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Published Online: 23 April 2024

Comparative Effectiveness of Clinician- Versus Peer-Supported Problem-Solving Therapy for Rural Older Adults With Depression

Brooke Hollister, Ph.D. [email protected], Rebecca Crabb, Ph.D., and Patricia Areán, Ph.D.Authors Info & Affiliations
Publication: Psychiatric Services
Preprint
https://doi.org/10.1176/appi.ps.20230027
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Abstract

Objective:

Self-guided and peer-supported treatments for depression among rural older adults may address some common barriers to treatment. This pilot study compared the effect on depression of peer-supported, self-guided problem-solving therapy (SG-PST) with case management problem-solving therapy (CM-PST) among older adults in rural California.

Methods:

Older adults with depression (N=105) received an introductory PST session with a clinician, followed by 11 sessions of CM-PST with a clinician (N=85) or SG-PST with a peer counselor (N=20).

Results:

Both interventions resulted in clinically significant improvement in depression by week 12. Depression scores in the CM-PST group dropped by 4.1 points more than in the SG-PST group between baseline and week 12 (95% CI=0.99–7.22, p<0.001, Hedges’s g=1.08).

Conclusions:

The results suggest that peer-supported SG-PST is a viable, acceptable option for rural older adults with depression as a second-line treatment if access to clinicians is limited.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Preprint

History

Received: 23 January 2023
Revision received: 20 January 2024
Accepted: 31 January 2024
Published online: 23 April 2024

Keywords

  1. Peer-supported therapy, Problem-solving therapy, Senior peer counselors, Depression
  2. Rural older adults
  3. Geriatric psychiatry

Authors

Affiliations

Brooke Hollister, Ph.D. [email protected]
Institute for Health and Aging, University of California, San Francisco, San Francisco (Hollister, Crabb); Center for Care Research South, Department of Health and Nursing Sciences, University of Agder, Agder, Norway (Hollister); Accelerating the Reach and Impact of Treatments for Youth and Adults With Mental Illness (ALACRITY) Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Areán).
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Rebecca Crabb, Ph.D.
Institute for Health and Aging, University of California, San Francisco, San Francisco (Hollister, Crabb); Center for Care Research South, Department of Health and Nursing Sciences, University of Agder, Agder, Norway (Hollister); Accelerating the Reach and Impact of Treatments for Youth and Adults With Mental Illness (ALACRITY) Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Areán).
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Patricia Areán, Ph.D.
Institute for Health and Aging, University of California, San Francisco, San Francisco (Hollister, Crabb); Center for Care Research South, Department of Health and Nursing Sciences, University of Agder, Agder, Norway (Hollister); Accelerating the Reach and Impact of Treatments for Youth and Adults With Mental Illness (ALACRITY) Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Areán).
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Notes

Send correspondence to Dr. Hollister ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

This work was supported by National Institute on Aging grant R01 AG043584.

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