Reaching and Engaging Depressed Senior Center Clients

Study Overview
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Brief Summary
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The purpose of this study is to test the feasibility of one type of therapy session, Virtual Augmented Engage (Engage-A). The research is being done because the researchers are trying to learn if these approaches could be used by therapists in the community social service agencies to treat older adults with depression. The research will also measure clinician satisfaction after training and supervision of utilization of Engage-A.

Official Title
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Reaching and Engaging Depressed Senior Center Clients Phase II

Conditions
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Depression in Old Age

Intervention / Treatment
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* Behavioral: Engage-A
* Other: Training and utilizing Engage-A therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 55 years' old PHQ-9 Score of ≥ 10 English or Spanish speaking MOCA ≥ 24 or mini-telephone MOCA ≥ 11 Member of/attends one of the REDS Senior Centers Capacity to provide written consent for both research assessment and the Engage-A intervention. Exclusion Criteria: Current active suicidal ideation defined by MADRS Suicide Item ≥ 4 (probably better off dead. Suicidal thoughts are common, and suicide is considered as a possible solution, but without specific plans or intention). Presence of psychiatric diagnoses other than unipolar, non-psychotic major depression or generalized anxiety disorder by SCID-IV. Severe or life-threatening medical illness (e.g., end stage organ failure). Currently seeing an individual psychotherapist *(if individuals are willing to go on a hiatus from their individual psychotherapist for the 15 weeks of the study, and meet all inclusion criteria, they will be considered eligible).

Ages Eligible for Study
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Minimum Age: 55 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
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Engage-A<br>Participants receive 9 individual in-person or remote therapy sessions. Each session will last approximately 60 minutes. During the sessions, the therapist will encourage the participant to engage in physical and social activities that are pleasurable or rewarding. | Behavioral: Engage-A<br>* Therapist will encourage participants to engage in physical and social activities that are pleasurable or rewarding. Engage is a stepped care psychotherapy based on what is known about how older adults respond to depression interventions. Stepped care is a model of treatment that starts with the minimum effective therapeutic techniques first, and then based on how well people respond to treatment, additional therapeutic techniques are added until people are recovered from their depression.<br>* Other names: Augmented Engage;|
| Experimental: Clinician<br>Clinicians will be trained in Engage-A and supervised while utilizing the therapy. | Other: Training and utilizing Engage-A therapy<br>* Therapist will be trained in Engage-A therapy and given supervision while utilizing this therapy.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Virtual ENGAGE-A Participants Who Attend Every Scheduled Therapy Session | Number of Virtual ENGAGE-A Participants who Attend Every Scheduled Therapy Session | 9 Weeks | 
| Change in Average Satisfaction Score of Virtual ENGAGE-A Participants as Measured by the CSQ | The Client Satisfaction Questionnaire (CSQ) assesses the clients' satisfaction with the services they are receiving. The CSQ ranges from 1-4, with higher scores indicating higher satisfaction. Domain 1 scores range from 1-4, with higher scores indicating higher satisfaction with the program. Domain 2 scores range from 1-4, with higher scores indicating higher satisfaction with the services received. Domain 3 scores range from 1-4, with higher scores indicating higher likelihood of wanting to receive similar services in the future. Higher scores for all three domains indicate a better outcome. | 6 weeks, 9 weeks, 12 weeks | 
| Average Satisfaction Score of Community Clinicians (LCSW) as Measured by the TSQ | The Therapist Satisfaction Questionnaire (TSQ) assesses the therapists' satisfaction with the Alacrity therapy training and intervention. The TSQ ranges from 1-4, with higher scores indicating higher satisfaction. Domain 1 scores range from 1-4, with higher scores indicating higher satisfaction with the skills obtained through training. Domain 2 scores range from 1-4, with higher scores indicating higher satisfaction with the therapy type. Domain 3 scores range from 1-4, with higher scores indicating higher likelihood that the therapist would use this therapy in their own practice. Higher scores for all three domains indicate better outcomes. | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Depressive Symptoms of Virtual ENGAGE-A Participants as Measured by HAM-D | Hamilton Depression Rating Score (HAM-D) assesses the severity of depression in patients. The HAM-D ranges from 0 to 52, with higher scores indicating higher severity of depression. | Baseline, 6 week, 9 week, 12 week | 
| Change in Behavioral Activation of Virtual ENGAGE-A Participants as Measured by the BADS | The Behavioral Activation for Depression Scale (BADS) measures levels of behavioral activation. The BADS ranges from 0 to 150, with higher scores indicating lower levels of behavioral activation. Domain 1 scores range from 0-42. Higher scores (better outcome) indicate greater activation. Domain 2 scores range from 0-48. Higher scores (worse outcome) indicate greater Avoidance and Rumination. Domain 3 scores range from 0-30. Higher scores (worse outcome) indicate greater Work/School impairment. Domain 4 scores range from 0-30. Higher scores (worse outcome) indicate greater social impairment. | Baseline, 6 week, 9 week, 12 week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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depression, geriatric, psychotherapy, group