Lay‐delivered behavioral activation for depressed senior center clients: Pilot RCT

Abstract

Objective We describe the development of a lay‐delivered behavioral intervention (“Do More, Feel Better”) for depressed senior center clients, and we present preliminary data from a pilot randomized controlled trial (RCT) on (a) the feasibility of training lay volunteers to fidelity and (b) the acceptability, impact, and safety of the intervention. Methods We trained 11 volunteers at two aging service settings in “Do More, Feel Better” and randomized 18 depressed clients to receive the intervention or referral to mental health services. Results Pilot data indicated that we can successfully train and certify 64% of older volunteers and that depressed clients receiving the intervention reported high levels of session attendance and satisfaction. While there were no significant differences in 12‐week reduction in Hamilton Depression Rating Scale scores between groups, intervention clients showed an 8‐point reduction in comparison with a 0‐point reduction among referral clients. Conclusions “Do More, Feel Better” has the potential of transferring evidence‐based behavioral interventions to the hands of supervised lay volunteers and can address the insufficient workforce providing geriatric mental health services.

Protocol for a collaborative randomised effectiveness trial of lay-delivered versus clinician-delivered behavioural activation in senior centres

“…We have demonstrated the feasibility of older lay volunteers delivering DMFB to fidelity and ability to conduct two pilot randomised controlled trials documenting client improvements in activity level and depressive symptoms. 22 23 This pilot research demonstrates the promise of transferring such an evidence-based intervention to the hands of lay providers, calling for a definitive effectiveness trial as described here.…”

“…‘Do More, Feel Better’: We streamlined BA into the highly structured DMFB intervention that lay providers can learn and administer. 22 A written manual includes scripts, agendas and supporting materials that retain key elements of BA. DMFB involves 9 weekly 30–45 min in-person or remote sessions.…”

Modernizing Training in Psychotherapy Competencies With Adaptive Learning Systems: Proof of Concept

“…and consisted of nine weekly in-person class meetings, each 2 hr in length. The course focused on basic clinical interviewing skills and a brief behavioral intervention called patient activation (Raue, Sirey, et al, 2019; Raue et al, 2019), consisting of strategies drawn from formal behavioral activation. Students typically spent the first hour in didactic classroom instruction and discussion and the second hour using the ITS and role-playing simulated clients played by either fellow students or instructors.…”

Mind, Mood, Mobility: Supporting Independence Among Rural Older Adults at Risk for Functional Decline

“…Interventions for older adults including TJQMBB and BA have been effectively delivered by non-clinically trained interventionists. 11,14 Given the national infrastructure of AAAs, training the existing AAA workforce to deliver this multicomponent intervention to older adults identified and referred through primary care may be a feasible implementation strategy despite geriatric health care workforce shortages.…”