Telephone Administered Psychotherapy for the Treatment of Depression for Veterans in Rural Areas
Study Details
Study Description
Brief Summary
The purpose of this study is to examine the efficacy of telephone-administered cognitive-behavioral therapy (T-CBT) in treating major depression among veterans served by community-based outpatient clinics (CBOCs) in the Veteran�s Integrated Service Network (VISN) 21, which serves rural areas in Northern California
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Phase 1/Phase 2 |
Detailed Description
More that 20% of patients in primary care have depressive disorders. While primary care is the principal venue for treatment for depression, fewer than 25% of depressed patients receive adequate treatment for their depression. These outcomes can be worse when there are barriers to treatment such as living in a rural area. Several studies have found that given a choice, about two-thirds of depressed primary care patients prefer psychotherapy or counseling over antidepressant medication.
This is a controlled, randomized trial in which subjects meeting criteria for major depressive disorder (MDD) from primary care settings in VISN 21 including CBOCs will be randomly assigned to one of two conditions: 1) a 16-session manualized telephone administered cognitive behavioral therapy (T-CBT) delivered over 24 weeks or 2) a treatment-as-usual (TAU) condition. Telephone-administered cognitive behavioral therapy (T-CBT) is an intervention aimed at improving coping skills and social functioning. It is divided into two phases: 1) an initial treatment phase consisting of 12 weekly sessions aimed at reducing symptoms of depression, and 2) a booster phase in which 4 sessions are provided at increasingly greater intervals to target maintenance of treatment gains. T-CBT, administered by doctoral level psychologists, will be compared to a treatment-as-usual (TAU) condition that controls for the natural course of depression during the course of treatment.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Other: Arm 1
|
Behavioral: GTelephone-administered Cognitive-Behavioral Therapy (T-CBT)
Procedure: Provider education, computer reminders, nurse case management
|
Outcome Measures
Primary Outcome Measures
- Reduction in severity of depression; scores on depression rating scales at baseline, 12 weeks and 24 weeks []
Secondary Outcome Measures
- Maintenance of treatment gains at 6 month follow-up (week 48). []
Eligibility Criteria
Criteria
Inclusion Criteria:
Patients must have chronic heart failure, systolic left ventricular dysfunction (ejection fraction less than or equal to 45%), not be receiving beta-blockers, and not have contraindications to beta-blockers.
Exclusion Criteria:
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | VA Northern California Health Care System, Mather, CA | Sacramento | California | United States | 95655 |
| 2 | San Francisco VA Medical Center, San Francisco, CA | San Francisco | California | United States | 94121 |
Sponsors and Collaborators
- US Department of Veterans Affairs
Investigators
- Principal Investigator: Barry M Massie, MD, San Francisco VA Medical Center, San Francisco, CA
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- CHI 99-063