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Evidence-based Practices in Mental Health and Aging. June 22, 2010 Cheryl Evans-Pryor, M.A.-G Aging Resources of Central Iowa 5835 Grand Avenue, Suite 106 Des Moines, IA. 50312-1437 (515) 255-6714, ext.322 [email protected] www.agingresources.com.

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evidence based practices in mental health and aging
Evidence-based Practices in Mental Health and Aging

June 22, 2010

Cheryl Evans-Pryor, M.A.-G

Aging Resources of Central Iowa

5835 Grand Avenue, Suite 106

Des Moines, IA. 50312-1437

(515) 255-6714, ext.322

[email protected]

www.agingresources.com

evidence based practices in depression care management
Evidence-based Practices in Depression Care Management
  • Goal: Present condensed overview of two models of depression care treatment.
  • Objectives:

1. Present model components.

2. Present behavioral activation & problem-solving approaches.

3. Discuss model outcomes/ success.

slide3

Evidence-based practices:

Offer brief treatment- time sensitive

Structured approach

Researched, proven to work

Flexible implementation – 1:1 or groups

Redefines issues/ current focus

Meets people where they are in life

Small, manageable steps

Cost-effective

evidence based practice model overview pearls healthy ideas
Evidence-based practice model overview (PEARLS & HEALTHY IDEAS)

Both models are grounded in Behavioral Activation & Change.

PEARLS - Program to Encourage Active, Rewarding Lives for Seniors.

Addresses Minor Depression & Dysthymia. Is not designed to address situational depression or grief issues.

Built on Medical/Psychiatric foundation with team approach to chronic care.

pearls core components
PEARLS - Core Components:

1. Problem-solving Treatment

2. Social & Physical Activation

3. Pleasant Events Scheduling

pearls
PEARLS

Patient-centered and patient directed, can participate in 1 or all 3 components.

Serves persons 60+ with physical impairments and social isolation.

Purpose= There isa direct connectionbetween unresolved problems & depression.

problem solving therapy
Problem Solving Therapy

Theory= Depression has many causes, and failed attempts to solve problems leads to learned helplessness.

Goal= Increase confidence and feelings of self-control.

Increase understanding of causal link btw. symptoms and current problems.

Increase pleasant, social, and physical activities.

problem solving therapy cont
Problem Solving Therapy – cont.

Adopt attitude of goals being attainable=increased success.

Decreases prolonged episodes/relapses.

Shift in thinking pattern that facilitates change (contemplation to action).

Fosters a sense of HOPE.

problem solving therapy1
Problem Solving Therapy

7 Steps of PST:

  • Identifying problem-what does it look like/ how does it impact your life?
  • Set realistic goals - attainable
  • Generate possible solutions
  • Consider Pro’s /Con’s of each solution
  • Select a solution of choice
  • Develop an action plan/steps to achieve solutions
  • Review & evaluate progress.
healthy ideas identifying depression empowering activities for seniors
HealthyIdeas=Identifying Depression, Empowering Activities for Seniors
  • Reduce symptoms of depression in older adults with chronic health conditions and functional limitations through existing community-based case management or counseling services.

Goal= to insure a systematic identification of depression through routine screenings (PHQ-2 & PHQ-9) from counselor or case managers.

healthy ideas cont
HealthyIdeas- cont.

Utilizes case management staff that already have an existing relationship with the client.

Screening and assessments occur at regular intervals/visits by case manager. Utilizes Behavioral Activation method.

Behavioral Activation= Re-establishes routines, reinforces experiences, overcome avoidance patterns (Jacobson et al., U. Wash).

behavioral model of depression
Behavioral Model of Depression

Depression results in behaviors that limit positive outcomes

→reduced pleasure, reduced accomplishment

Lowered Mood

Decreased Pleasant Activities

Decreased Activity

Healthy

Ideas

behavioral activation
Behavioral Activation
  • Improve mood by:
      • Increasing frequency of behaviors that lead to positive outcomes
      • Doing activities that “feel good” or are pleasurable or reduce stress (may involve a task, something social or an activity)

Rewarding

Activities

Decreased Depressive Symptoms

Improved Mood

Healthy

Ideas

.

slide15
HEALTHY IDEAS- Core Components:
  • Screening and assessment
  • Helps clients examine own mood and relationship to behavior by self monitoring symptoms.
  • Encourages clients to examine current and/or meaningful activities.
  • Educates clients to recognize symptoms and how to ask for help or talk to providers.
  • Referral, link to treatment as needed, follow-up
  • Empower through Behavioral Activation.
  • Accountability to engage in change by assessing likelihood of follow-through. (Readiness Ruler)
  • Assess client progress
outcomes
Outcomes
  • Track and review data for each client.
  • Provide telephone follow-up btw. visits.
  • Brief intervention period= 6-9 months.
  • Examine both qualitative and quantitative outcomes.
resources
Resources

PEARLS : http://depts.washington.edu/pearlspr/

University of Washington Health Promotion Research Center, Seattle, WA.

HEALTHY IDEAS : www.careforelders.org/healthyideas

Huffington Center on Aging, Baylor College of Medicine, Houston, TX.

www.cdc.gov/aging and www.chronicdisease.org

SAMHSA National Registry of Evidence-Based Programs & Practices

http://mentalhealth.samhsa.gov

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