Session: Development of Mental Health Interventions for Disabled Older Adults



Bridging Disciplinary Boundaries (January 11 - 14, 2007)


Saturday, January 13, 2007: 8:00 AM-9:45 AM
Seacliff B (Hyatt Regency San Francisco)
Development of Mental Health Interventions for Disabled Older Adults

Organizer:	Zvi D. Gellis, PhD, State University of New York at Albany
		Problem Solving Therapy for Generalized Anxiety in Rehabilitation Settings Zvi D. Gellis, PhD, Amy Horowitz, DSW, Thalia MacMillan, MSW, Joann P. Reinhardt, PhD
		Predicting the Persistence Versus Remission of Subthreshold Depression Amy Horowitz, DSW, Joann P. Reinhardt, PhD
		Racial/Ethnic Differences in Attitudes toward Depression Treatments among Low-Income Older Adults Namkee G. Choi
		A Stakeholder Preferences Assessment to Inform Treatment Development for Community Long-Term Care Elderly Clients Leslie Hasche, MSW, Enola Proctor, PhD, Martha Shumway, PhD, Deanna Davidson, Nancy Morrow-Howell, PhD
Abstract Text: Current estimates of the incidence of mental illness among older persons range from 15 to 25 percent. The provision of mental health care to older adults poses a unique set of challenges to social work practitioners. The large anticipated growth of older adults and their psychosocial needs underscores the importance of evidence-based practice (EBP) infusion in service delivery. In this symposium, we view the current trend toward evidence-based practice in social work as the latest development in the profession's age old struggle to place its practice on a scientific footing. We report on four studies with a focus on community-based mental health intervention development for older adults. One paper provides the results of a pilot randomized controlled trial of problem solving therapy (PST) for anxiety disorders in disabled older adults. Another reports on follow-up data from a longitudinal study of disabled older adults with subthreshold depression. The final two papers examine attitudes and preferences among community-based older adults towards psychosocial treatments for depression. We specifically focus on applications to clinical social work practice and the development of methods of intervention. With this in mind, the first paper presents controlled trial data from a pilot research program to test the outcomes of Brief PST in a rehabilitation setting that targets the needs of disabled older adults (n=16) with anxiety symptomatology. Few studies have examined PST as a developing evidence-based intervention for anxiety in late life and none in rehabilitation settings. The second paper reports on six-month follow-up data from a longitudinal study of depressed older adults (n=584) with vision-impairment. Little is known about the extent to which subthreshold depression persists over time and the factors that predict its natural course for disabled elders. The third paper examines racial/ethnic differences in older adults' attitudes toward psychological and pharmacological treatments for depression among 206 participants. The final paper reports on stakeholder preferences to inform implementation of evidence-based depression treatments into community long-term care service agencies. These studies support the principles and implications of the NIH consensus statement on geriatric mental health, which emphasized the prevalence of mental health disorders in disabled elderly populations. Much progress has been made in understanding the diagnosis, etiology, and treatment of geriatric mental health disorders. Yet, few studies have examined late life depression or anxiety in community-based public-sector and rehabilitation settings. The symposium will conclude with a discussion of the implications of this body of knowledge for the development and adoption of evidence-based practice (EBP) interventions for depressed and anxious older adults. The potential benefits of EBP interventions for social work are significant. By selecting interventions that are demonstrably effective, the likelihood of improving social work outcomes over the long term will be greatly increased.

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