Date of Award

8-2016

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Dr. Galen Alessi

Second Advisor

Dr. Amy Naugle

Third Advisor

Dr. Scott Gaynor

Fourth Advisor

Dr. Karen Blaisure

Keywords

Computer-delivered treatments, behavioral activation, attitudes, depression, older adults, usability

Abstract

Depression is a common psychological disorder among older adults and is associated with serious secondary effects to health and social well-being. Behavioral activation has been found to be an efficacious treatment for depression. However, there is limited research on the treatment effects of behavioral activation with older adults. In general, older adults under-utilize mental health treatments. Computer-delivered treatments have been developed to address access and under-utilization. The purpose of this dissertation was to evaluate the acceptability and effects of a computer-delivered values-based behavioral activation treatment for depression in older adults. This study consisted of two phases. Phase I consisted of a 10-session computer-delivered values-based behavioral activation treatment for two older adults. Repeated measures of depression and activation were assessed, and quality of life was assessed at pre and post treatment. Phase II was exploratory and included 21 older adults from a general population. This phase probed participant reviewers ‘awareness of depression, their process for seeking mental health services, their attitudes and perceptions of a computer-delivered values-based behavioral activation treatment program, and their experienced usability of this computer-delivered treatment.

Participant 003 experienced clinically significant reductions in symptoms of depression from baseline to follow-up. She reported increases in her activation levels and quality of life. Participant 002 did not complete treatment, and did not have a treatment response. However, she reported improvements in her symptoms of depression and activation from baseline to her final treatment session.

Phase II reviewers reported an overall positive experience with the computer-delivered program, a high degree of usability, and increased ratings of credibility and expectations for improvement from pre to post review of the program. Further research is warranted to test the effects of this program with older adults using more rigorous research design. There is a need for improving dissemination and awareness of computer-delivered mental health treatments. More research should explore the comparative effects of integrative and stepped care models. Behavioral activation manuals and computer-delivered programs need to better adapt treatments to meet the needs and the preferences of older adults.

Access Setting

Dissertation-Open Access

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