Cognitive Behavioral Therapy Group for Older Adults Delivered by Telethealth

Study Overview
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Brief Summary
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The present aim of the study is to to adapt an established, manualized enhanced Group CBT (CBT-E) for seniors to a telehealth format, which will allow us to offer the group virtually during the COVID-19 pandemic.

Detailed Description
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The goal of this project is to adapt an established, manualized enhanced Group CBT (CBT-E) for seniors to a telemedicine format. Currently the Geriatric Psychiatry service associated with the Nova Scotia Health Authority offer two CBT-E groups every year. They are usually facilitated by psychiatry residents, under the supervision of a staff psychiatrist. Due to the risk of COVID-19, we will not be holding in-person groups this year. Instead we will offer the group in a smaller, telemedicine format. For this project, we will change the group structure and activities to allow it's delivery in a virtual format. This study will assess feasibility, tolerability of the telehealth format by using the System Usability Scale and Group Satisfaction Survey. It will also assess response to online therapy buy using pre- and post-group questionnaires including the Beck Depression Inventory, Beck Anxiety Inventory and Perceived Quality of Life Questionnaire. Paired t-tests will be used to analyse the data and determine whether there has been an improvement in participant's symptoms and quality of life.

Official Title
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Feasibility of Delivering Group Cognitive Behavioral Therapy for Older Adults With Depression and Anxiety by Telehealth

Conditions
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Major Depressive Disorder, Generalized Anxiety Disorder, Social Anxiety Disorder, Panic Disorder

Intervention / Treatment
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* Behavioral: Group Cognitive Behavioral Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: People over the age of 65 Diagnosis of either or both Major Depressive Disorder (MDD) of mild or moderate severity and an anxiety disorder, including generalized anxiety disorder, social anxiety disorder or panic disorder. Exclusion Criteria: Patients with psychosis Patients with dementia Patient with severe Major Depressive Disorder or Anxiety Disorder Patients with antisocial or borderline personality disorder Patients with acute suicidal ideation. Older adults who do not have access to the technology required for group; computer, phone or tablet with a webcam and access to Internet These are also exclusion criteria for the CBT group outside of the study. People younger than 65 are also excluded from the group because it is offered to older adults only.

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: Feasibility and acceptability study
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Teletherapy Group CBT participants<br>Patients over the age of 65 with either a Major Depressive Disorder or Generalized Anxiety Disorder who will be participating in a Group CBT delivered by Teletherapy | Behavioral: Group Cognitive Behavioral Therapy<br>* Therapy will be delivered weekly for 8 weeks by Zoom.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility of Telehealth CBT group for older adults | This will be assessed by a questionnaire: System Usability Scale. | This will be completed at the end of the 8 week Telehealth CBT group. | 
| Acceptability of Telehealth CBT group for older adults | This will be measured by a questionnaire administered to participants titled Satisfaction Survey. | This will be completed at the end of the 8 week Telehealth CBT group. | 
| Attrition to the Telehealth CBT group for older adults | Attendance will be noted by group facilitators at each group session | 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effect size between pre-group and post-group questionnaires (anxiety) | The following scale will be administered before and after completing the group to determine if there is any change in the result: Beck Anxiety Inventory. | Scales will be administered at baseline and at the end of the 8 weeks of group therapy. | 
| Effect size between pre-group and post-group questionnaires (depression) | The following scale will be administered before and after completing the group to determine if there is any change in the result: Beck Depression Inventory. | Scales will be administered at baseline and at the end of the 8 weeks of group therapy. | 
| Effect size between pre-group and post-group questionnaires (perceived quality of life) | The following scale will be administered before and after completing the group to determine if there is any change in the result: Perceived Quality of Life questionnaire. | Scales will be administered at baseline and at the end of the 8 weeks of group therapy. |