsohn and colleagues, the evolution of this work, and related contemporary research initiatives, such as that led by Jacobson and colleagues. We examine the diverse ways in which BA has been investigated over time and its emerging application to a broad range of populations and problems. We close with reflections on important directions for future inquiry.

Is depression in Alzheimer's caregivers really due to activity restriction? A preliminary mediational test of the Activity Restriction Model

This study is a preliminary examination of the Activity Restriction Model of depressive symptoms. A total of 16 elderly Alzheimer's caregivers and 9 non-caregivers completed measures of activity restriction and depressive symptoms. Mediation was tested using the Sobel test with bootstrapping procedures. Results indicated that caregivers experienced significant elevations in depressive symptoms and activity restriction relative to non-caregivers ( p < 0.05). Activity restriction significantly mediated the relationship between caregiving status and depressive symptoms ( z = 2.29, p = 0.031), accounting for 86% of this relationship. Behavioral interventions for depression might be particularly relevant for Alzheimer's caregivers to reduce activity restriction and, thus, depressive symptoms.

A Cognitive and Behavioral Intervention for Depression in Fifth Grade Children

A Cognitive and Behavioral Intervention for Depression in Fifth Grade Children